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PACES > Abdominal > Flashcards

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
Q

What is tuberous sclerosis?

A

genetic disorder causing hamartomas (skin, brian and kidneys). autosomal dominant. typically presents in childhood with epilepsy and typical skin changes

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