The above picture shows gynaecomastia and multiple spider naevi. When you see this in the exam whether medical student or MRCP, think of none other than chronic liver disease (liver cirrhosis)
You need to know the signs at your finger tips.
Nails - leuconychia, clubbing
Wrist/Hands - flapping tremor, palmar erythema, Dupuytren's contracture
Face - Jaundice, Parotid swelling(esp alcoholic), look also for KF ring(Wilson)
Chest - Gynaecomastia, spider naevi, loss of axillary hair
Abdomen - Caput medussa, prominent veins, Ascites, Splenomegaly
Legs - Oedema
Note that you rarely get hepatomegaly in chronic liver disease because by then the liver would be cirrhotic and shrink. However, if it is enlarged, think of malignant transformation or alcoholic liver disease.
Can you list the investigations you would perform in these patients ?
6 comments:
Viral hepatitis screening
Liver function tests: ALAT, ASAT, GGT, total protein, albumin, bilirubin
Coagulation profile: PT, APTT
Alpha feto protein
USE
CT, MRI
ERCP/MRCP
Liver biopsy
If there is clinical suspicion:
Serum iron, Transferrin saturation
Autoimmune Ab
HepBsAg and Anti HCV would be enough for viral hepatitis screening. How about other causes of liver cirrhosis such as PBC, alpha1 antitripsin deficiency ? yup, basically u got the idea :)
for PBC the antimitochondrial antibody while for alpha 1 antitrypsin deficiency- serum alpha 1 antitrypsin level with or without phenotyping
for autoimmune hepatitis-autoantibodies such as ANA,LKM, SLA-LP and SMA
Thanks for telling
This article regarding Chronic liver disease is very interesting and useful, the liver failure issue can affect your sexual activity, and this not only happen to older people as I used to believed, young people can also be affected so you may need to buy generic viagra to help yourself on those situations. Thanks for sharing and have a nice day.
Great blog all the best
It was during my research on HIV/Herpes that I stumbled upon the Hiv/Herpes information; information which is quite easy to find when doing a search for STD on google. I was into conspiracy at the time thought of HIV/Herpes Cured' being a conspiracy was something Ignorance though,I found pretty interesting about herbal medicine. I asked questions about the Herbal cure's on official HIV/Herpes websites and I was banned for doing so by moderators who told me that I was parroting Hiv/Herpes propaganda. This reinforced my belief that there is a cure for Hiv/Herpes Then i found a lady from germany name Achima Abelard Dr Itua Cure her Hiv so I send him a mail about my situation then talk more about it and send me his herbal medicine I drank for two weeks.And today I'm Cured no Hiv/Herpes in my life,I searched for Hiv/Herpes groups to attempt to make contact with people in order to learn more about Hiv/Herpes Herbal Cure's I believed at this time that you with the same disease this information is helpful to you and I wanted to do the best I could to spread this information in the hopes of helping other people.That Dr Itua Herbal Medicine makes me believes there is a hope for people suffering from,Parkinson's,Alzheimer’s disease,Bechet’s disease,Crohn’s disease,Cushing’s disease,Heart failure,Multiple Sclerosis,Hypertension,Colo_Rectal Cancer,Lyme Disease,Blood Cancer,Brain Cancer,Breast Cancer,Lung Cancer,Kidney Cancer,Love Spell,psoriasis,Lottery Spell,disease,Schizophrenia,Cancer,Scoliosis,Fibromyalgia,Fluoroquinolone Toxicity Syndrome Fibrodysplasia Ossificans Progressiva.Infertility,Tach Disease ,Epilepsy ,Diabetes ,Coeliac disease,,Arthritis,Amyotrophic Lateral Sclerosis,Autism,Alzheimer's disease,Adrenocortical carcinoma.Asthma, (measles, tetanus, whooping cough, tuberculosis, polio and diphtheria)Allergic diseases.Parkinson's disease,Schizophrenia,Lung Cancer,Breast Cancer,Colo-Rectal Cancer,Blood Cancer,Prostate Cancer,siva.Fatal Familial Insomnia Factor V Leiden Mutation ,Epilepsy Dupuytren's disease,Desmoplastic small-round-cell tumor Diabetes ,Coeliac disease,Creutzfeldt–Jakob disease,Cerebral Amyloid Angiopathy, Ataxia,Arthritis,Amyotrophic Lateral Scoliosis,Fibromyalgia,Fluoroquinolone ToxicitySyndrome Fibrodysplasia Ossificans ProgresSclerosis,Seizures,Alzheimer's disease,Adrenocortical carcinoma.Asthma,Allergic diseases.Hiv_ Aids,Herpe ,Copd,Glaucoma., Cataracts,Macular degeneration,Cardiovascular disease,Lung disease.Enlarged prostate,Osteoporosis.
Dementia.Lung Cancer, Leukemia Lymphoma Cancer,Lung Mesothelioma Asbestos,
Ovarian Cervical Uterine Cancer,
Skin Cancer, Brain Tumor, ,Hiv_ Aids,Herpes,Inflammatory bowel disease ,Copd,Diabetes,Hepatitis,Lupus,I read about him online how he cure Tasha and Tara,Conley,Mckinney and many more suffring from all kind of disease so i contacted him . He's a herbal doctor with a unique heart of God, Contact Emal. ... drituaherbalcenter@gmail.com Phone or whatsapp..+2348149277967.
Post a Comment