Meeran revision GI Flashcards
Chronic stable liver disease signs and causes
causes-alcohol, autoimmne, hepatitis A/B/C, other
Spider naevi- above nipple line/svc distrib-blanch if press
Gynacomastia/testicular atrophy
Hair loss
palmar erythema
duyprutens
alcoholic neuropathy
Clubbing
very common in paces
portal HTN- rarer-
see caput medusae
ascites
Splenomegaly, hepatomegaly-
oesophageal varices
this is NOT decompensated-
thats jaundice, ascites, flap, leukonychia, bruising
signs of portal HTN
portal HTN- rarer-
see caput medusae
ascites
Splenomegaly, hepatomegaly-
oesophageal varices
this is NOT decompensated- that comes woth jaundice, bruising, encelopathy, leukonychia
signs of decompensated Liver disease
this is NOT decompensated- that comes woth jaundice, bruising, encelopathy(Ammonia), leukonychia, portal HTN
direction of the flow of caput medusae
can tell you some difference between IVC obstruct vs Portal HTN-> below the umbilicus veins
causes of ascites
portal HTN/thrombosis (buddchaiari)
IVC obstruct
Pericarditis
cancer
tuberculosis
ovarian
Nephrotic
etc
Bloods,and obs
ix- drain ascites- protein, SAAG
Cholestatic Jaundice signs
itching-bile acids, dark urine/negative for urobilinogen, pale stools is cholestatic-
if jaundice with no itching/other-hepatic/prehepatic
causes ofc- gallstones, PSC, PBC
differentiate bwteen spleen and L kidney
can ballot Kidney, can get above it
spleen moves down towardsumbilicus
spleen dull to percuss, spleen got a notch
Ruptured AAA mx
Hypovalemic shocks- need to help fast
Agressive fluid ressus- and blood as soon as possible until surgeons arrive
consider permissive hypotension
Hypovalemic shock signs
Low BP but very dry-tiny JVP
give agressive fluids, bloods and HELP
Types of shock and differences
Cardiogenics- JVP HIGH and cold peripheries-Heart failure–mx with dobutamine
Sepsis- DRY, low JVP-hot hands= Adrenaline
Hypovalemic-DRY, low JVP-cold hands=bloods transf
Erythema nodosum causes
PAINFUL red lesion on legs
caused-
IBD, SArcoid, TB, sulphonamides
erythema multiforme causes
target lesions
most common-HSV
Mycoplasma
when severe- SJS so care (liver failure)
Erythema ab igne
Its a rash caused by hot water bottle -usually with people treating heat as pain relief–
like on shins, knees, back
permanent brown discoloration of skin
can be a sign of joint disease, or even bony mets
