Gastroenterology

Acute Appendicitis

1 patients · 2 clips

Patient 1: This is a middle-aged man with acute appendicitis. **RLQ tenderness at McBurney’s point** **Psoas sign**

Erythema Nodosum

4 patients · 8 clips

Characterized by red, painful nodules (histologically it is a panniculitis) most often seen on the lower extremities (shins, calves, thighs, ankles) and it generally flares when the inflammatory bowel disease flares. Ery

Splenomegaly

1 patients · 1 clips

**Scratch test** This is a middle-aged woman with Laennec’s cirrhosis complicated by splenomegaly. The scratch test to assess the size of the spleen is demonstrated in the video.

Ascites

2 patients · 5 clips

Card Tutorial Patient 1: This patient is a middle-aged man with cirrhosis from alpha-1-antitrypsin deficiency. Patient 2: This patient has cirrhosis. This patient also has palmar erythema.

Ascites (bulging flanks)

Clinical finding with teaching media.

Asterixis

5 patients · 6 clips

Describes jerking movements of the hand when the wrist is in full extension (also known as a “flap”). Usually associated with hepatic encephalopathy or uremia. Gastroenterology Patient 1: This is a middle-aged woman with

Caput Medusa

Clinical finding with teaching media.

Caput Medusae

2 patients · 2 clips

Distended and engorged superficial epigastric veins, which are seen radiating from the umbilicus across the abdomen. The name caput medusae (Latin for “head of Medusa”) originates from the apparent similarity to Medusa’s

Jaundice

3 patients · 8 clips

- Means yellowing of the skin from elevated bilirubin, either from the destruction of red blood cells in hemolysis or more commonly from liver disease or obstruction of bile ducts. - Not seen until the bilirubin level is

Palmar Erythema

9 patients · 16 clips

Erythema of the thenar/hypothenar portion of the hand with a pale central palm, seen in liver disease (likely from imbalance of estrogens to androgens). Gastroenterology Patient 1: This is a middle-aged woman with cirrho

Pulsatile Liver

1 patients · 1 clips

Patient 1: This is a woman in her mid 20s with an opioid use disorder who presented with fever. The finding is a pulsatile liver from severe tricuspid valve regurgitation due to endocarditis.

Spider Angioma

6 patients · 8 clips

A form of telangiectasias where a central arteriole feeds telangiectasias, and is seen in conditions of estrogen excess, such as pregnancy and liver disease. In liver disease, the spiders are most often seen in the face

Unilateral Icterus

1 patients · 2 clips

In a patient who previously underwent surgery for ocular melanoma and now has a glass eye, the presence of unilateral icterus (of the normal eye) should raise suspicion for subsequent development of liver metastases. Gas

Cutaneous Porphyria

1 patients · 6 clips

Patient 1:

Dilated Forearm Veins

1 patients · 1 clips

Patient 1: 69 y/o man with end-stage liver disease admitted with decompensation, found to have visible forearm veins and a normal jugular venous pressure.

Dupuytren’s Contracture

2 patients · 2 clips

Thickening of the palmar fascia, caused by a variety of conditions (hereditary, trauma, diabetes), but also associated with alcoholic liver disease. Gastroenterology Patient 1: This patient has Dupuytren’s contracture. P