Hernia Hernia Symptoms and Diagnosis 2 — Questions and Answers
Question 1: What term describes a hernia that cannot be manually reduced back into the abdominal cavity?
- Reducible
- Incarcerated (Correct answer)
- Occult
- Sliding
Correct answer: Incarcerated
An incarcerated hernia is one that cannot be returned to the abdominal cavity, raising the risk of strangulation.
Question 2: Which sign on physical exam involves palpating an impulse along the inguinal canal when the patient coughs?
- Murphy's sign
- Cough impulse sign (Correct answer)
- Obturator sign
- Psoas sign
Correct answer: Cough impulse sign
A palpable cough impulse along the inguinal canal is a classic physical finding in inguinal hernia examination.
Question 3: What is the Howship-Romberg sign associated with?
- Inguinal hernia
- Femoral hernia
- Obturator hernia (Correct answer)
- Hiatal hernia
Correct answer: Obturator hernia
The Howship-Romberg sign—pain radiating to the medial thigh on hip extension—is pathognomonic for obturator hernia.
Question 4: CT scan is preferred over ultrasound for hernia diagnosis in which scenario?
- Uncomplicated groin bulge
- Suspected occult or internal hernia causing bowel obstruction (Correct answer)
- Pediatric umbilical hernia
- Routine pre-operative assessment
Correct answer: Suspected occult or internal hernia causing bowel obstruction
CT is superior for detecting internal or occult hernias and for evaluating complications such as bowel obstruction or strangulation.
Question 5: Which symptom is typically absent in a reducible hernia but present in an incarcerated one?
- A visible bulge
- Constant, severe local pain at rest (Correct answer)
- Bulge enlarging with coughing
- Groin discomfort with exercise
Correct answer: Constant, severe local pain at rest
Constant pain at rest indicates the hernia contents are trapped and potentially ischemic, unlike a reducible hernia which is usually asymptomatic at rest.
Question 6: What gastrointestinal symptom may be present with a large incarcerated hernia containing bowel?
- Diarrhea
- Constipation and inability to pass gas (Correct answer)
- Increased appetite
- Heartburn
Correct answer: Constipation and inability to pass gas
Obstruction of the trapped bowel segment causes cessation of flatus and stool, a hallmark of bowel obstruction.
Hernia Hernia Symptoms and Diagnosis 2
What term describes a hernia that cannot be manually reduced back into the abdominal cavity?