Palpable gallbladder in a jaundiced patient due to biliary obstruction is called?

Appeared in: KPSC Staff Nurse - 2021

Explanation

Courvoisier's sign is the presence of a palpable, non-tender gallbladder in a patient with jaundice.
This sign strongly suggests that the biliary obstruction is due to a cause other than gallstones, most commonly a malignancy.
The underlying principle, Courvoisier's Law, posits that chronic gallstone disease causes gallbladder fibrosis, preventing it from distending, whereas extrinsic compression (like a tumor) obstructs a healthy gallbladder, causing it to dilate.

Option A: Blumberg's sign is rebound tenderness, which is a sign of peritoneal irritation (peritonitis), often seen in conditions like appendicitis or a perforated organ.
Option C: Blumberg sign is the same as Blumberg's sign (rebound tenderness) and indicates peritoneal inflammation, not a distended gallbladder from biliary obstruction.
Option D: Roger's sign is not related to abdominal pathology. It is a term used in cardiology.

Clinical Relevance

Nursing practice connection: Use the key finding related to Eponymous signs in abdominal assessment for biliary obstruction to guide bedside assessment, documentation, and the next nursing action.
Courvoisier's sign is a critical bedside finding that helps a nurse or physician to narrow down the differential diagnosis for obstructive jaundice, prioritizing investigation for malignancy.
A positive Courvoisier's sign warrants an urgent workup, typically starting with an ultrasound followed by CT or MRI, to identify the cause of obstruction, which is often pancreatic or biliary cancer.
What if? If the patient had a palpable gallbladder that was extremely tender on palpation, especially during inspiration (Murphy's sign), the diagnosis would shift from suspected malignancy to acute cholecystitis, which is inflammation of the gallbladder, usually caused by a gallstone.

How to Approach the Question

First, analyze the question stem to identify the key clinical findings: a palpable gallbladder and jaundice.
Recognize that this combination of signs points to a specific clinical eponym related to biliary obstruction.
Evaluate each option. Recall or deduce the meaning of each sign.
Eliminate Blumberg's sign, as it relates to peritonitis (rebound tenderness).
Eliminate Roger's sign, as it is a cardiac sign.
Identify Courvoisier's sign as the correct eponym that specifically describes a palpable, distended gallbladder in a jaundiced patient, typically due to malignant obstruction.

Concept Tested & Keywords

Concept Tested: Eponymous signs in abdominal assessment for biliary obstruction.
Stem keywords: Palpable gallbladder, jaundiced patient, biliary obstruction
Lead-in keywords: is called

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Practise the full KPSC Staff Nurse - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.