GI/Abdo findings

Question 1

Firm + irregular liver

Answer 1

cirrhosis, metastatic Dx, hydatid Dx, granuloma, amyloid, cysts

Question 2

Tender liver edge

Answer 2

hepatitis, rapid enlargement due to RHF or budd chiari, HCC

Question 3

Renal Mass causes

Answer 3

Bilateral= polycystic kidneys, hydronephrosis, bilateral RCC, bilateral renal vein thrombosis, amyloid/lymphoma/other infiltrative Dx, acromegaly

Unilateral= RCC, hydronephrosis, polycystic kidneys, renal vein thrombosis

Question 4

Massive Splenomegaly causes

Answer 4

Massive= CML, myelofibrosis, lymphoma, hairy cell leukaemia, malaria

Question 5

Moderate Splenomegaly causes

Answer 5

Moderate= portal HTN, leukaemia (chronic or acute), thalassaemia, storage diseases

plus as per massive

Question 6

Mild Splenomegaly causes

Answer 6

Small= other myeloproliferative Dx (PRV ET), haemolytic anaemia, infection (EBV, hepatitis, IE), CT Dx or vasculitis (RA, SLE, PAN), infiltration (amyloidosis, sarcoidosis)

plus as per mod + massive

Question 7

Massive hepatomegaly causes

Answer 7

Massive= metastases, alcoholic liver disease with fatty infiltration, myeloproliferative Dx, right heart failure, HCC

Question 8

Moderate hepatomegaly causes

Answer 8

Moderate= haemochromatosis, haematological disease (CML, lymphoma), fatty liver (obesity, DM, toxins)

plus as per massive

Question 9

Mild hepatomegaly causes

Answer 9

Mild= hepatitis (viral, drugs), cirrhosis, biliary obstruction, granulomatous disorders, hydatid disease, amyloidosis/other infiltrative Dx, HIV, ischaemia

plus as per mod + massive

Question 10

Causes hepatosplenomegaly

Answer 10

Chronic liver disease with portal hypertension
Haematological disease (myeloproliferative disease, lymphoma, leukaemia, pernicious anaemia, sickle cell anaemia)
Infection (acute viral hepatitis, glandular fever, CMV)
Infiltration (amyloidosis, sarcoidosis)
CT Dx- SLE
Acromegaly
thyrotoxicosis

Question 11

Spleen vs kidney

Answer 11

Spleen no palpable upper border
Spleen has notch
Spleen moves inferomedially on respiration
No resonance over splenic mass
Spleen not ballotable
Friction rub may be heard over spleen

Question 12

Generalised Lymphadenopathy Causes

Answer 12

Lymphoma- rubbery and firm
Leukaemia- CLL and ALL
Malignant disease- mets or reactive changes usually cause asymmetric and very firm
Infections Viral (CMV, HIV, mono), bacterial (TB, brucellosis), protozoa (toxo)
CT Dx- RA, SLE
Infiltrations- sarcoidosis
Drugs- phenytoin