Gastroenterology Flashcards
Differential diagnosis in liver palpation
- Massive hepatomegaly:
a. metastases,
b. alcoholic liver disease with fatty infiltration
c. myeloproliferative disease
d. right heart failure
f. hepatocellular carcinoma - moderate
a. the above causes
b. haemochromatosis
c. haematological disease- CML, lymphoma
d. fatty liver - obesity, diabetes mellitus, toxins - mild
a. the above causes
b. hepatitis
c. cirrhoiss
d. biliary obstruction
f. HIV infection
g. amyloidosis and other infiltrative disease
h. granulomatous disease
causes of hepatosplenomegaly
- chronic liver isease with portal hypertension
- haematological disease- myeloproliferative diseae, lymphoma, leukemia, sickle cell anaemia
- infection - acute viral hepatitis, glandular fever, cytomegalovirus
- infiltration - amyloidosis, sarcoidosis
- connective tissue disease-SLE
- acromegaly
- thyrotoxicosis
right iliac fossa mass
appendiceal abscess carcinoma of the caecum Crohn's disease pelvic kidney Ovarian tumour or cyst Carcinoid tumour Amoebiasis Psoas abscess Ileocaecal tuberculosis
left iliac fossa
faeces carcinoma of sigmoid or descending colon diverticular disease Ovarian tumouror cyst psoas abscess
upper abdomen mass
retroperitoneal lymphadenopathy abdominal aortic aneurysm (pulsatile) carcinoma of stomach pancreatic pseudocyst or tumour pyloric stenosis carcinoma of transverse colon
what is in MEN1
TAP3
thyroid, adrenal parathyroid, pituitatry, pancrea
what is in MEN2A
TAP
throyd, adreanl parathyroid
WhBat is in MEN2
MNP
Medullary thyroid cancer
Neuromas
Pheocromacytoma
what are the signs of alcohol misuse?
cachexia tremor parotid enlargement dupuytren's contracture cerebellar syndrome peripheral neuropathy myopathy
What are the consequences of cirrhosis:
Consequences of portal hypertension - oesophageal varices - ascites - hyperspenism/thrombocytopenia cosnequences of liver dysfunction - coagulopathy - encephalopahty - jaundice - hypoalbuminaemia Hepatocellular carcinoma
causes of transudate acites
related to portal hyeprtension (serum-to-ascites albumin >11g/L
a. cirrhosis
b. alcoholic hepatitis
c. cardiac ascites(right heart failure or constrictive pericarditis)
d. Budd-chiari syndorme (hepatic vein thrombosis ) or inferior venal caval obstruction
DD of tender hepatomegaly?
infectious disease(viral hepatitis) alcoholic hepatitis malignancy hepatic congestion )cardiac failure vascular liver disease (budd chiari syndrome)
what are the infective causes of acute hepatitis?
hepatitis A,B,CE
EBV, CMV
toxoplasmosis
herpes simplex virus
causes of exudated fluid?(SAAG
not related to portal hypertension
a. peirtoneal carcinomatosis
b. peritoneal tuberculosis
c. pancreatitis
d. nephrotic syndrome
