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Short case lists > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What are the causes of hepatosplenomegaly?

A

CHIICAT

  • Chronic liver disease with portal hypertension
  • Haematological diseases: lymphoma, myeloproliferative disease, leukemia
  • Infections: viral hepatitis, CMV, EBV
  • Infiltrative: sarcoidosis, amyloidosis
  • Connective tissue: SLE
  • Acromegaly
  • Thyrotoxicosis
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2
Q

Causes of massive hepatomegaly?

A

Al My Right Hand Man

  • Alcoholic liver disease with fatty infiltration
  • Myeloproliferative disease
  • Right heart failure
  • Hepatocellular carcinoma
  • Metastasis
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3
Q

Causes of moderate hepatomegaly?

A

(Al My Right Hand Man) Has Hairy Feet

  • Haemachromatosis
  • Haematological diseases: CML, lymphoma
  • Fatty liver - obesity, diabetes myelitis, toxins
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4
Q

Causes of mild hepatolmegaly?

A

(Has hairy feet)

  • Infiltrative: sarcoidosis, amyloidosis
  • Infection: Hepatitis, HIV, granulomatosis
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5
Q

What are causes of firm and irregular liver?

A
  • Cirrhosis
  • Hepatocellular carcinoma
  • Cysts, hydatid disease, granulomas, amyloid
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6
Q

What are causes of tender liver?

A
  • Hepatitis
  • HCC
  • Rapid liver enlargement: RHF, Budd Chiari syndrome
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7
Q

What are causes of pulsatile liver?

A
  • Tricuspid regurgitation
  • HCC
  • Vascular abnormality
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8
Q

Causes of renal masses (bilateral)?

A

Poly Ha Ha Ah Ah Ah

  • Polycystic kidney disease
  • Hydronephrosis or pyonephrosis
  • Hypernephroma (bilateral renal cell carcinoma)
  • Acute renal vein thrombosis (bilateral)
  • Acromegaly
  • Amyloid, lymphoma and other infiltrative diseases
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9
Q

Causes of unilateral renal masses?

A

Poly Ha Ha Ah No

  • Polycystic kidney diease
  • Hydronephosis/pyonephrosis
  • Renal cell carcinoma
  • Acute renal vein thrombosis
  • Normal right kidney or a solitary kidney
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10
Q

If you find polycystic kidney disease on exam, what do else do you want to examine for in extra time?

A
  • BP
  • Urinalysis - haematuria, proteinuria
  • Anaemia/polycythemia
  • Hepatic cysts, splenic cysts
  • Can discuss cerebral aneurysm screening
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11
Q

Causes of massive splenomegaly

A

Chris My Pimp Hairy Man Kala-Azar

  • CML
  • Myelofibrosis
  • Primary lymphoma
  • Hairy cell leukemia
  • Malaria
  • Kala-Azar
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12
Q

Causes of moderate splenomegaly?

A

Causes of massive splenomegaly + Poor Little Lucy Standing There

  • Portal hypertension
  • Lymphoma
  • Leukemia
  • Storage diseases (Gaucher)
  • Thalassemia
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13
Q

Causes of Right Iliac Fossa Mass

A
  • Appendiceal abscess
  • Carcinoma of caecum
  • Crohn’s disease
  • Pelvic kidney
  • Ovarian tumour or cyst
  • Carcinoid tumour
  • Amoebiasis
  • Psoas abscess
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14
Q

Causes of Left Iliac Fossa masses

A
  • Faeces
  • Carcinoma of sigmoid or descending colon
  • Diverticular disease
  • Ovarian tumour or cyst
  • Psoas abscess
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15
Q

Causes of upper abdominal mass?

A
  • Retroperitoneal lymphadenopathy (lymphoma/teratoma)
  • Abdominal aortic aneurysm
  • Carcinoma of stomach
  • Pancreatic pseudocyst
  • Pyloric stenosis
  • Carcinoma or transverse colon
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16
Q

How to distinguish between a spleen and a kidney?

A
  • Spleen has no palpable border
  • Spleen has a notch
  • Spleen moves inferomedially on inspiration
  • There is no resonance over a splenic mass
  • Spleen is not ballotable
  • Friction rub may be heard over spleen
17
Q

Signs of decompensated liver disease?

Staging?

A

Any complication of cirrhosis: (4+3)

  • Ascites
  • SBP
  • Variceal haemorrhage
  • Hepatic encephalopathy
  • Hepatorenal syndrome
  • Hepatopulmonary syndrome
  • HCC

Child Pugh Staging

  • Bilirubin
  • INR
  • Albumin
  • Ascites
  • Encephalopathy
18
Q

Signs of portal hypertension

A
  • Caput medusa
  • Ascites
  • Splenomegaly
  • Oesophageal/gastric varices; haemorrhoids
19
Q

Indications for HCC screening?

A
  • Surveillance - 6 monthly liver USS and AFP
    • Indications
      • Anyone with cirrhosis
      • In chronic HBV: FHx/PMHx HCC, Asian men >40 or women >50; africans >20
      • HBV >40yo w high HBV DNA and high ALT
20
Q
A

Short case lists (2 decks)

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