Please enable JavaScript.

Coggle requires JavaScript to display documents.

Hepatomegaly (Examination (Significant Negatives (Splenomegaly, Acute…

- - - - CLD
        
        EtOH: palmar erythema, Dupuytren’s
        
        HH: skin discolouration
        
        Ca: cachexia
        
        CCF: ↑ JVP, bibasal creps, ascites, peripheral oedema
        
        Haematological: pallor, bruising, purpura, LNs
  - - - Define fingerbreadths below costal margin at which liver
        edge palpable.
        
        Moves inferiorly on inspiration
        
        Can’t get above it
        
        Dull PN
      - Features to note
        
        Edge: smooth, craggy, nodular
        
        Tenderness
        
        Pulsatile
      - Percuss above and below to confirm enlargement
      - Auscultate for liver bruit
        HCC
    - - Splenomegaly
      - Inguinal nodes
      - Ascites
- - - - sarcoidosis
      - amyloidosis
      - Gaucher’s
      - ADPKD
      - HH
        
        venesection ± desferrioxamine
      - Wilson’s
        
        penicillamine
  - - - EtOH
        
        abstinence + support
      - viral
        
        supportive or anti-viral therapy
      - NAFLD
    - - ACEi, β-B and diuretics
- - - - BR, urobilinogen
      - Proteinuria: amyloid
    - - FBC
        
        ↓Hb: malignancy, chronic disease
        
        Lymphocytosis: hepatitis viruses, EBV (atypical)
      - U+E: CCF → renal impairment
      - LFT
      - Clotting
      - Liver screen
    - - Abdo US + PV and hepatic duplex
        
        Liver size and texture
        
        Focal lesions
        
        Ascites
        
        Portal vein flow
        
        Hepatic veins: thrombosis
      - CT: e.g. for tumour
      - MRI: good quality images of liver parenchyma
    - - Check clotting first
      - Nodular Pattern
        Micronodular: EtOH, HH, Wilson’s
        Macronodular: viral
      - Iron: Pearl’s stain
      - Copper: Rhodamine stain
      - α1ATD: PAS stain (α1AT globules accumulate in liver)
      - Amyloid: apple-green birefringence w/ Congo Red
      - Granulomata: PBC