Abdo Short Flashcards by Tan Kitipornchai | Brainscape

Q

Signs of alcoholic liver disease (7)

General inspection (2)

Hands (2)

Neuromuscular (3)

A

Cachexia

Parotid enlargement

Tremor

Dupuytren’s contracture

Cerebellar syndrome

Peripheral neuropathy

Myopathy

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Q

Peripheral signs of chronic liver disease

General inspection and face (3)

A

Cachexia

Jaundice - scleral icterus

Anaemia - conjunctival pallor

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Q

Peripheral signs of chronic liver disease

Hands (3)

A

Clubbing

Leuconychia (low albumin state)

Palmar erythema

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Q

Peripheral signs of chronic liver disease

Chest (3)

A

Spider Naevi

Gynaecomastia

Loss of body hair

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Q

Causes of cirrhosis (5 broad categories)

A

Alcohol

Viral - Chronic Hep B and Hep C

Autoimmune - hepatitis, PBC, PSC

Metabolic - NASH, HHC, A1 antitrypsin deficiency, Wilson’s

Drugs - Methotrexate, Isoniazid, Amiodarone, Phenytoin

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Q

Consequences of portal hypertension (3)

A

Oesopageal varices

Ascites

Hypersplenism / Thrombocytopaenia

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Q

Consequences of liver dysfunction (4) + (1)

A

Coagulopathy

Encephalopathy

Jaundice

Hypoalbuminaemia

Hepatocellular Carcinoma

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Q

Child Pugh Score Components (5)

A

Bilirubin <35 to > 52

Ascites

Encephalopathy

PT (INR)

Albumin >35 to < 28

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Q

Child Pugh Mortality

A

B

C

A

Child Pugh A 5-6: 90% survive 5 years

Child Pugh B 7-9: 80% survive 5 years

Child Pugh C 10: 33% one year mortality

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Q

Most common causes of ascites (5)

A

Cirrhosis

Malignancy

Heart failure

Tuberculosis

Pancreatitis

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Q

What is the Serum albumin - ascites gradient?

And what does it mean?

A

SA-AG = serum albumin - ascites albumin

if SA-AG > 11 = transudative

Ascites likely due to portal hypertension

if SA-AG < 11 = exudative

Ascites likely due to other causes other than portal HTN,
heart failure or veno-occlusive disease

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Q

Causes of hepatomegaly (5)

without splenomegaly

A

Viral hepatitis

Alcoholic hepatitis

Malignancy

Hepatic congestion (from cardiac fialrue)

Vascular liver disease (Budd-Chiari syndrome)

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Q

Causes of MASSIVE splenomegaly (5)

A

Chronic Myeloid Leukamia (CML)

Myelofibrosis

Splenic lymphoma

Malaria

Kala-azar

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Q

Causes of moderate splenomegaly (5)

A

Portal hypertension

Lymphoma

Leukaemia (acute or chronic)

Thalassaemia

Glycogen and lipid storage disease (Gaucher’s disease)

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Q

Causes of mild splenomegaly (5)

A

Other myeloproliferative diseases (PRV)

Haemolysis

Infection (HIV, EBV, infectious endocarditis)

Autoimmune Disease (RA, SLE)

Infiltrative conditions (Amyloid, Sarcoid)

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Q

RIF abdominal masses (5)

Infectious (3)

Malignant (2)

Other (2)

A

Appendiceal abscess

Psoas abscess

Ileocaecal TB

Caecal cancer

Ovarian tumour

Crohn’s Disease

Pelvic kidney

Q

LIF Abdominal masses (5)

A

Faeces (indent)

Sigmoid / colon cancer

Diverticular Disease

Psoas abscess

Ovarian tumour

Q

Upper abdominal mass

Features of normal organs (Liver / Spleen / Kidneys)

Pulsatile mass?

GI masses?

Other types of masses?

A

Liver - moves down with respiration, can’t get above

Spleen - moves down with respiration, can’t get above

Kidneys - balottable

AAA - pulsatile mass

Others: Stomach / Colon / Pancreatic

Retroperitoneal lymphadenopathy - lymphoma / teratoma

Q

Polycystic kidney disease

Clinical features (4)

A

Bilateral flank masses

Irregular in shape

Able to get above

Does not move with respiration

Q

What are the extra-renal manifestations of
Autosomal dominant polycystic kidney disease?

Brain

Liver

Heart

A

Cerebral aneurysms

Liver cysts (+/- pancreas, ovary, spleen)

Valvular heart disease - MVP and AR

Q

Differentials for bilateral flank masses? (4)

A

Simple renal cysts

Bilateral hydronephrosis

Amyloidosis

Von Hipple Lindau syndrome

Q

Complications of polycystic kidney disease

Pain

A

Pain secondary to stretching of the renal capsule

Acute flank pain - suggestive of haemorrhage or infection

If recurrent - consider nephrectomy!