Clinical Examination

List 2 clinical feature of ascites on abdominal examination

1) Shifting dullness

2) Fluid thrill

What is asterixis?

Flapping tremor when the hands are extended and wrists dorsiflexed

Which location of the body are caput medusae found?

Paraumbilical – distended veins

What is the underlying cause of caput medusae?

Portal hypertension

Describe positive Murphy’s sign

Palpation in the right upper quadrant below the liver edge during deep inspiration causes increased pain and catching of breath

In which condition is positive Murphy’s sign on clinical examination commonly elicited?

Acute cholecystitis

What condition is asterixis (liver flap) a sign of?

Hepatic encephalopathy

List the triad of Wernicke’s encephalopathy

1) Confusion

2) Cerebellar ataxia

3) Ophthalmoplegia

List the 2 main ophthalmic features of Wernicke’s encephalopathy

1) Nystagmus

2) 6th nerve palsy

What speech disturbance may occur in Wilson’s disease?

Dysarthria

What corneal abnormality may be seen in Wilson’s disease?

Kayser-Fleischer rings

Describe Kayser-Fleischer rings

Brown rings around the iris

Which method of examination is best used to examine for Kayser-Fleischer rings in Wilson’s disease?

Slit-lamp examination

What skin abnormality is Grey-Turner’s sign

Bruising

In which region of the abdomen can Grey-Turner’s sign be seen?

Flanks

In what condition can Grey-Turner’s sign be found?

Acute pancreatitis

What skin abnormality is Cullen’s sign?

Bruising

In which region of the abdomen can Cullen’s sign be seen?

Peri-umbilical

In what condition can Cullen’s sign be found?

Acute pancreatitis