Podcast
Questions and Answers
What is the primary difference between a sign and a symptom in medical terminology?
What is the primary difference between a sign and a symptom in medical terminology?
Which of the following is an example of a sign?
Which of the following is an example of a sign?
Acanthosis nigricans is characterized by which of the following features?
Acanthosis nigricans is characterized by which of the following features?
Which of the following best describes the term 'asymptomatic'?
Which of the following best describes the term 'asymptomatic'?
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Which physiological mechanism might contribute to the thickened skin observed in acanthosis nigricans?
Which physiological mechanism might contribute to the thickened skin observed in acanthosis nigricans?
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What is the goal of examining techniques when assessing for specific GIT pathology?
What is the goal of examining techniques when assessing for specific GIT pathology?
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What does it mean when a patient has complaints that are not accompanied by observable signs?
What does it mean when a patient has complaints that are not accompanied by observable signs?
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Which type of examination technique is essential for assessing GIT conditions effectively?
Which type of examination technique is essential for assessing GIT conditions effectively?
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Which medical conditions are associated with Cushing's disease?
Which medical conditions are associated with Cushing's disease?
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What is a visible sign of angular stomatitis/cheilitis?
What is a visible sign of angular stomatitis/cheilitis?
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Which physiological mechanism is primarily involved in the skin changes seen in diabetes mellitus?
Which physiological mechanism is primarily involved in the skin changes seen in diabetes mellitus?
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What physical examination sign indicates hyperpigmentation in body folds and creases?
What physical examination sign indicates hyperpigmentation in body folds and creases?
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Which of the following is NOT a risk factor for angular stomatitis/cheilitis?
Which of the following is NOT a risk factor for angular stomatitis/cheilitis?
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During a physical examination, where should you focus when eliciting signs of dark velvety hyperpigmentation?
During a physical examination, where should you focus when eliciting signs of dark velvety hyperpigmentation?
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Which endocrine dysfunction is particularly associated with insulin-like growth factor receptor activation?
Which endocrine dysfunction is particularly associated with insulin-like growth factor receptor activation?
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Which of the following conditions is a common cause of angular stomatitis in the elderly?
Which of the following conditions is a common cause of angular stomatitis in the elderly?
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What does Dupuytren's contracture primarily affect in the hand?
What does Dupuytren's contracture primarily affect in the hand?
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Which finger is most commonly affected by Dupuytren's contracture?
Which finger is most commonly affected by Dupuytren's contracture?
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During a physical examination for Dupuytren's contracture, which specific action helps assess range of motion?
During a physical examination for Dupuytren's contracture, which specific action helps assess range of motion?
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What underlying change occurs in the palmar fascia in Dupuytren's contracture?
What underlying change occurs in the palmar fascia in Dupuytren's contracture?
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What is NOT a common symptom reported by individuals with Dupuytren's contracture?
What is NOT a common symptom reported by individuals with Dupuytren's contracture?
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What causes the skin discoloration known as ecchymosis?
What causes the skin discoloration known as ecchymosis?
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What is the primary function of the palmar fascia in the hand?
What is the primary function of the palmar fascia in the hand?
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In which area does Dupuytren's contracture typically begin?
In which area does Dupuytren's contracture typically begin?
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What is the primary underlying cause of Terry's nails?
What is the primary underlying cause of Terry's nails?
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What appearance is characteristic of leukoplakia?
What appearance is characteristic of leukoplakia?
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Which of the following conditions is NOT associated with leukoplakia?
Which of the following conditions is NOT associated with leukoplakia?
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How can leukoplakia be typically identified during a physical examination?
How can leukoplakia be typically identified during a physical examination?
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Which medical condition is NOT commonly associated with asterixis?
Which medical condition is NOT commonly associated with asterixis?
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What is the primary characteristic of asterixis during an examination?
What is the primary characteristic of asterixis during an examination?
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Which common habit is most frequently linked to the development of oral leukoplakia?
Which common habit is most frequently linked to the development of oral leukoplakia?
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What is a potential sign of cancer when observing leukoplakia?
What is a potential sign of cancer when observing leukoplakia?
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Which physiological mechanism is suspected to be involved in the occurrence of asterixis?
Which physiological mechanism is suspected to be involved in the occurrence of asterixis?
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Which of the following is NOT a feature of leukoplakia?
Which of the following is NOT a feature of leukoplakia?
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What appearance is characteristic of candidiasis?
What appearance is characteristic of candidiasis?
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Which factor is NOT a risk for developing candidiasis?
Which factor is NOT a risk for developing candidiasis?
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What contributes to the appearance of the distal brown portion in Terry's nails?
What contributes to the appearance of the distal brown portion in Terry's nails?
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What underlying condition could lead to chronic candidiasis infections?
What underlying condition could lead to chronic candidiasis infections?
