Clinical Skills

Question 1

Give 10 causes of Hepatomegaly

Answer 1

Physiological: Hyperextended chest, Riedel’s lobe
Alcoholic

Question 2

Give 10 causes of Hepatomegaly

Answer 2

Physiological: Hyperextended chest, Riedel’s lobe
Liver Disease: Fatty Liver, Alcoholic liver, Amyloid, Haemachromatosis, Wilson’s Disease, Sarcoidosis
Infective: Malaria, Hepatitis, EBV, CMV, Tb, Abscess
Malignant: HCC, Metastasis, Lymphoma, Leukemia
Portal HTN from RHF and Tricuspid regurg.

Question 3

What is Riedel’s lobe?

Answer 3

Anatomical variant of liver characterised by extension of the right lobe inferiorly (toward iliac crest)

Question 4

How large does a spleen have to be before it is palpable?

Answer 4

2x size

Question 5

Give the 3 causes of massive splenomegaly

Answer 5

3Ms
Malaria
CML
Myelofibrosis

Question 6

Give 6 causes of splenomegaly

Answer 6

Infective: Malaria, EBV, CMV, HIV
Metabolic: Amyloidosis
Malignant: CML, Myelofibrosis, Lymphoma
Portal HTN from RHF and Tricuspid regurg.
Haematological: Sickle Cell disease, Hemolytic anaemia
Trauma

Question 7

How would you differentiate between an enlarged spleen and an enlarged kidney? (5)

Answer 7

Spleen has a notch
Spleen moves with respiration
Kidney is ballotable
Kidney is Hyperresonant
Can get over Kidney, Cannot over spleen

Question 8

Go through the levels of the cervical lymph nodes

Answer 8

Question 9

Give 5 causes of an epigastric mass