Abdo exam Flashcards
(20 cards)
Causes of hepatomegaly (6)
Cirrhosis
HCC
CCF
Infective (HBV, HCV)
Immune (PBC, PSC, AIH)
Infiltrative (amyloid, myeloproliferative disease)
Top 3 causes of ascites
Cirrhosis (80%)
HCC
CCF
Complications of cirrhosis - 3
Variceal haemorrhage from portal HTN
Hepatic encephalopathy
SBP
Signs of decompensated liver disease (5)
Ascites
Asterixis
Hepatic encephalopathy
Upper GI bleed
?jaundice
Causes of palmar erythema - 5
Cirrhosis
Hyperthryoidism
RA
Pregnancy
Polycythaemia
Causes of spider naevi - 4
Chronic liver disease
PBC
Pregnancy
OCP
What causes gynaecomastia? 8
Puberty, Old age, Kleinfelter’s syndrome, Cirrhosis, Drugs (spironolactone, digoxin), Testicular tumour, Thyroid disease, Addison’s disease
What are the indications for liver transplant? 3
Cirrhosis, Acute hepatic failure (HAV, HBV, paracetamol), HCC
HAV: Hepatitis A virus, HBV: Hepatitis B virus
What skin signs are seen in transplant patients? (4 malignant, 2 infection)
Malignancy: Dysplastic change, SCC, BCC, malignant melanoma; Infection: Viral warts, cellulitis
SCC: Squamous cell carcinoma, BCC: Basal cell carcinoma
What are the extra-hepatic complications of HH (haemochromatosis)? 6
Endocrine: DM, hypogonadism, testicular atrophy; Cardiac: CCF; Joints: Arthropathy, pseudo-gout
HH: Hemochromatosis, DM: Diabetes mellitus, CCF: Congestive cardiac failure
What are the causes of splenomegaly? (3 increased storage, 8 infiltration, 5 increased function, 6 immune hyperplasia)
Increased storage: Myelo/lymphoproliferative disease, CML, myelofibrosis;
Infiltration: Gaucher’s, amyloidosis, sarcoidosis, lipid storage diseases; Abnormal flow: Portal HTN, Budd Chiari, PV thrombosis;
Increased function: Haemolytic anaemias, Hereditary Spherocytosis, thalassaemia, nutritional anaemias, early sickle cell anaemia;
Immune hyperplasia: EBV, malaria, visceral leishmaniasis, infective hepatitis, IE, Felty’s syndrome
CML: Chronic myeloid leukaemia, HS: Hereditary spherocytosis, SCA: Sickle cell anaemia, EBV: Epstein-Barr virus, IE: Infective endocarditis
What are the indications for splenectomy? 3
ITP, Hereditary spherocytosis, Trauma
ITP: Immune thrombocytopenic purpura
What causes renal enlargement? (4 unilateral, 5 bilateral)
Unilateral: PKD with contralateral nephrectomy, RCC, Simple cysts, Hydronephrosis;
Bilateral: PKD, Bilateral RCC, Tuberous sclerosis, VHL syndrome, Amyloidosis
PKD: Polycystic kidney disease, RCC: Renal cell carcinoma, VHL: Von Hippel-Lindau syndrome
What are the indications for dialysis?
Acidosis, Refractory hyperkalaemia, Intoxicants (see other card), Refractory fluid overload, Uraemic pericarditis/encephalopathy
What drugs / toxins can be dialysed out? 9
isopropyl alcohol, salicylates, theophylline, uraemia, methanol, barbiturates, lithium, ethylene glycol, dabigatran
What are the indications for renal transplant? 11
Glomerulonephritis, Diabetic nephropathy, hypertensive, PKD, Drug-induced (ciclosporin, aminoglycosides, NSAIDs), AI (SLE, RA, GPA, anti-GBM), Obstructive uropathy, VUR, Recurrent UTI, Alport’s syndrome, HRS/CRS
AI: Autoimmune, SLE: Systemic lupus erythematosus, RA: Rheumatoid arthritis, GPA: Granulomatosis with polyangiitis, anti-GBM: Anti-glomerular basement membrane, VUR: Vesicoureteral reflux, UTI: Urinary tract infection, HRS: Hepatorenal syndrome, CRS: Cardiorenal syndrome
What are the side effects of immunosuppressants? (ciclosporin 4, tacrolimus 3, mycophenalate 4, sirolimus 3)
Ciclosporin: Tremor, gingival hyperplasia, hypertrichosis, nephrotoxicity; Tacrolimus: Tremor, rash, DM; Mycophenolate: Tremor, rash, peripheral oedema, GI symptoms; Sirolimus: Peripheral oedema, acne, arthralgia
DM: Diabetes mellitus, GI: Gastrointestinal
What are the clinical signs of steroid use? 6
Cushingoid appearance, Thin skin, Abdominal striae, Easy bruising, Proximal myopathy, Cataracts
What causes gum hypertrophy? (3 drug, 4 other)
Drugs: Ciclosporin, phenytoin, nifedipine; Scurvy; Acute myelomonocytic leukaemia; Pregnancy; Familial
What are the extra-intestinal manifestations of IBD? (3 occular, 3 GI, 1 lung, 3 MSK, 2 skin)
Ocular: Uveitis, scleritis, episcleritis; Mouth: Aphthous stomatitis; Hepatobiliary: PSC, pancreatitis; Lung: Bronchiectasis; MSK: Polyarticular large joint arthritis, axial arthropathies, osteoporosis
Skin: pyoderma gangrenosum, erythema nodosum
IBD: Inflammatory bowel disease, PSC: Primary sclerosing cholangitis, MSK: Musculoskeletal