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How can the presence of asterixis be described in neurological terms?
How can the presence of asterixis be described in neurological terms?
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Which condition is least likely to predispose an individual to oral candidiasis?
Which condition is least likely to predispose an individual to oral candidiasis?
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What do petechiae look like on the skin?
What do petechiae look like on the skin?
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What causes the formation of petechiae?
What causes the formation of petechiae?
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Which condition is NOT associated with pruritus?
Which condition is NOT associated with pruritus?
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What sensation is primarily associated with pruritus?
What sensation is primarily associated with pruritus?
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During a physical examination for pruritus, what is crucial for diagnosis?
During a physical examination for pruritus, what is crucial for diagnosis?
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What do clumps of petechiae resemble on the skin?
What do clumps of petechiae resemble on the skin?
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Which of the following is a treatment for pruritus?
Which of the following is a treatment for pruritus?
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Which medical condition is specifically linked to common yellowing of the skin indicating potential pruritus?
Which medical condition is specifically linked to common yellowing of the skin indicating potential pruritus?
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Study Notes
Gastrointestinal (GIT) General Physical Signs
- Key signs related to GIT conditions can be identified and described.
- Mechanisms behind these signs are understood where applicable.
- Physiological mechanisms governing abnormal signs are described.
- Specific examination techniques for GIT conditions are detailed.
- Expected findings and variations in general examination for GIT diseases are outlined.
- Signs are differentiated from symptoms.
Signs vs Symptoms
- Signs are objective physical manifestations of a disease detectable and measurable by an examiner.
- Examples include: rapid pulse, high temperature, low blood pressure, bruising, open wounds, etc.
- Symptoms are subjective experiences of the disease, felt by the patient.
- Examples include: pain.
- Patients may have symptoms (complaints) accompanied by signs on examination or laboratory abnormalities. Conversely, patients may have signs or abnormalities without experiencing symptoms.
Acanthosis Nigricans
- A skin condition characterized by dark, velvety discoloration in skin folds and creases.
- Associated with: Cushing's disease, diabetes mellitus, hypothyroidism, and cancers (prostate/ovarian).
- During examination, inspect the skin, focusing on skin folds (neck, armpits, groin, navel, forehead).
- Underlying mechanism: endocrine dysfunction, particularly insulin resistance and hyperinsulinemia, activates the insulin-like growth factor receptors, which leads to keratinocyte and fibroblast proliferation in the skin.
Angular Stomatitis/Cheilitis
- Inflammation of the corners of the lips, often with maculopapular, vesicular or scaly lesions.
- Risk factors include lip licking, drooling, hypersalivation, malocclusion, Down syndrome, orthodontic treatment, denture use, nutritional deficiencies, hypervitaminosis A, atopic dermatitis, HIV, and immunodeficiency.
- Physical exam: look for bleeding, redness, swelling, cracking, blistering, itching, or pain.
Aphthous Ulceration
- Recurrent round or oval sores/ulcers inside the mouth, not tightly bound to underlying bone (lips, cheeks, and tongue).
- Associated with emotional stress, lack of sleep, mechanical trauma (self-inflicted bites), deficiencies in vitamin B, iron, and folic acid, certain foods (chocolate), certain toothpastes, menstruation, and viral infections.
Asterixis
- Motor disturbance characterized by intermittent lapses in assumed posture, due to intermittent lapses in sustained muscle contractions.
- Associated with hepatic encephalopathy, renal failure, metabolic encephalopathy, and Wilson's disease.
Candidiasis
- A yeast infection caused by Candida albicans characterized by white patches in the mouth or vagina.
- Associated with antibiotic use, pregnancy, uncontrolled diabetes, impaired immune systems, oral contraceptives, hormone therapy that increases estrogen levels, and HIV.
- Clinical exam: inspect the mouth or vagina for white plaques or erythematous patches.
Clubbing
- Bulbous enlargement of the distal ends of fingers or toes.
- Associated with: infective endocarditis, cyanotic heart disease, atrial myxoma, primary biliary cirrhosis, ulcerative colitis, Crohn's disease, lung abscess, bronchiectasis, cystic fibrosis, lung cancer, benign mesothelioma, hyperthyroidism, neurogenic tumours, and Familial Pachydermoperiostosis (PDP).
- During exam, ask patients to hold up their hands and place the thumbs' tips together. Check the angles formed and massage the nail bed to evaluate for softness and spongy texture.
Dupuytren's Contracture
- A condition where one or more fingers become permanently bent in a flexed position due to thickening of the palmar fascia.
- Associated with thyroid problems, liver disease, epilepsy, and diabetes.
- During exam, inspect the hands for thickening of flexion contractures; palpate the hands, wrists, and fingers for swelling or tenderness in the palm for nodules. Have patients try to straighten their fingers.
