Abdominal examination quiz part 2

Inflammatory bowel disease and hepatic cirrhosis are the only abdominal diseases that cause clubbing. (Link)

The sensitivity and specificity of percussion for splenomegaly is approximately 80%, with the sensitivity reduced in obesity and the specificity reduced following recent food intake. Palpation is only approximately 25% sensitive but > 95% specific. (Link)

A kidney usually moves downward a little with respiration and is unable to be palpated above it. Due to overlying colon, it is usually resonant to percussion, It is usually balottable from the loin.

Both kidneys may be palpable in the first 48 hours of the neonatal period, but only the lower pole of the right kidney is usually palpable in about 10% of normal people. This is because it is lower than the left, not due to any maldistribution of peri-renal fat. (Link)

The urinary bladder usually becomes palpable when it contains 125mL of urine. (Link)

The normal prostate is usually 4 cm wide, 2.5 to 3 cm high, 4.5 cm long and has a volume of 20 mL. It is normally non tender, smooth, slightly movable, and of rubbery consistency. Two distinct lobes should be felt separated by a median sulcus with distinct lateral sulci. (Link)

A normal transplanted kidney usually lies beneath an arcuate LIF (or RIF scar), is a 8-12 cm ovoid mass that is superficial (extraperitoneal), relatively mobile and able to be palpated around. It is normally non-tender and has no movement on respiration.(Link)

The Normal dimensionsof the adult spleen are: length < 12 cm; width < 7 cm; cephalocaudad diameter < 13 cm; and weight < 250 g. Dullness > 8 cm above the costal margin indicates splenomegaly. (Link)

The correct answer is 3% (Link)

The examination features of the spleen are: unable to get above it; palpable notch; moves towards RIF on inspiration; ballotable from laterally; dull to percussion. (Link)

Subacute bacterial endocarditis usually only causes mild splenomegaly. (Link)

Haemolytic anaemia usually only causes mild splenomegaly. (Link)

SLE usually only causes mild splenomegaly. (Link)

Apart from RHF, the other options usually only cause mild splenomegaly. (Link)

The features of Dupuytren’s contracture include thickening of the palmar fascia (usually the ring or little finger) that starts as a nodule and may develop into a fibrous band leading to fixed flexion at the MCP and PIP joints. It is associated with Garrod’s knuckle pads in 50%, plantar fibromatosis in 20% and penile fibromatosis (Peyronie’s disease) in 5%. It has a variety of causes including alcohol
ism, anticonvulsants, smoking, diabetes and may be idiopathic.(Link)