Abdominal Examination MCQ Kamal Bani-Hani FRCS (Glasgow), M.D. (Leeds) King Abdullah University Hospital Department of Surgery – Faculty of Medicine Jordan University of Science & Technology

All the following are true, Except: The left kidney is palpable in thin females The direction of spleen enlargement is mainly towards the RIF The aorta may be palpable in thin person Shifting dullness is more sensitive test than transmission thrill for ascitis The edge of the liver may be palpable in normal person

All the following are true Except: During examination of abdomen you should stand on the patient’s right side Grey Turner’s sign is positive in acute appendicitis Campbell de Morgan spot could be seen in old age Spider angiomas are associated with chronic liver disease Petechiae may be seen in fat embolism

During inspection of the abdomen all are true, Except Caput Medusae is a sign of portal hypertension Collateral veins may result from inferior vena cava obstruction Absence of secondary sexual hair may indicate hypopituitarism Cessation of respiratory movements of the abdomen is seen in peritonitis Expansile pulsation is normal in thin persons

In gastric outlet obstruction all are true, Except Visible gastric peristalsis may be seen Could result from chronic duodenal ulcer or distal gastric carcinoma Succussion splash may be detected Venous hum is characteristic The vomiting is projectile

In acute appendicitis all are true Except Initially the pain start in the peri-umbilical region before it shift to the RIF Anorexia is a common symptom Murphy’s sign is positive Rebound tenderness may be positive Jaundice is not part of the classical picture

Palpable gall bladder may be seen in all the following Except Carcinoma gallbladder Carcinoma head of pancreas Chronic cholecystitis Empyema of gall bladder Mucocele

During auscultation of the abdomen all are true Except increase in frequency and intensity of bowel sound is associated with paralytic ileus bruit may be heard in renal artery stenosis venous hum may be heard in portal hypertension in hepatoma a bruit may be detected friction sounds may be heard in perisplenitis

During examination of the groin all are true Except The femoral artery is found just below the mid-inguinal point Strangulated hernia become tense and tender without impulse on coughing Direct inguinal hernia commonly descend to the scrotum In relation to pubic tubercle, inguinal hernia protrude above and medial, while femoral hernia protrude below and lateral Following reduction, obliteration of the deep inguinal ring will control indirect inguinal hernia

Regarding hernia all are true Except Examining the patient in standing position is essential Risk of strangulation is more common in femoral than inguinal hernias There is increase risk of incisional hernia if there is history of wound infection in abdominal incisions Umbilical hernia is more common in adult males than in babies and multiparous women In epigastric hernia the extraperitoneal fat bulge through a defect in linea alba

During examination of the rectum all are true Except Normal prostate is smooth, firm, regular with 2 lateral lobes and median groove In prostate carcinoma, the gland become hard, irregular with no median groove Haemorrhoids and seminal vesicle are normally palpable Anal fissure is tender Small prostate is associated with Klinefelter’s syndrome

In vaginal hydrocele all are true Except the swelling is confined to the scrotum the testis and epididymis not definable the swelling is opaque usually not tender feels like a bag of worm