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OSCEs > GI > Flashcards

GI Flashcards

(49 cards)

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1
Q

Position of patient

A

General exam: sat upright

Close exam: supine

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2
Q

General Inspection

A 
Bedside treatment
Patients appearance
Body habitus (obese etc.)
Scars
Jaundice
Anaemia
Abdo distention
Masses
Dressings
Needle track marks
Excoriations
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3
Q

Jaundice indicates..

A

cirrhosis/hepatitis

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4
Q

Anaemia indicates..

A

pallor > GI bleeding

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5
Q

Abdo distention indicates..

A

ascites/bowel obstruction/large masses

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6
Q

Masses indicate..

A

malignancy / organomegaly

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7
Q

Excoriations indicate..

A

pruritus, which is a sign of cholestasis

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8
Q

Signs on hands

A 
clubbing
koilonychia
leukonychia
palmar erythema
Dupuytren's contracture
Hepatic flap
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9
Q

Clubbing indicates..

A

IBD, cirrhosis, coeliac disease

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10
Q

Koilonychia indicates..

A

spooning of nails > chronic iron deficiency

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11
Q

leukonychia indicates..

A

whitened nail bed > hypoalbuminemia (liver failure)

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12
Q

palmar erythema indicates..

A

reddening of palms > liver disease, pregnancy

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13
Q

Dupuytren’s contracture indicates..

A

thickening of palmar fascia > alcohol excess, or family history

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14
Q

Hepatic flap

A

hold hands dorsiflexed for 15 seconds
+ve test= hands will flap irregularly
Causes= hepatic encephalopathy, uraemia, CO2 retention

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15
Q

Signs on arms and what they represent

A

Bruising: abnormal coagulation, secondary to liver failure
Petechiae: low platelets e.g. splenomegaly
Excoriations: cholestasis
Track marks: IV drug use > hepatitis/HIV

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16
Q

Signs in axillae and what they represent

A

Lymphadenopathy: malignancy/infection
Hair loss: malnourishment / iron deficiency anaemia
Acanthosis nigricans: GI adenocarcinoma / obesity

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17
Q

Signs in eyes

A

Jaundice
Conjunctival pallor
Xanthelasma

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18
Q

What does jaundice suggest?

A

haemolysis, hepatitis, cirrhosis, biliary obstruction

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19
Q

Conjunctival pallor

A

anaemia

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20
Q

xanthelasma

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A

raised yellow deposits surrounding eyes > hyperlipidaemia

21
Q

Signs around the mouth

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A

angular stomatitis
oral candidiasis
mouth ulcers
glossitis

22
Q

Angular stomatitis

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A

inflamed red areas at the corners of the mouth: iron / B12 deficiency

23
Q

oral candidiasis

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A

white slough on oral mucous membranes: iron deficiency/immunodeficiency

24
Q

mouth ulcers

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A

crohn’s or coeliac

25
glossitis
smooth swelling of tongue with associated erythema: iron/B12/folate deficiency
26
Virchows nodes
left supraclavicular fossa suggest gastric malignancy
27
Chest signs
Spider naevi Gynaecomastia Hair loss
28
Spider naevi
central red spot with reddish extensions (>5 suggest chronic liver disease)
29
Causes of gynaecomastia
liver cirrhosis, digoxin, spironolactone
30
Pulsation on abdo inspection suggests
AAA
31
Cullen's sign
bruising around umbilicus > retroperitoneal bleed e.g. pancreatitis or ruptured AAA
32
Grey-Turners sign
bruising in flanks > retroperitoneal bleed e.g. pancreatitis or ruptured AAA
33
Abdominal distention
5 F's: | Fat, fluid, faeces, fetus, flatus
34
Striae indicate
abdominal distention
35
caput medusae
engorged paraumbilical veins > portal hypertension
36
Setting up for palpation
Ask if the patient is in pain Kneel so you are level with the patient Observe patients face when palpating
37
Rebound tenderness
pain is worse when releasing pressure - peritonitis
38
Guarding
involuntary tension in the abdo muscles
39
Assessing masses
Location Size Shape Consistency- smooth, soft, hard, irregular Mobility- attached to superficial/underlying tissues Pulsatility
40
+ve Murphy's sign =
cholecystitis
41
Spleen is palpable when..
it is at least 3 times the normal size
42
Steps for palpation
``` Light palpation Deep palpation Liver Spleen Ballot the kidneys ```
43
Palpation of the organs the patient must...
take deep breathes in and out, and you palpate when they breathe in
44
Steps for percussion
Liver, spleen, shifting dullness
45
Key for shifting dullness
If fluid is present, the area that was previously dull (when supine) will now be resonant (when lying on side)
46
Auscultation
Bowel sounds
47
Tinkling bowel sounds
bowel obstruction
48
Absent bowel sounds
ileus/peritonitis
49
Suggest further assessments
Check for hernias PR exam External genitalia - if appropriate

OSCEs (26 decks)

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