Enlarged spleen or liver

Question 1

Causes of splenomegaly

Answer 1

chronic Myeloid leukaemia
Myelofibrosis
Malaria

Question 2

Causes of hepatomegaly

Answer 2

Malignancy (metastatic or primary)
Hepatic congestion
Anatomical - Riedel’s lobe (normal variant)
Infection
Haematological
Others: Fatty liver, Porphyria, amyloidosis, glycogen storage disorders

Question 3

Cause of hepatic congestion (that results in hepatomegaly)

Answer 3

Right heart failure

Hepatic vein thrombosis (Budd-Chiari syndrome)

Question 4

Infectious causes of hepatomegaly

Answer 4

Infectious mononucleosis (glandular fever)
Hepatitis viruses
Malaria
Schistosomiasis
Amoebic abscess
Hydatid cyst

Question 5

Haemotological causes of hepatomegaly

Answer 5

Leukaemia
Lymphoma
Myeloproliferative disorders e.g. myelofibrosis
Sickle cell disease
Haemolytic anaemia

Question 6

Differentiating an (enlarged) spleen from an enlarged kidney

Answer 6

Cannot get it above ribs
Dull to percussion
Moves towards RIF with inspiration (kidney tho moves downwards)
May have palpable notch on its medial side