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Surgery class test Q/A Lump

Abdominal Lump:-

Q.1- What Is the Position for Examination of Intra-Abdominal Lump?

A. Supine Position, Relaxed With Legs Semiflexed, Exposure Of Abdomen At The Level Of Nipple To The Groin.

Q.2- What Is To Be Inspected In Abdominal Lump?

A. Whether The Abdominal Lump Is Scaphoid, Normal, Distended.

Q.3- What Is Scaphoid?

A. Imagine The Line From Tip Of Xiphoid Process To Pubic Symphysis, If The Abdomen Is Concave-Lies Below The Imaginary Line Is Scaphoid.

Q.4- What Is the Normal Abdominal Position?

A. Abdomen Is More Or Along With Imaginary Line Is Normal Position.

Q.5- What Is Distended Abdomen?

A. Abdomen Is Above The Imaginary Line And Convex Is Called The Distended Abdomen.

Q.6- What Should Be Observed In Case Of Distended Abdomen?

A. It Is Observed Whether The Distension Is Uniform Or Asymmetrical.

Q.7- What Should Be Observed In Skin Over The Abdomen?

A. Redness, Scar, Striae, Branching Marks, Nodules, Dilated Vein.

Q.8- What Does The Redness Around The Umbilicus Suggest?

A. It Suggest The Acute Hemorrhagic Pancreatitis.

Q.9- What Does The Branching Mark Suggest?

A. Long Standing, Chronic Pain.

Q.10- What Does The Hard Subcutaneous Nodules Suggest?

A. It Suggests Secondary Spread Of Malignancy In Skin.

Q.11- The Dilated Vein Surrounding Umbilicus With Centrifugal Is What Suggest?

A. It Suggest Portal Hypertension With Caput Medusa.

Q.12- Where the Appendectomy Scar Present?

A. Mcburney’s Point.

Q.13- Where The Scar Of Cholecystectomy Is Present?

A. Right Coastal Margin.

Q.14- Which Are the Significance of the Examination Of Umbilicus?

A. Normally the Umbilicus Is Present Between Midline, Midway Xiphoid Process & Pubic Symphysis. It Is Displaced Upward By The Lump Arising In Pelvis. In Case Of Ascitis It Is Displaced Downward.

Q.15- What Is Tanyol’s Sign?

In This Sign The Distance Between Xiphoid Process To Umbilicus Is More Than Distance Between Umbilicus To Pubic Symphysis.

Q.16- Which Shape Of Umbilicus in Ascitis?

A. It Is Transversely Stretched Like Laughing Umbilicus.

Q.17- Which Is Shape Of Umbilicus Hernia?

A. Everted Shape.

Q.18- Which Type of Breathing Present in Male?

A. Thoraco-Abdominal Type of Breathing.

Q.19- Which Type of Breathing Present in Female?

A. Abdomino-Thoracic Type of Breathing.

Q.20- Which Type of Breathing Present In Local Peritonitis?

A. Only Thoracic Type Is Present, Abdomen Type Is Absent.

Q.21- Which Type of Lump Moves during Respiration?

A. Lump Connected To Diaphragm That Is From Liver, Gall Bladder, and Spleen & Stomach Moves During Respiration And Renal Lump Moves Slightly.

Q.22-Which Lump Does Not Move With Respiration?

A. Retroperitoneal & Intra-Abdominal Lump Which Are Not Connected To Diaphragm.

Q.23- Which Is the Characteristic Sign of Pyloric Stenosis?

A. Visible Peristaltic Movement Going From Left to Right.

Q.24- In Which Condition Step-Ladder Pattern Of Peristalsis Occurs?

A. Low Iliac Obstruction.

Q.25- What Is the Step-Ladder Pattern?

A. Multiple Distended Loops Arising Towards The Central Is Step Ladder Pattern.

Q.26- What Is Troisier’s Sign?

A. Left Supraclavicular Lymph nodes Enlarged Due To Secondary Deposit of Malignancy of Stomach, Colon and Testis.

Q.27- What Is Virchow’s Lymph Nodes?

A. Enlarged Left Supraclavicular Lymph Nodes Is Virchow’s Lymph Nodes.

Q.28- Which Other Sites Should Be Exam In Case Of Abdominal Lump Other Than Abdominal Inspection?

A. Scrotum, Hernia Orifice, Spine, Left Supraclavicular Nodes.

Q.29- What Is Rebound Tenderness?

A. Palpate The Tender Area With The Flat Hand And With Slowly Pressed Down The Hand Pressing Deeper With Each Expiration, Now Withdraw The Hand Suddenly If The Patient Gets Acute Pain After Withdrawing The Hand It Is Rebound Tenderness

Q.30- What Is Guarding Phenomenon?

A. Abdomen When Pressed, The Wall Muscles Contracts And Wall Becomes Firm And Nonelastic The Phenomenon Is Called The Guarding Phenomenon.

Q.31- Which Swelling Needed To Be Auscultated In Case Of Abdominal Lump?  

A. Abdomen, Liver, Spleen, Abdominal Aorta, Renal Arteries.

Q.32- What Is Rigidity?

A. If the Muscles Are In State of Sustained Contraction Even When It Is Not Palpated It Is Rigidity

Q.33- What Does Rebound Tenderness Suggest In Case Of Intestinal Obstruction?

A. It Suggests Strangulation.

Q.34- How To Know That The Lump Is Intra-Abdominal?

A. Keep The Hand At Lower Border Of Swelling And Ask The Patient To Take Deep Breath, If The Swelling Moves With Respiration It Is Intra Abdominal.

Q.35- What Is Suspected If There Is Tingling Sound On Auscultation Of Periumbilical Area?

A. Intestinal Obstruction.

Q.36- When the Lump Is Suspected As Subcutaneous?

