Let’s have some quick useful tips for Abdominal examination station exams.
Abdominal Examination is an easy system to examine than others because the findings are few and easy to pick. These pearls will make it even easier for you to elicit findings & make a diagnosis with confidence.
Pearl # 1
When you see a patient with an arteriovenous (AV) fistula and a surgical scar on the abdomen, think of a Transplanted Kidney.
Pearl # 2
When you see a renal transplant patient, always look for signs of immunosuppression and comment during naration of your findings to the examiners.
Pearl # 3
With a Chronic Liver disease (CLD) patient, you are expected to look for all the stigmata of CLD. Be ready to answer about its causes and complications.
Pearl # 4
When you see jaundice with splenomegaly, think of chronic hemolytic causes thalassemia, sickle cell (in early disease) & hereditary spherocytosis followed by hematological malignancies.
Pearl # 5
If you encounter a patient with hemochromatosis in Asian countries, think of secondary hemochromatosis while in Western countries’ patient, consider primary hereditary hemochromatosis.
Pearl # 6
If you see a patient with adult polycystic kidney disease, be mentally prepared to answer about its associated complications because its an exam favorite.
Pearl # 7
In tense ascites, do not attempt to demonstrate shifting dullness. You don’t have to because you know there are ascites. A common sense that shifting dullness is done when you suspect mild ascites. In exams, we tend to let go of common sense.
Pearl # 8
For causes of ascites, please remember Transudative & Exudative causes separately. But you can only impress the examiner when you are able to apply your knowledge to the patient. Remember, the SAAG ratio to differentiate between ascites due to portal hypertension & rest of the causes.
Pearl # 9
In gross ascites, do not forget to auscultate the chest for pleural effusion especially right sided
Pearl # 10
In patients with stigmata of chronic liver disease, remember signs specific to alcoholic liver diseases like cachexia, tremors, Dupuytren’s contractures, cerebellar syndrome, peripheral neuropathy & myopathy.
Good Luck Folks!
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