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Shorties > Abdo > Flashcards

Abdo Flashcards

1
Q

What are the signs of portal hypertension on examination?

A 
Ascites
Bleeding, varices, purpura
Caput medusae
Diminished liver
Enlarged spleen
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2
Q

What are the findings in decompensated chronic liver disease?

A

Findings associated with decompensated cirrhosis are:

  • Oesophageal variceal bleeding
  • Hepatic encephalopathy
  • Ascites
  • SBP
  • HCC
  • Hepatorenal syndrome
  • Hepatopulmonary syndrome
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3
Q

What are the possible aetiologies of chronic liver disease?

A

Chronic viral hepatitis (B, C)
Alcohol-associated
Haemochromatosis
MAFLD

Less common:
Autoimmune
Primary and secondary biliary cirrhosis
PSC
Medications (MTX, isoniaid)
Wilson disease
Coeliac disease
Alpha-1 antitrypsin deficiency
Polycystic liver disease
Infection (eg brucellosis, syphilis, echinococcosis)
R side heart failure
Hereditary haemorrhagic telangiectasia
Veno-occlusive disease
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4
Q

What features would lead you to diagnose PCKD?

A

Patients with ADPKD can present with hypertension, hematuria, proteinuria, or kidney function impairment. Flank pain, due to kidney hemorrhage, obstructive calculi, or urinary tract infection, is the most common symptom reported by patients

Flank fullness
Ballotable kidneys
Cerebral aneurysms

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5
Q

How do you differentiate L) renal mass from spleen?

A
  • Spleen moves down and medial, compared with kidney which moves downwards but not medially
  • Spleen has a notch on its upper border (spleen needs to be at least moderate for a notch to be appreciated)
  • Spleen is not ballotable
  • Cannot get above a spleen
  • Splenomegaly causes dullness in Traube’s space
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6
Q

What are extra-renal manifestations of PCKD?

A

Cerebral aneurysms

Poly cystic liver disease

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7
Q

What are side effects of ISx that may be found on examination?

A
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8
Q

How would you investigate Kidney transplant graft function?

A
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9
Q

Where is the liver span measured?

A

Mid-clavicular line

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10
Q

What liver span defines massive hepatomegaly?

A

Massive hepatomegaly >20 cm

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11
Q

What liver span defines moderate hepatomegaly?

A

Moderate hepatomegaly: 15 - 20 cm

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12
Q

What are the differential diagnoses for massive hepatomegaly?

A

Myelofibrosis
Myelodysplasia
Liver metastases, hepatocellular carcinoma
Chronic liver disease with fatty infiltrate
Tricuspid regurgitation (pulsatile liver)

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13
Q

What are the differential diagnoses for moderate hepatomegaly?

A 
As for massive hepatomegaly
Haemochromatosis
Myelodysplasia
CML
Lymphoma
MAFLD
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14
Q

What are the differential diagnoses in mild hepatomegaly?

A

Same as for moderate/massive hepatomegaly

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15
Q

What are the differentials for marked splenomegaly?

A

Myelofibrosis
CML
Myelodysplasia

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16
Q

What are the differentials for moderate splenomegaly?

A

Lymphoma
CLL
PRV
Portal hypertension (with CLD, liver may be small due to cirrhosis)

17
Q

What are the differentials for mild splenomegaly?

A

PRV, ET, haemolytic anaemia, ITP
Connective tissue disorders
Sarcoid, amyloid
Portal hypertension (with signs of CLD)

18
Q

What are the differential diagnoses for hepatosplenomegaly?

A
  • CLD but ONLY if there is a concurrent infiltrative disorder (Fatty liver, haemochromatosis, hepatitis, hepatoma, amyloid, sarcoid)
  • Acute infections
  • Infiltrative disorders: Lymphoid, amyloid
  • Connective tissue diseases
  • Myelofibrosis, myelodysplasia (CML)
  • CLL, Lymphoma
19
Q

What are the differential diagnoses for massive hepatomegaly and splenomegaly?

A

Myelofibrosis

Myelodysplasia (CML/CMML)

20
Q

What are the differentials for moderate hepatomegaly and moderate splenomegaly?

A

Myelofibrosis
Myelodysplasia (CML/CMML)
CLL
Lymphoma

21
Q

What are the anatomic landmarks of Traube’s space?

A

Superior: Left 6th rib
Lateral: Left mid axillary line
Inferior: Left costal margin

22
Q

Normal liver span?

A

12 cm

23
Q

mildly enlarged liver span?

A

12 - 15cm

24
Q

Moderately enlarged liver span?

A

15-20

25
Q

Massively enlarged liver span?

A

> 20 cm

26
Q

Massive hepatomegaly - differentials

A

Myelofibrosis, myelodysplasia
Secondaries or hepatoma
CLD with fatty infiltration or hepatoma - look for evidence of CLD
TR, pulsatile

27
Q

Moderate hepatomegaly - differentials

A

As for massive
Haemochromatosis
Myelodysplasia, CML, Lymphoma
Fatty liver, metabolic syndrome, diabetes etc.

28
Q

Massive splenomegaly - differentials

A

Myelofibrosis
CML
Myelodysplasia

29
Q

Moderate splenomegaly - differentials

A

Lymphoma, CLL, PRV

Portal hypertension

30
Q

Mild splenomegaly - differentials

A 
PRV, ET, Haemolytic anaemia, ITP, Thalassaemia, Sickle cell
Acute leukaemia, epecially AML
CTD
Sarcoid, amyloid
Acromegaly
Portal hypertension (with signs of CLD)
31
Q

Hepato-splenomegaly - differentials

A
  • CLD but ONLY if there is a concurrent infiltrative disorder (Fatty liver, haemochromatosis, hepatitis, hepatoma)
  • Acute infections
  • Infiltrative disorders: Lymphoid, amyloid
  • Connective tissue diseases
  • Myelofibrosis, myelodysplasia (CML)
  • CLL, Lymphoma
32
Q

Abdo inspection - 10 things

A 
Patient's age
Patient's face (PCV, jaundice, drowsiness)
Body (malnourished, cachectic)
Flanks
Umbilicus
Organs, liver, spleen, kidneys
Scars (renal transplant, tenkhoff catheters)
Veins
Masses
Tubes

Shorties (6 decks)

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