Abdominal Examination
Could be:
renal
liver
gastrointestinal
haematological/oncological
metabolic
cardiac
respiratory
Obs
Abdomen
Peripheries targeted at likely system
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Wash hands
Watch on door
Stem (2m): Name, age, body system
Bag
Visualise below
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START WATCH
Introduction
Ex (kindly) at 1 min (thinking what might have cause eg HTN, and what might HTN cause?
Interpret Ex at 10mins
DDx
Chronic Liver Disease
renal
liver
gastrointestinal
haematological/oncological
metabolic
cardiac
respiratory
Obs
Abdomen
Peripheries targeted at likely system
-----------------------------------------------------------------------------------------------
Wash hands
Watch on door
Stem (2m): Name, age, body system
Bag
Visualise below
-----------------------------------------------------------------------------------------------
START WATCH
Introduction
- Intro: "Good Morning / Afternoon, I'm ... / Sticker
- Washed: "I have Washed my hands outside"
- Stem: "I have been asked to see X, an Xyo, and examine their X
- Intro "You must be X?, G'day, who have you brought with you? Nice to meet you both.
- Position
- Exposure: ?'nipples to knees'
- Pain: During the exam if anything makes you uncomfortable or causes you pain please let me know"
Ex (kindly) at 1 min (thinking what might have cause eg HTN, and what might HTN cause?
- General Inspection (EWGOD)
- Equipment: There is no medical Equipment
- Well: X looks Well
- Growth and puberty: I would estimate their height as borderline for their age, their weight appears adequate, ie out pot proportion, but it would be important to confirm this on Growth charts, Puberty
- Other Obvious: Asymmetry, Skin, Scars
- Dysmorphology: There are no unusual (Dys)Morphologic features, they resemble their parents
- Triangular face: Alagille (?Peripheral Pulmonary Stenosis)
- Front and back: Hands > Head > Chest > Abdo > Legs
- Obs: Are any Observations available
- Abdomen
- Inspection
- Scratch marks (CLD)
- Distention (Ascites, Mass, Organomegaly)
- Umbilical inversion (as above)
- Caput Madusa (portal hypertension from CLD)
- Striae
- Scars
- ?Extrahepatic obstruction (eg extrahepatic biliary atresia or a choledochal cyst)
- ? liver transplant
- Gallstone (chronic haemolysis)
- umbilical port easily missed
- Auscultation
- Does it hurt > Palpation
- Hernia
- Hepatomegaly (tender ?acute, no jaundice ?storage disorder)
- Splenomegaly
- Percussion
- Inspection
- Hands
- Nails
- Pallor (CLD, CKD, Haemolysis)
- Clubbing: Chronic liver disease; IBD
- Koilonychias
- Leukonychia (hypoalbuminaemia)
- Palms
- Pallor
- Erythema (CLD)
- Nails
- Eyes
- jaundice (haemolysis, )
- pallor
- Mouth
- angular cheilitis
- glossitis
- ulceration
- Inspection
- Spider naevi (CLD)
- Scar ?Extrahepatic obstruction (eg extrahepatic biliary atresia or a choledochal cyst) ? liver transplant
- Auscultation
- Does it hurt > Palpation
- Percussion
- Ascites (Portal hypertension)
Interpret Ex at 10mins
- I was asked to see X, an Xyo, and examine their X
- I found...
- Should time permit I would also like to examine... look for causes other causes of finding, and other thing findings may cause
DDx
Chronic Liver Disease