The appearance of distended and engorged superficial epigastric veins is known as which of the following?

DSSSB 12 August 2024

Medical Surgical Nursing

Easy

Appeared in: DSSSB 12 August 2024

Explanation

Caput medusae is the medical term for a network of distended, engorged veins radiating from the umbilicus across the abdomen.
This sign is a direct consequence of severe portal hypertension, a condition where blood pressure in the portal vein system is abnormally high, often due to liver cirrhosis.
The high pressure causes the reopening (recanalization) of the umbilical vein, which creates a collateral pathway for blood to bypass the obstructed liver, leading to the visible venous pattern.

Option A: Palmar erythema is the reddening of the palms, particularly the thenar and hypothenar eminences. It is not related to distended abdominal veins.
Option C: A spider angioma (or spider naevus) is a small, central red arteriole with fine, radiating vessels, resembling a spider. It is typically found on the face, neck, and upper trunk.
Option D: Erythema migrans is a characteristic skin rash of Lyme disease, a tick-borne illness. It typically appears as an expanding red ring, often with central clearing ('bull's-eye' appearance).

Clinical Relevance

Nursing practice connection: Knowing Clinical signs of portal hypertension and chronic liver disease helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
The presence of caput medusae is a significant physical finding that indicates advanced liver disease and severe portal hypertension.
Its identification should prompt the nurse to assess for other complications of portal hypertension, such as ascites, splenomegaly, and especially esophageal varices, which carry a high risk of life-threatening hemorrhage.
What if? If the patient had distended veins on the flanks rather than around the umbilicus, this would still suggest portal hypertension creating collateral circulation, but the specific term 'caput medusae' would not apply. It would be described as dilated abdominal wall collaterals.

How to Approach the Question

This is a factual recall question that tests your knowledge of specific clinical signs.
First, identify the key descriptive phrase in the question stem: 'distended and engorged superficial epigastric veins'.
Recognize that this describes a specific, named medical sign related to abdominal circulation.
Evaluate the options to find the correct medical term that matches this exact description.
Differentiate the correct term from other options. Note that Palmar erythema and Spider angioma are also signs of liver disease but have different appearances and locations. Erythema migrans is a sign of an unrelated infectious disease.

Concept Tested & Keywords

Concept Tested: Clinical signs of portal hypertension and chronic liver disease.
Stem keywords: distended, engorged, superficial epigastric veins
Lead-in keywords: known as
Negative lead-in flag: false

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