Abdominal

Question 1

Causes of abdominal distension

Answer 1

Fat, fluid, fetus, flatus, faeces

Question 2

How do you differentiate spleen vs kidney?

Answer 2

Can you get above it?
The spleen has a notch
The spleen moves from left to right towards RIF
Spleen is not ballotable

Question 3

Causes of hepatomegaly

Answer 3

SHIRT
Structural

• Extrahepatic biliary atresia, choledocal cyst, Alagille syndrome, polycystic disease
• Storage - Gaucher, Niemann-Pick, Glycogen storage disorders, galactosaemia, tyrosinaemia, Wilsons, Alpha-1 antitrypsin deficiency

Haematological/Heart

• Thalassaemia, sickle cell disease, acute leukaemia

Infection

• Congential rubella, CMV, EBV, hepatitis
• Malaria, TB

Rheumatological

• Systenic JIA, lupus

Tumour/hamartoma

• Hepatoblastoma, hepatocellular carcinoma,
• Secondary - Wilms, neuroblastoma
• Vascular malformations