Family Nurse Practitioner Exam

What is the best description of Cullen's sign?

1. A reddish-purple discoloration that is located on the flank area

2. A bluish discoloration or bruising that is located on the umbilical area

3. The onset of hyperactive bowel sound before the onset of ileus

4. The acute-onset subcutaneous bleeding seen during acute pancreatitis

The correct answer is: A bluish discoloration or bruising that is located on the umbilical area

Cullen's sign is characterized by a bluish discoloration around the umbilical area, which may indicate the presence of intra-abdominal bleeding. This sign can be seen in conditions such as pancreatitis, ectopic pregnancy, or ruptured abdominal aortic aneurysms, where bleeding leads to tissue necrosis and subsequent bruising in the skin surrounding the navel. This discoloration occurs due to the accumulation of blood within the subcutaneous tissue, leading to the distinctive blue hue. In contrast, other descriptions provided pertain to different signs or symptoms of various medical conditions. The reddish-purple discoloration mentioned relates to Grey Turner's sign, which indicates flank bruising and is more associated with retroperitoneal bleeding. Hyperactive bowel sounds are more indicative of conditions that irritate the gastrointestinal tract, such as early obstruction or infectious processes. Acute-onset subcutaneous bleeding, while relevant to the context of bleeding disorders or certain acute conditions, does not specifically define Cullen's sign. Understanding the specific characteristics of these signs can aid in the clinical assessment and management of abdominal and systemic pathologies.