Abdominal Flashcards

1
Q

Causes of cirrhosis?

A
Alcohol
Non alcoholic fatty liver disease
Infections (Hep B and C)
Autoimmune (PBC, PSC, autoimmune hepatitis)
Metabolic (hemochromatosis, Wilson's)
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2
Q

Causes of hepatomegaly?

A

Cirrhosis (alcohol, NAFLD, autoimmune)
Carcinoma (primary of secondary metastases)
Congestive cardiac failure
Infections (EBV, Hep B or C)
Infiltrative (amyloid or myeloproliferative disease)

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3
Q

What demonstrates decompensation of liver diseases?

A

asterixis
ascites
encephalopathy

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4
Q

investigations for patient with hepatomegaly

A

FBC, clotting, U&Es, LFTs and glucose
USS abdomen
ascitic tap
if cirrhosis proven; autoantibodies, hep B/C serology, ferritin, caeruloplsmin, alpha-1 antitrypsin, AFP

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5
Q

What autoantobodies are associated with autoimmune hepatitis?

A

anti - smooth muscle antibodies

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6
Q

What autoantibodies are associated with primary biliary cirrhosis?

A

anti-mitochondrial antibodies

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7
Q

Causes of ascites?

A

cirrhosis, carcinoma, CCF

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8
Q

Causes of gynaecomastia?

A
age
Kleinfelter's
cirrhosis
drugs (spironolactone, digoxin)
testicular tumour
thyroid disease
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9
Q

What is the prognostic classification score for cirrhosis?

A

Child-Pugh classification

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10
Q

vitamin K is a cofactor for which coagulation factors?

A

II, VII, IX, X and for proteins C and S

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11
Q

Signs of haemochromatosis?

A

pigmented skin, signs of chronic liver disease, hepatomegaly, venesection, joint replacements, finger prick marks from CBG testing

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12
Q

Conditions associated with haemochromotosis other than chronic liver disease?

A
arthopathy due to pseudogout
diabetes
cardiomyopathy or cardiac conduction abnormalities
hepatocellular carcinoma
hypogonadism
osteoporosis
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13
Q

What is the genetics of haemochromotosis?

A

autosomal recessive mutation on HFE gene on chromosome 6

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14
Q

How to investigate for haemochromotosis?

A

ferritin (increased) and transferrin saturation (increased), liver biopsy, genotyping, blood glucose, ECG, CXR, echo, , liver USS, AFP,

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15
Q

Causes of massive splenomegaly >8cm enlargement (>20cm total spleen); (name 3)

A

CML
myelofibrosis (primary or secondary due to polycythaemia ruba vera or essential thrombocytosis)
malaria

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16
Q

Most common causes of splenomegaly in UK, any size?

A

EBV
portal hypertension
myeloproliferative disease

17
Q

Causes of moderate splenomegaly (4-8cm enlargement)?

A
Myeloproliferative disease (CML, myeofibrosis, Polycythaemia rubra vera, essential thrombocytosis)
Lymphoproliferative disease (lymphoma, acute and chronic lymphocytic leukaemias, multiple myeloma)
Infiltration (amyloidosis or Gaucher's disease)
18
Q

Causes of mild spenomegaly (tip)?

A

Portal hypertension
Haemolytic anaemia
Infections (EBV, endocarditis, hepatitis)
myelo and lymphoproliferative disorders

19
Q

Investigations for spelnomegaly

A
FBC, blood film, LFTs, 
USS abdomen
CT chest and abdomen
Bone marrow aspirate
Lymph node biopsy
Malaria films
Viral serology
20
Q

How should a splenectomy patient be managed?

A

Vaccination (ideally 2/52 before if planned)
pneumococcus, meningococcus, haemophilus influenza,
Prophylactic penicillin
Medic alert

21
Q

Indications fora splenectomy

A

trauma
ITP
hereditary spherocytosis

22
Q

Causes for single kidney enlargement

A

hydronephrosis
tumour
simple cysts
polycystic kidney disease

23
Q

Causes of bilateral kidney enlargement

A
polycystic kidney disease
bilateral renal cell carcinoma
bilateral hydronephrosis
amyloidosis
tuberous sclerosis (renal angiolipomata and cysts)
24
Q

Tuberous sclerosis - signs?

A
Ash leaf macules >6
periungal fibromas
adenoma sebacecum on the face
shagreen patches
epilepsy
25
What is tuberous sclerosis?
genetic disorder causing hamartomas (skin, brian and kidneys). autosomal dominant. typically presents in childhood with epilepsy and typical skin changes