Gastro Osce Flashcards
A smooth enlarged liver would be indicative of _____
Venous congestion, Fatty infiltration
A Knobbly liver edge would be indicative of ______
Metastasis / Cysts
A pulsatile liver is associated with _________
TR
A tender liver would be indicative of ________
Hepatitis, RHF (capsular pain)
A bruit of the liver would indicate __________
Hepatocellular carcinoma , AV malformation
Multifactorial aetiology of ascites
1) Portal hypertension
2) Hypoalbuminaemia
3) Salt and water retention (RAAS activation)
Causes of gynaecomastia
1) Physiological (puberty and elderly)
2) Testicular failure
- Klinefelters syndrome
- Viral orchitis / Testicular trauma
- Haemodialysis
3) Increase oestrogen
- Chronic liver disease
- Thyrotoxicosis
- Oestrogen secreting tumour
4) Drug induced (DISCO MTV)
- Digoxin
- Isoniazid
- Spironolactone
- Cimetidine and Calcium channel blockers
- Oestrogen
- Methyldopa
- Tricyclics
- Verapamil
What are the main causes of hepatosplenomegaly
Infection - Hepatitis - EBV - Malaria Haematological - Lymphoma - Leukaemia - Myelofibrosis - Haemolytic anaemia Infiltrative - Sarcoid and amyloid
Extra-intestinal manifestations of IBS
- Finger clubbing
- Mouth ulcers
- Eyes
- episcleritis
- conjunctivitis
- Skin
- erythema nodosum
- Pyoderma gangrenosum
- Joints
- Seronegative Spondyloarthropathy
- PSC (especially Ulcerative colitis)
- Amylodosis (especially Crohn’s)
What are the causes of transudate ascities
Transudate (Protein < 30g/L)
- CLD
- CCF
- Volume overload
- Hypoalbuminaemia
- Constrictive pericarditis
What are the causes of Exudate ascites
Exudate (Protein >30g/L)
- Infection - TB, Pyogenic infection
- Inflammation -Pancreatitis
- Malignancy - luminal, Pancrease, Liver, Ovarian, Lymphoma
Infectious causes of hepatomegaly?
Infection
- hepatits
- EBV
- Malaria
- Liver abscess
Neoplastic causes of hepatomegaly?
Neoplastic
- Primary
- Metastatic
Congestive causes of hepatomegaly?
- RHF
- Tricuspid regurgitation
- Budd-Chiari syndrome
Haematological causes of Hepatomegaly
Haematological
- Lymphoma / Leukaemia
- Myelofibrosis
- Sickle cell and haemolytic anaemia
Infiltrative causes of hepatomegaly
Infiltrative
- Sarcoid / Amyloid
- Haemochromatosis
- Fatty liver
Billiary causes of hepatomegaly
Billiary
- Primary billiary sclerosis
- Primary sclerosing cholangitis
Causes of a massive splenomegaly (past umbilicus)
Massive (MM) - past umbilicus
- Malaria
- Myeloproliferative (myelofibrosis, CML)
Causes of moderate splenomagaly (up to umbilicus)
Moderate - up to umbilicus
- Lymphoma / Leukaemia
- Portal Hypertension
- Haemolytic anaemia
Causes of a mild splenomegaly
Mild - Hard to grip
- Glandular fever
- RA (felty’s syndrome)
- Infective endocarditis
- Pernicious anaemia
