Abdominal Examination Flashcards

1
Q

What is macroglossia? Suggest some possible causes.

A

An unusually enlarged tongue. It can be caused by:

  • Amyloidoses
  • Acromegaly
  • Vascular malformations
  • Muscular hypertrophy
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2
Q

A deficiency of which substance can result in glossitis?

A

Vitamin B12

Other acceptable answers were Vitamins B1-B3 and iron

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3
Q

Why does leukonychia occur? Suggest some conditions which can cause this.

A

Low albumin:

  • Nephrotic syndrome
  • Hepatic failure
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4
Q

Suggest some gastrointestinal causes of clubbing.

A
  • Cirrhosis
  • Malabsorption
  • Inflammatory Bowel Disease
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5
Q

Why is the left supraclavicular node of particular interest in a gastrointestinal examination?

A

Virchow’s - gastric malignancy commonly metastasises here.

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6
Q

Suggest some conditions which can cause koilonychia (spooning) of the nails.

A
  • Hypochromic anaemia (especially iron deficiency)

- Plummer-Vinson syndrome (dysphagia & oesophageal webs)

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7
Q

What is melena? Suggest five possible causes of melena.

A
  • Peptic Ulcer Disease (really common as they are always bleeding)
  • Malignancy (upper GI - will also be getting some haematemesis)
  • Gastritis
  • Oesophageal varices
  • Warfarin & other anticoagulants (in excess)
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8
Q

Suggest some possible reasons for hepatic flap.

A
  • Hepatic failure (build up of ammonia) - hepatic encephalopathy
  • Other encepathlopathies
  • Wilson’s disease
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9
Q

What are spider naevi? What can they indicate and what level of spider naevi qualifies for further investigation?

A

Small swollen blood vessels (telangiectasis) found in the region of the SVC, caused by excess oestrogen. They can be a sign of:

  • Liver failure/cirrhosis (cannot metabolise ammonia - failure of urea cycle)
  • OCP or HRT

Having more than 3 (in clinical practice more than 5) warrants follow up.

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10
Q

Given the way spider naevi form, what other sign in the same area should you look for?

A

Gynecomastia - spider naevi are caused by an imbalance in the level of oestrogen, as is gynecomastia.

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11
Q

Suggest some possible gastrointestinal causes of palmar erythema?

A
  • Portal hypertension

- Chronic liver disease (cirrhosis, hepatitis)

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12
Q

Suggest four different conditions that could lead to malabsorption.

A
  • Alcohol
  • Crohn’s disease
  • Ulcerative colitis
  • Infective - Whipple’s disease, C. diff
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13
Q

What is dupuytren’s contracture? What type of GI problem could be indicated?

A

A fixed flexion of the fingers possibly due to liver cirrhosis.

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14
Q

What might visible peristalsis be a sign of?

A

Intestinal obstruction

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15
Q

Describe the different types of liver edge and

A
  • Craggy/nodular - malignancy (metastases or hepatocellular) or cirrhosis
  • Smooth - hepatitis, right-heart failure or fatty liver disease
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16
Q

When might a NORMAL liver be palpable?

A
  • COPD
  • Right-sided pleural effusion
  • Thin body
17
Q

What is guarding?

A

A voluntary reaction of the abdominal musculature to tenderness, fear/anxiety or examiner’s cold hands.

18
Q

What is tenderness?

A

Discomfort elicited by palpation.