GI Examination Flashcards
What are you looking for with general inspection for GI?
Expose from nipple to knee Wasting, distension, scars Body habitus Jaundice Spider naevi, gynaecomastia, bruising, tattoos and peripheral oedema Dressings Needle track marks
What do you look for in the hands for GI?
Clubbing (IBD, cirrhosis, coeliac)
Palmer erythema (liver disease, pregnancy), Dupuytren’s contractures (alcohol)
Leukonychia (hypoalbuminaemia, liver failure)
Koilonychia (chronic iron deficiency)
Hepatic flap!
What do you look for in the face and neck for GI exam?
Jaundice in eyes, conjunctival pallor Kayser-Fleischer rings (Wilson's) Gingivitis (gums) Ulcers Hydration Peri-oral pigmentation Hepatic fetor (liver breath) Lymph nodes Virchow's node
Causes of splenomegaly
Chronic myeloid leukaemia, CLL Myelofibrosis Lymphoma Malaria EBV Portal hypertension RA
Causes of hepatomegaly
1º hepatocellular carcinoma Metastatic liver disease Cirrhosis NASH Hepatitis Leukaemia Lymphoma
Inspection of abdomen
Scars Caput medusae Spider naevi Ascites Striae
What can cause hepatic flap?
CO2 retention
Uraemia
Hepatic encephaolpathy
What is Cullen’s sign?
Bruising surrounding umbilicus – retroperitoneal bleed (pancreatitis/ruptured AAA)
What is the Grey-Turner sign?
Bruising in the flanks – retroperitoneal bleed (pancreatitis/ruptured AAA)
What can cause abdominal distension?
5 F's Fluid (ascites) Fat (obesity) Faeces (constipation) Flatus Fetus (pregnancy)
What is caput medusae?
Engorged paraumbilical veins
Portal hypertension
What is Murphy’s sign?
Place your hand in the area noted above (right costal margin, mid-clavicular line)
Ask the patient to take a deep breath
As the gallbladder is pushed down into your hand the patient may suddenly develop pain and stop inspiring.
If this occurs and there is no discomfort in the same location on the left side of the abdomen then this is known as a positive Murphy’s sign, which is suggestive of cholecystitis
What are you feeling for in a DRE?
2 lobes of prostate
Craggy/smooth/enlarged
Faecal matter/impaction
Anal tone
What are you looking for in a DRE?
Skin tags Warts Fistulae Excoriation Prolapsed piles On glover after DRE: blood/faecal matter/mucus
