Gastrointestial

Question 1

What are the 5 signs of chronic liver disease?

Answer 1

Hormonal: 1. Spider naevi 2. Gynaecomastia 3. Testicular atrophy Hands: 4. Palmar erythema 5. Clubbing 6. Leukonychia (hypoalbuminaemia) Others: 7. Hepatic fetor on breath 8. Purpura 9. Hepatic flap 10. Scratch marks 11. Muscle wasting 12.Jaundice

Question 2

What are the 4 signs of liver failure?

Answer 2

a. Fetor
b. Ascites
c. Oedema
d. Coagulopathy
e. Encephalopathy (Hepatic flap)
f. Jaundice

Question 3

What are the 3 signs of portal hypertension?

Answer 3

1. Caput medusa
2. Ascites
3. Melaena
4. PR Bleeding

Question 4

What are the 2 signs of alcohol abuse?

Answer 4

1. Parotits
2. Dupuytren’s contracture

Question 5

anti-GBM is positive in people with?

Answer 5

Goodpasture’s syndrome

Question 6

What are the causes of obstructive jaundice?

Answer 6

C, N, S, C, P, S, A, N (mnemonics - CNS Collective SPAN)

Cholelitihiasis

Neoplasia - Cancer of the head of pancreas: often presents with OJ; Bile duct (cholangiocarcinoma); Ampulla

Sclerosing cholangitis

Congenital biliary atresia - Failure of normal bile duct formation, and often accompanied reduction in the number of intra- hepatic ducts

Strictures (often following surgery)

Pancreatitis +/- pseudocysts

Accidental (..surgical ligation of the CBD)

Non-pathological cause - Gallbladder dyskinesia - Acalculous cholecystitis

Question 7

What are the causes of portal hypertension?

Answer 7

Prehepatic Portal vein thrombosis Intrahepatic pre-sinusoidal Schistosomiasis Sarcoidosis Primary biliary cirrhosis sinusoidal cirrhosis (e.g. alcoholic) partial nodular transformation post-sinusoidal veno-occlusive disease Budd-Chiari syndrome Posthepatic RHF (rare) Constrictive pericarditis IVC obstruction

Question 8

What are the causes of jaundice?

Answer 8

a. Haemolytic jaundice: increase bilirubin load for the liver cells. e.g. excessive Hb destruction, sickle cell anemia, G6PD deficiency, HUS (Hemolytic-uremic syndrome) b. Congenital hyperbilirubinaemia: defects in conjugation c. Cholestatic jaundice, incl. hepatocellular (parenchymal - The parenchyma are the functional parts of an organ in the body. This is in contrast to the stroma, which refers to the structural tissue of organs, namely, the connective tissues.) liver disease and ;large duct obstruction.

Question 9

What are the causes of liver failure?

Answer 9

VINDICATE

Question 10

What are the classical signs of Budd-Chiari syndome?

Answer 10

Triad of: abdo. pain acites hepatomegaly