Bluish discoloration of periumbilical area

Turner's sign is? - JIPMER Nursing Officer-2024

JIPMER Nursing Officer-2024

Medical & Surgical Nursing

Easy

Appeared in: JIPMER Nursing Officer-2024

Explanation

Turner's sign is the clinical term for ecchymosis (bruising) or bluish discoloration appearing on the flanks, which is the area between the ribs and the hip.
It is a key indicator of retroperitoneal hemorrhage, which is bleeding in the space behind the main abdominal cavity.
This sign is most commonly associated with severe, acute necrotizing pancreatitis, but can also be seen in abdominal trauma or a ruptured aortic aneurysm.

Option A: Redness of the skin is known as erythema. It is caused by increased blood flow due to inflammation, infection, or allergic reactions, not by retroperitoneal hemorrhage.
Option C: Bluish discoloration around the periumbilical (belly button) area is known as Cullen's sign. Although it also indicates intra-abdominal bleeding, its location is different from Turner's sign.
Option D: Flapping of the fingers is known as asterixis. It is a neurological sign of metabolic encephalopathy and is not related to skin discoloration or hemorrhage.

Visual 1: Clinical Photograph - An image showing the characteristic bluish-purple discoloration on a patient's flank to illustrate Turner's sign.
Visual 2: Anatomical Diagram - A diagram showing the retroperitoneal space and how blood from a source like the pancreas can track along fascial planes to the flanks.
Visual 3: Comparison Image - A side-by-side photo showing Turner's sign on the flank and Cullen's sign around the umbilicus to highlight the difference in location.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Eponymous signs of intra-abdominal and retroperitoneal hemorrhage as background academic context rather than a clinical decision trigger.
Recognizing Turner's sign is a critical nursing assessment skill, as it can be an early indicator of a life-threatening internal hemorrhage requiring immediate medical intervention.
Its presence, especially alongside Cullen's sign and symptoms like severe abdominal pain, hypotension, and tachycardia, warrants urgent escalation to the medical team for diagnostic imaging (like a CT scan) and management.
What if? If a patient with abdominal pain develops bluish discoloration around the umbilicus instead of the flanks, the nurse would document Cullen's sign. This still indicates a high suspicion of intra-abdominal bleeding and requires the same urgent response.

How to Approach the Question

First, identify the key term in the question stem: 'Turner's sign'.
This is a factual recall question that tests your knowledge of medical eponyms (signs named after people).
Access your memory for the definition of Turner's sign and related clinical signs.
Evaluate each option against the definition. 'Bluish discoloration of flanks' directly matches the definition of Turner's sign.
Differentiate it from other signs: 'Bluish discoloration of periumbilical area' is Cullen's sign, 'Redness' is erythema, and 'Flapping' is asterixis. Select the option that correctly defines the term.

Concept Tested & Keywords

Concept Tested: Eponymous signs of intra-abdominal and retroperitoneal hemorrhage
Stem keywords: Turner's sign
Lead-in keywords: is

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