Gastrointestinal Mini-CEX Flashcards
(30 cards)
What is the first step in the examination process?
Perform hand hygiene, introduce yourself, explain purpose, and obtain consent. Position the patient supine and expose the abdomen appropriately.
What should be reported after the introduction step?
No findings to report. Focus is on communication and patient preparation.
What actions are taken during the general inspection?
Observe the patient’s overall appearance and check the bedside chart for vital signs. Look for posture, comfort/distress, mental state, body habitus, color, wasting, distension, and hydration.
What should be reported after the general inspection?
The patient appears comfortable, alert, with normal habitus and colour. No signs of wasting or distension. Hydration appears adequate. I would check the bedside chart for vital signs.
What actions are taken for the hands and upper limbs examination?
Ask to see hands (palmar & dorsal), look for palmar erythema, pallor, clubbing, Dupuytren’s, nail changes, perform Schamroth test for clubbing, and check for flapping tremor.
What should be reported after examining the hands and upper limbs?
No palmar erythema, pallor, or Dupuytren’s contracture. No koilonychia, leukonychia, or Muehrcke’s lines. No clubbing. No flapping tremor.
What actions are taken during the vital signs and arms examination?
Comment only: I would take radial pulse, BP, and respiratory rate. Inspect arms for spider naevi, bruising, wasting, and scratch marks.
What should be reported after the vital signs and arms examination?
No spider naevi, bruising, wasting, or excoriations.
What actions are taken during the face examination?
Inspect eyes, ask patient to pull down eyelids, look for jaundice, pallor, KF rings, xanthelasma, palpate parotids, and inspect oral cavity.
What should be reported after the face examination?
No jaundice, conjunctival pallor, KF rings, or xanthelasma. Parotids are not enlarged or tender. Oral cavity normal: no lesions, candidiasis, leukoplakia, or cheilitis.
What actions are taken during the neck lymph nodes examination?
Comment only: I would palpate cervical and axillary lymph nodes.
What should be reported after the neck lymph nodes examination?
No findings reported (as palpation not performed).
What actions are taken during the chest and abdomen inspection?
Expose chest/abdomen with consent, inspect chest for spider naevi, gynecomastia, bruises, and inspect abdomen for posture, movement, distension, scars, veins, striae, pigmentation, masses, pulsations.
What should be reported after the chest and abdomen inspection?
No spider naevi, gynecomastia, or bruises. Abdomen: posture and respiration normal; no distension. No visible masses, peristalsis, or pulsations. Surface normal: no scars, striae, bruising, or pigmentation.
What actions are taken during the abdomen palpation?
Ask about tenderness first, perform superficial and deep palpation (all 9 regions), check for guarding, rigidity, rebound tenderness, and assess McBurney’s point and Rovsing’s sign.
What should be reported after the abdomen palpation?
Abdomen is soft and non-tender. No masses, guarding, rigidity, or rebound tenderness. No focal tenderness at McBurney’s point. Rovsing’s sign negative.
What actions are taken during the liver examination?
Palpate liver from RIF upwards, percuss for liver span, and test Murphy’s sign.
What should be reported after the liver examination?
Liver and gallbladder not palpable. Murphy’s sign negative. Liver span is __ cm and within normal limits.
What actions are taken during the spleen examination?
Palpate from RIF to LUQ, repeat in right lateral decubitus, and percuss Traube’s space for dullness.
What should be reported after the spleen examination?
Spleen is not palpable.
What actions are taken during the kidneys and bladder examination?
Palpate kidneys using ballottement. Comment only: I would palpate and percuss for the bladder in suprapubic region.
What should be reported after the kidneys and bladder examination?
Kidneys not palpable. No findings reported for bladder.
What actions are taken during the abdominal aorta examination?
Use fingertips of both hands to palpate and estimate aortic width by noting pulsation margins.
What should be reported after the abdominal aorta examination?
Abdominal aortic width is within normal limits.
