Abdominal

Question 1

What are the causes of Ascites? (in order of frequency) - 5

Answer 1

Cirrhosis (75%)

Malignancy (10%)

Heart Failure (3%)

TB (2%)

Pancreatitis (1%)

Question 2

Causes of isolated Hepatomegaly? - 4 most common + 4 less common

Answer 2

4 most common:

1. Cirrhosis of any cause – ALD, NAFLD, PBC, PSC
2. Malignancy: primary or secondary
3. Hepatitis: Alcoholic, Viral
4. Heart failure

Less common:

1. Metabolic: Haemochromatosis
2. Infectious: liver abscess
3. Vascular: Budd-Chiari
4. Infiltrative: amyloid, sarcoid
5. Polycystic liver disease

Question 3

Causes of splenomegaly? (in order of frequency) 3+

Answer 3

Portal Hypertension (33%)

Hematological malignancy (27%)

Infection (HIV, endocarditis) - 23%

Congestion (e.g. HF) - 8%

Primary splenic disease (e.g. splenic vein thrombosis) - 4%

Question 4

4 causes of massive splenomegaly?

Answer 4

Myelofibrosis

CML

Malaria

MAC + HIV

Kala-Azar (visceral LeishManiasis)

Question 5

Distinguishing between spleen vs kidney? (4)

Answer 5

Spleen (vs. kidney):

• Percussion note dull (resonant)
• Moves with respiration (does not move)
• Cannot get above (yes)
• Not ballotable (ballotable)