Git Combanium

Question 1

Normal liver span

Answer 1

12-15 cm

Question 2

Riedels lobe

Answer 2

Tongue like projection from right lobe,bimanually palpable,

Question 3

Normal palpable liver

Answer 3

Thin individuals
Visceroptosis
Emphysema
Right sided pleural eff
Right pneumothorax

Question 4

Causes of massive hepatosplenomegaly

Answer 4

HCC
Secondary ca liver
Pyogenic and amoeibic abscess
Polycystic disease of liver
Leukemia
Amyloidosis

Question 5

Soft smooth surfaced tender liver

Answer 5

Acute viral hepatitis
Acute congestion( CCF,Budd chiari)
Pyogenic liver abscess
Fatty liver

Question 6

Firm regular liver

Answer 6

Chronic congestion(CCF,Budd chiari)
Early cirrhosis in hemochromatosis and sec biliary cirrhosis
Amyloidosis

Question 7

Firm nodular liver

Answer 7

HCC
Sec ca
Late stages of cirrhosis, hemochromatosis,Wilson’s,sec biliary cirrhosis
Tertiary syphillis

Question 8

Pulsatile liver

Answer 8

Systolic
Tr
Severe ar
Diastolic
Ts

Question 9

Enlargemtnet of left lobe of liver

Answer 9

HCC
Metastasis
Abscess
Cyst
Hepar lobatum(syphillis)

Question 10

Methods for spleen percussion

Answer 10

Percussion of traubes space
Nixons method
Castells method

Question 11

Size classification of spleen

Answer 11

Mild <3
Moderate 3-7
Massive > 7 cm

Question 12

Causes of mild splenomegaly

Answer 12

Infective
Infectious mononucleosis
Malaria
Tb
Brucellosis
Viral hepatitis
Collagen vascular diseases
Congestion

Question 13

Causes of massive splenomegaly

Answer 13

Tropical splenomegaly syndrome
Kala azar
Chronic myeloid leukemia
Lymphoma
Polycythemia rubra vera
Cll
Sarcoidosis
Auto immune hemolytic anemia

Question 14

Splenomegaly with jaundice

Answer 14

Hemolytic anemia
Hepatitis viral
Hepatic failure
Infections,malaria

Question 15

Splenomegaly with lymphadenopathy

Answer 15

Infectious mono
Lymphoma
Leukemia
Sarcoidosis
Disseminated tb

Question 16

Splenomegaly with ascites

Answer 16

CLD with portal hypertension
Disseminated tb
Git / ovarian malignancy

Question 17

Splenomegaly with anemia

Answer 17

Hemolytic anemia
Leukemia
Lymphoma
Disseminated tb

Question 18

Small spleen with small liver

Answer 18

Infections(inf mono,viral hep,malaria,tb)
CCF chronic
Collagen vascular diseases

Question 19

Small spleen with large liver

Answer 19

CCF acute
Liver met
Polycystic liver

Question 20

Large spleen with small liver

Answer 20

Kala azar
Tropical splenomegaly syndrome
EHPVO

Question 21

Large spleen with large liver

Answer 21

Myeloproliferative disorders
Lymphoproliferative disorders
Hemolytic anemia
Storage diseases

Question 22

Normal urine color in jaundice means

Answer 22

Unconjugated hyperbilirubinemia

Question 23

What is melena

Answer 23

Black sticky stools with offensive odor,indicates that blood has been in gi system for 8-14 hrs

Question 24

Cirrhotic facies

Answer 24

Sunken eyes and cheeks with malar prominence,bilaterally enlarged parotid gland

Question 25

Why parotid enlargemtnet

Answer 25

Malnutrition

Question 26

Why leuconychia

Answer 26

Hypoalbunemia

Question 27

Why dupuytrens contracture

Answer 27

Fibrosis of palmar aponeurosis resulting in flexion deformities in the ring and little finger seen in alcoholic cirrhosis Mech: injury by radics released as a result of conversion of excessive tissue hypoxanthine by xanthine oxidase

Question 28

DD of palmar erythema

Answer 28

Pregnancy Rheumatoid arthritis Thyrotoxicosis Leukemia Acute febrile illness

Question 29

Why fetor hepaticus

Answer 29

Due to production of mercaptans

Question 30

What is spider naevi

Answer 30

Central arteriolar dilatation with radiating small vessels 1-2 mm to 1-2 cm

Question 31

DD of spider naevi

Answer 31

Pregnancy Rheumatoid arthritis Thryotoxicosis

Question 32

Why kf ring

Answer 32

Deposition of copper in descemets membrane of cornea

Question 33

Causes of kf ring

Answer 33

Wilson's Cryptogenic cirrhosis Intra ocular copper body PBC

Question 34

Causes of gynecomastia

Answer 34

Puberty Chronic liver disease Drugs(spironolactone,cimetedine,ketoconazole) Tumour of testis/ lungs

Question 35

Asterixis also seen in

Answer 35

Uremia Resp failure(CO2 narcosis) Hypokalemia Hypomagnesia Certain drugs

Question 36

Blumbergs sign

Answer 36

Rebound tenderness

Question 37

Features of decompensation

Answer 37

Ascites Gi bleed Jaundice Hep encephalopathy Splenomegaly

Question 38

Precipitants of hep encephalopathy

Answer 38

Renal failure Diuretic therapy Gi bleeding Infection Constipation Diet protein overload Drugs(antipsycjotics,antideps,benzodiazapene)

Question 39

Grades of hep encephalopathy

Answer 39

Grade 0- subclinical 1- mild confusion 2- drowsiness 3- drowsy but arousable 4- coma

Question 40

Hepatorenal syndrome

Answer 40

A continuum of renal dysfunction that may be observed in patients with cirrhosis,caused by vasoconstriction of large and small renal arteries and the impaired renal perfusion that results

Question 41

How to diagnose hepatorenal syndrome

Answer 41

Creatinine clearance<40 ml/min Serum creatinine>1.5 mg/ dl Urine volume<500 ml/ day Urine sodium<10 meq/ L Urine osmolality > plasma osmolality

Question 42

Low risk drinking

Answer 42

Males-21 units per week Females-14 units per week 1 unit =10 ml/8 gm

Question 43

Screening test to identify problem drinking

Answer 43

CAGE test

Question 44

Treatment of alcoholic

Answer 44

Stabilization Detoxification Rehabilitation