Gastroenterology Examination
Related Subjects:
|Cardiology Examination
|Cardiology History Taking
|Respiratory Examination
|Gastroenterology Examination
👀 Introduction & General Inspection
- ⚖️ Weight loss → Malabsorption, malignancy, chronic disease. Cachexia strongly suggests cancer.
- 🤎 Skin bronze pigmentation → Haemochromatosis.
- 💛 Jaundice → Check sclera carefully. Suggests raised bilirubin.
- 👁️ Kayser-Fleischer rings → Wilson’s disease (copper in Descemet’s membrane, slit-lamp needed).
- 👁️ Xanthelasma → Primary biliary cholangitis.
- 🌟 Spider naevi (>6 = pathological) → Normal in pregnancy but usually liver disease.
- 💉 Tattoo / track marks → Consider viral hepatitis.
- 👄 Lip freckles → Peutz-Jeghers (GI polyps).
Telangiectasia → Osler-Weber-Rendu (hereditary haemorrhagic telangiectasia).
✋ Hands
- 👉 Clubbing → GI causes (IBD, coeliac, cirrhosis).
- 🤲 Dupuytren’s contracture & Palmar erythema → Chronic liver disease.
- ⚪ Leuconychia (“white nails”) → Low albumin.
- 🥄 Koilonychia (spoon nails) → Iron deficiency anaemia.
- ✋ Asterixis (“flapping tremor”) → Hepatic encephalopathy.
- 🟢 Virchow’s node (left supraclavicular node) → GI malignancy spread via thoracic duct.
👄 Oral Cavity
- 👃 Breath → Fetor hepaticus (liver failure), ketosis, alcohol.
- 📍 Angular stomatitis → Denture irritation, candida, B12/iron deficiency.
- 💨 Parotid swelling → Alcoholism, malignancy, mumps.
- ⚠️ Aphthous ulcers → Recurrent, consider IBD, coeliac, B12/folate deficiency.
- ⬜ Leukoplakia → Precancerous; squamous carcinoma risk (smoking, alcohol, betel nut).
- 🌿 Lichen planus → Premalignant risk.
- 🍄 Oral candidiasis → Diabetes, HIV, antibiotics, inhaled steroids.
- 🌫️ Hairy leukoplakia → HIV/AIDS (EBV-related).
- 🌑 Oral pigmentation → Addison’s, Peutz-Jeghers, melanoma.
- 🪥 Gingivitis / caries → Alcoholism, neglect, Vit C deficiency (bleeding gums).
- 🦷 Teeth: Hutchinson’s incisors & Moon’s molars → Congenital syphilis. Bulimia → erosion. Caries → Streptococcus mutans.
👅 Tongue
- 🍖 Glossitis (smooth “beefy” tongue) → B12, folate, niacin, or iron deficiency.
- 🗺️ Geographic tongue → Benign red patches.
- 👅 Macroglossia → Acromegaly, amyloidosis, hypothyroid, Down’s.
- ⚡ Fasciculating / wasted tongue → LMN lesion (e.g. MND, syringobulbia).
- ⬆️ Spastic tongue → UMN lesion (pseudobulbar palsy).
- ⚠️ Tongue cancer → Squamous cell carcinoma.