A. If The Lump Is Movable It Is Subcutaneous.

Q.37-If The Lump Is Fixed On Contracting Wall Of Muscle, What Can Be Suspected?

A. Lump Is Intra Muscular.

Q.38- What Does The Well Defined Margin Suggest In Case Of Swelling?

A. It Suggests The Neoplasm.

Q.39-What Does The Ill Defined Margin Suggest?

A. Suggests Inflammatory Swelling.

Q.40- What Is Ballotabilty?

A. Keep Anterior Hand Over The Lumbar Region And Give Sudden Forward Push To The Swelling With Posterior Hand, If The Mass Touches The Anterior Hand And Falls Back It Is Termed As Ballotability.

Q.41-Which Test Is Performed If Swelling Is Cystic?- Fluctuation.

Q.42- How Mobility of Swelling Is Checked?

A. If The Swelling Is In The Upper Part Of Abdomen The Mobility Is Seen With Respiration. If The Cyst Present In The Abdomen Mobility Is Seen By Moving The Swelling Manually. If The Swelling Is Mobile Then Check For Restriction Of Movement.

Q.43- How To Check Whether The Lump Is Pulsatile Or Not?

A. Place The Index Finger Over Two Sides Of Swelling As Far As Possible. Note The Pulsation And If Fingers Move Far Away It Is Known As Expansile Pulsation.

Q.44- In Which Condition Expansile Pulsation in Swelling Is Seen?

A. Aneurysm.

Q.45- How To Check Whether The Pulsatile Swelling Is Because Of Aneurysm Or Any Other Condition?

A. Keep The Fingers On Swelling And If Fingers Are Moving Up And Down And Far Away Then It Is Due To Transmitted Pulse And Swelling Is Lying Over Artery And Is Due To Aneurysm.

Q.46- How To Differentiate Other Type Of Swelling From Aneurysm?

A. Ask The Patient Kneel In Knee Elbow Position And Check For Pulsation. If The Pulse Is Transmitted Then The Expansile Pulsation Will Not Be Felt In Swelling As The Swelling Will Be Away From Aorta But Aneurysm Will Palpate.

Q.46- How To Palpate The Rest Of Abdomen In Swelling?

A. Palpate For Enlarged Liver, Spleen And Kidneys.

Q.47- How To Palpate The Liver?

A. Palpation Of Liver Is Done In Right Iliac Fosse Along The Mid Clavicular Line With Fingers Parallel To Liver Border And Exerting Moderate Pressure During Expiration.

Q.48- What Is To Be Noticed If Liver Is Palpable?

A. Size, Border, Surface, Consistency and Tenderness.

Q.49- How To Palpate Spleen?

A. Palpation Of The Spleen Is Done At Right Iliac Fosse Towards Coastal Margins With Fingers Parallel To Left Coastal Margin.

Q.50- What Is To Be Noticed If The Spleen Is Palpable?

A. Size In Centimeter From Left Coastal Margin Then Palpate The Anterior Border For Splenic Notch.

Q.51- Which Is the Method of Palpation of Spleen If It Is Not Palpated In Normal Supine Position?

A. Turn The Patient To His Right Side Place The Left Hand Firmly Over The Left Lower Chest, Keep The Right Hand Under The Right Coastal Margin And Ask The Patient To Take Deep Breath.

Q.52- How To Palpate Renal Lump?

A. Palpate Both Lumbar Regions Bimanually.

Q.53- Which Are the Areas to Be Palpated For the Tenderness?

A. Colon, Lower Intercoastal Spaces, Renal Angle.

Q.54- In Which Condition Pitting Edema of Leg Is Seen In Case Of Abdominal Lump?

A. If There Is Large Lump In Pelvic Or Retroperitoneal Space Or Is Large To Compress Inferior Vane Cava, Obstruction Of Lymphatic’s.

Q.55- What Is To Be Examined In Back In Case Of Abdominal Lump?

A. Deformity in Spine, Tenderness of Renal Angle, Virchow’s Nodes.

Q.56- What Sound Is Heard When Percussion Of Solid Swelling Is Done?

A. Dull Note.

Q.57- What Sound Is Heard When Swelling Is Retro Peritoneal?

A. Resonant Note

Q.58- Where the Percussion of Spleen Is Done?

A.9TH Intercoastal Space from Posterior Axillary Line.

Q.59- In Case Of Renal Lump Where the Percussion Is Done?

A.Posteriorly to the Lateral to Erector Spinae.

Q.60- What Sound Is Heard In Case Of Enlarged Kidney?

A. Dull Note.

Q.61- What Note Is Heard In Presence Of Other Lump Like Splenic Lump?

A. Resonant Note.

Q.62- How Ascitic Fluid Is Detected By Percussion?

A. Percussion from Umbilicus To Flanks.

Q.63- What Sound Is Heard In Case Ascitis?

A. Dull Note With Shifting Type.

Q.64- How the Hydatid Thrill Test Is Performed?

A. Spread Three Fingers Of Left Hand And Percuse Gently Over Middle Area, A Peculiar Waving Sensation Will Be Felt By Lateral Finger.

Q.65- What Is Horse-Shoe Shaped Dullness?

A. If The Dullness Extent To Both Flanks And Supra Pubic Region.

Q.66- What Test Is Performed If There Is Large Ascitis Or Cystic Lump?

A.Fluid Thrill

Q.67- How the Fluid Thrill Test Is Performed?

A. Ask The Assistant To Press Ulner Border Of Hand Vertically Over The Center Of Swelling.Keep Your Left Hand Over One Side And Tap The Opposite Side With Right Hand, The Other Hand Will Feel Thrust After Small Delay.

Q.68- Which Test Is Performed If There Is Hydatid Cyst?-. Hydatid Thrill

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