Abdominal Exam Osce

Clubbing is a medical condition where the nails curve around the fingertips and is often associated with certain underlying diseases. The correct answers provided - Cirrhosis, Malabsorption (Coeliac disease), and IBD (Crohn's) are known abdominal causes of clubbing. Gastritis, Gallstones, and Appendicitis are not typically associated with clubbing.

Palmar erythema, characterized by redness of the palms, is commonly associated with pregnancy, hyperthyroidism, rheumatoid arthritis (RA), and chronic liver disease. Contact dermatitis, sunburn, and diabetes are not typically known to cause palmar erythema.

Symptoms such as anaemia, weight loss, dysphagia, PR blood loss, malaena, and abdominal masses are considered red flags for upper GI pathology as they may indicate serious underlying conditions.

Upper GI bleeding is typically caused by conditions affecting the upper gastrointestinal tract such as peptic ulcers, esophagitis, varices, gastritis, neoplasms, and hereditary conditions.

Lower GI bleeding is typically caused by conditions related to the gastrointestinal tract such as haemorrhoids, anal fissures, diverticular disease, neoplasms, inflammatory bowel disease, small bowel disease, and Meckel's diverticulum. Heavy lifting, high blood pressure, and food allergies are not commonly associated with lower GI bleeding.

Jaundice can be caused by various factors related to the liver, but pre-hepatic causes such as haemolysis and Gilbert's syndrome are common triggers. Post-hepatic causes involve mechanical obstructions, not cholecystitis. Liver failure is a broad term and not a specific cause of jaundice.

Abdominal swelling can be caused by a variety of factors including fat, faeces, fluid, flatus, foetus, and fatal growth (tumour). Muscle, food, and inflammation are not typically associated with abdominal swelling.

Kayser-Fleischer rings are a distinctive green-yellow ring that can be seen encircling the iris of the eye. These rings are due to copper deposition in the cornea and are often a sign of Wilson's disease, a genetic disorder that affects copper metabolism in the body.

Angular stomatitis is a condition characterized by inflammation at the corners of the mouth. The correct answer includes deficiencies in iron, vitamin B12, and thiamine as common causes. Poor oral hygiene, excessive saliva production, and fungal infections are not typically associated with angular stomatitis.

Hereditary telangiectasia, also known as Osler-Weber-Rendu syndrome, is characterized by the presence of small dilated blood vessels on the skin and mucous membranes, leading to symptoms such as epistaxis and GI bleeds. It is associated with pulmonary, hepatic, and cerebral arteriovenous malformations.

Trosier's sign is specifically associated with an enlarged Virchow's node and is often considered a potential indicator of malignancy.

Spider naevi are actually vascular lesions characterized by a central arteriole with radiating vessels. Up to 5 spider naevi are considered normal. Causes include liver disease, contraceptive steroids, and pregnancy.

Caput medusae refers to distended and engorged paraumbilical veins that flow towards the legs upon pushing down. This is different from IVC obstruction where the flow is towards the head.

Peritonitis is inflammation of the peritoneum, the thin tissue that lines the inner wall of the abdomen. Signs of peritonitis on examination typically include rebound tenderness/percussion tenderness, involuntary guarding, and absent bowel sounds. Decreased heart rate, hyperactive bowel sounds, or decreased respiratory rate are not commonly associated with peritonitis.

Murphy's sign is a clinical finding of tenderness in the right upper quadrant of the abdomen. Pain during inspiration while the gallbladder is palpated is a classic sign of cholecystitis.

Courvoisier's law helps in clinical diagnosis by indicating that certain characteristics of a patient's gallbladder and jaundice can point towards potential causes. It is a valuable tool in differentiating various conditions affecting the gallbladder.

The correct answer includes various serious conditions that commonly lead to hepatomegaly, such as malignancy, congestive heart failure, infections, and hematological disorders. The incorrect answers do not typically cause hepatomegaly.

Splenomegaly can be caused by various conditions such as chronic myeloid leukemia, myelofibrosis, and malaria, but infectious mononucleosis, thyroid disorders, and lupus are not typically associated with splenomegaly.

When differentiating between the spleen and kidney, it is important to focus on factors such as palpation, movement on inspiration, and percussion rather than size, texture, or location.