Abdominal masses

Question 1

right iliac fossa masses

Answer 1

appendix mass/abscess; crohns; pelvic mass; intussusception; TB masss; transplanted kidney; kidney malformation; tumour in an undescended testis

Question 2

abdominal distention

Answer 2

flatus, fat, faeces, fetus

Question 3

causes of ascites

Answer 3

malignancy, infections, decr albumin, CCF, pericarditis, pancreatitis, myxoedema

Question 4

causes of ascites with portal hypertension

Answer 4

cirrhosis, portal nodes, IVC or portal vein thrombosis

Question 5

tests in abdominal distension

Answer 5

aspirate ascitic fluid- cytology, culture, protein level; US

Question 6

left upper quadrant mass

Answer 6

spleen, stomach, kidney, colon, pancrease or a rare cause eg neurofibroma.

Question 7

causes of splenomegaly with fever

Answer 7

infection (malaria, hepatitis, EBV, TB, CMV, HIV), sarcoid, malignancy

Question 8

causes of splenomeg with lymphadenopathy

Answer 8

glandular fever, leukaemia, sjogrens

Question 9

splenomeg with purpura

Answer 9

septicaemia, DIC, amyloid,meningococcocaemia

Question 10

splenomeg with arthritis

Answer 10

sjogrens, RA, SLE, infection, vasculitis/behcets

Question 11

splenomeg with ascites

Answer 11

carcinoma, portal HTN

Question 12

splenomeg with a murmur

Answer 12

SBE/IE, rheumatic fever, amyloid

Question 13

splenomeg with anaemia

Answer 13

sickle cell, thalassaemia, leukaemia, pernicious naaemia

Question 14

splenomeg with weight loss and CNS signs

Answer 14

cancer, lymphoma, TB, paraproteinaemia

Question 15

massive splenomeg

Answer 15

malaria, myelofibrosis

Question 16

smooth hepatomegaly

Answer 16

hepatitis, CCF, sarcoidosis, early alcoholic cirrhosis

Question 17

craggy hepatomegaly

Answer 17

secondaries or primary hepatoma

Question 18

investigations

Answer 18

CT, US, IVU, liver and spleen radioisotope scan, mantoux test, routine tests, MRI

Question 19

pelvic masses

Answer 19

fibroids, fetus, bladder, ovarian cyst or malignancy