Ecchymosis (Bruising)
- Discoloration of the skin due to blood escaping from ruptured blood vessels.
- Associated with trauma, amyloidosis, lymphocytic leukaemia, clotting factor deficiencies (haemophilia), vitamin K deficiency, scurvy, defective platelet actions, hereditary haemorrhagic telangiectasia, and Cushing's syndrome.
- Inspect skin for discoloration (red, black, blue, purple, or a combination).
Erythema Nodosum
- A skin disorder with red, tender nodules/plaques predominantly on the lower extremities (extensor surfaces).
- Associated with inflammatory diseases, infections (streptococcal, tuberculosis), sarcoidosis, and rheumatoid disorders.
Glossitis
- Inflammation of the tongue characterized by loss of surface papillae, resulting in a smooth, red appearance.
- Associated with nutritional deficiencies (celiac disease, protein-calorie deficiency, vitamin B12 malnutrition), pernicious anemia, carcinoid syndrome, and Sjögren's syndrome.
Gynecomastia
- Enlargement of glandular tissue in the male breast.
- Associated with hepatic cirrhosis, hyperthyroidism, radiotherapy, renal failure, hypogonadism, and testicular tumors.
Jaundice
- Yellowing of the skin, sclera, and mucous membranes due to increased bilirubin levels.
- Associated with liver cirrhosis, acute pancreatitis, haemochromatosis, liver/gallbladder/pancreatic cancers, hepatitis (viral and toxic), malaria, and porphyria.
- Clinically: inspect the eyes, to detect discoloration (jaundice).
Leukonychia
- Whitening of the nail plate due to abnormal vasculature.
- Associated with trauma, hereditary factors, hypoalbuminaemia, hepatic cirrhosis, chronic renal failure, congestive heart failure, and diabetes.
- Clinically: inspect patient nails for discoloration
Leukoplakia
- Thick, white, or grayish patches in the mouth; associated with mouth injuries, rough teeth, poorly fitting dentures, inflammatory conditions, long-term alcohol use, and infections (HIV, HPV).
- Clinical exam: inspect the mouth, gums, inside of cheeks, tongue, or lips for patches.
Muscle Wasting
- Also known as muscle atrophy, signifying loss of muscle tissue.
- Associated with amyotrophic lateral sclerosis (ALS), Multiple Sclerosis (MS), arthritis, myositis, radiculopathy, peripheral neuropathy, and peripheral vascular disease.
Pallor
- Paleness of skin and mucous membranes due to reduced oxyhemoglobin or decreased peripheral perfusion.
- Associated iron deficiency, anemia, leukaemia, chronic renal disease, and rheumatoid arthritis.
Palmar Erythema
- Symmetrical redness on the thenar and hypothenar prominences of the palms, potentially with a mottled appearance that blanches with pressure.
- Associated with chronic liver disease, autoimmune conditions (rheumatoid arthritis), neoplastic conditions, endocrine disorders (thyroid, diabetes), and infectious conditions.
Petechiae
- Pinpoint, round, red/brown spots on the skin due to bleeding from broken capillaries.
- Associated with vitamin C deficiencies, blood disorders (thrombocytopenia, idiopathic thrombocytopenic purpura, leukaemia), vasculitis, and infections.
- Clinically: note if clustered or disseminated, if discoloration remains on application of pressure.
Pruritus (Itchy Skin)
- Uncontrollable itching sensation.
- Associated with internal disorders (bile duct obstruction, cirrhosis, anaemia), nervous system disorders (diabetes, multiple sclerosis), and skin conditions (psoriasis, eczema).
- Other causes: medications (antifungals, narcotics, anticonvulsants, antibiotics).
Skin Pigmentation
- Skin discoloration (blotchy, darker, lighter).
- Associated with liver disease, skin cancer, chronic renal disease, vitiligo, albinism, Chediak-Higashi syndrome, and Hermansky-Pudlak syndrome.
- Clinically: inspect skin colour, texture, and tone.
Spider Naevus
- Small, central red spots with reddish extensions radiating outward (spider-like).
- Associated with liver disease, hormonal changes (oral contraceptives, pregnancy!), liver failure, liver cirrhosis.
- During examination, apply pressure to the center of the spot, observe if color changes.
Xanthomas
- Papules or nodules of skin or mucous membranes containing lipids.
- Associated with diabetes, liver disease, hyperlipidaemia (hypercholesterolaemia), hypothyroidism, late-stage kidney disease, HIV, and sarcoidosis.
- Clinically: observe for papules or nodules, presence on skin/tendons/fascia.
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Description
Explore the key physical signs associated with gastrointestinal conditions and understand the physiological mechanisms behind them. Learn to differentiate between objective signs and subjective symptoms, and familiarize yourself with examination techniques specific to GIT diseases. This quiz will enhance your knowledge of GIT examination practices.
