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Surgery > Abdominal Masses > Flashcards

Abdominal Masses Flashcards

0
Q

Causes of abdominal distension

A 
Flatus
Fat
Faeces
Fluid
Foetus
Flipping big tumour
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1
Q

Right Iliac Fossa Masses

A 
Appendix mass/abscess
Caecal carcinoma
Crohn's disease
Pelvic mass (fibroid, foetus, bladder, ovarian cyst/malignancy)
Intussusception 
TB mass
Amoebic abscess
Transplanted kidney
Kidney malformation
Tumour in undecended testis
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2
Q

Causes of ascites

A 
Malignancy
Infections - esp TB
Decreased albumin (eg nephrosis)
CCF; pericarditis
Pancreatitis
Myxoedema
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3
Q

Ascites with portal HTN

A

Cirrhosis
Budd-Chiari syndrome
IVC or portal vein thrombosis
Portal nodes

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4
Q

Ddx for left upper quadrant mass

A 
Spleen
Stomach 
Kidney
Colon
Pancreas
Neurofibromatoma
Pancreatic cyst
Pseudocyst
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5
Q

Causes of splenomegaly with fever

A

Infection (malaria/IE/EBV/TB/CMV/HIV/hepatitis)

Sarcoid; malignancy

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6
Q

Causes of splenomegaly with lymphadenopathy

A

Glandular fever
Leukaemias
Lymphoma
Sjögren’s syndrome

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7
Q

Causes of splenomegaly with purpura

A 
Septicaemia
Typhus
DIC
Amyloid
Meningococcaemia
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8
Q

Causes of splenomegaly with arthritis

A 
Sjögren's syndrome
RA
SLE 
Infection eg Lyme
Vasculitis/Behcet's
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9
Q

Causes of splenomegaly with ascites

A

Carcinoma

Portal hypertension

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10
Q

Causes of splenomegaly with a murmur

A

IE/SBE
Rheumatic fever
Amyloid
Hypereosinophilia

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11
Q

Causes of splenomegaly with anaemia

A

Sickle cell
Thalassaemia
Leukaemia
Pernicious anaemia

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12
Q

Causes of splenomegaly with weight loss and CNS signs

A 
Cancer
Lymphoma
TB
Arsenic poisoning
Paraproteinanemia
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13
Q

Causes of massive splenomegaly

A

Malaria
Myelofibrosis
CML

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14
Q

Ddx for smooth hepatomegaly

A 
Hapatitis
CCF 
Sarcoidosis
Early alcoholic cirrhosis
Tricuspid incompetence (-> pulsatile liver)
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15
Q

Ddx for craggy hepatomegaly

A

Secondaries or 1o hepatoma

16
Q

Features of a spleen

A

Arises in left hypochondrium, below tip of 10th rib
Can’t get above it
Moves downwards and medially on inspiration
May have a palpable notch on supero-medial edge
Dull to percussion

17
Q

Ddx for unilateral enlarged kidney

A

Renal cell carcinoma (Wilm’s in children)
Hydronephrosis
Simple cyst
Asymmetrical Polycystic kidney disease

18
Q

Features of an enlarged kidney

A 
Palpable in lumbar region
Descends vertically on inspiration
Bimanually palpable (ballotable)
Usually resonant to percussion unless very big
Can get above it (sometimes!)
19
Q

Adult Polycystic kidney disease

A

Autosomal dominant
Usually bilateral
Presents with bleeding, infection, abdominal pain
Hypertension
Chronic renal failure
Subarachnoid haemorrhage (due to poorly controlled HTN)
Often get renal transplant and leave Polycystic kidneys behind
PKD1 gene on chromosome 16 responsible for 85% of cases

Surgery (19 decks)

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