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Common Abdominal Examination exam questions for medical finals, OSCEs and MRCP PACES

Click on the the example questions below to reveal the answers

 

Question 1: 

What are the common causes of cirrhosis?

  • Alcohol
  • Viral
  • Fatty liver (NAFLD/NASH)
  • Autoimmune
    • PBC, PSC, AI
  • Genetic
    • CF, HH, Wilsons
    • Glycogen storage diseases
  • Drugs
    • Isoniazid
    • Methotrexate, amioderone, phenytoin, nitrofurantoin
  • Vascular
    • Budd-Chiari
  • Idiopathic

What are the complications of cirrhosis?

  • Liver failure
    • Coagulopathy and encephalopathy
  • Portal hypertension
  • Ascites
    • Varices
    • Hypersplenism
  • Jaundice
  • HCC

How do you manage cirrhosis?

  • Slowing disease
    • Antiretrovirals, immunosuppression in autoimmune
  • Prevent more damage
    • Stop ETOH, vaccinate against Hep B and C, and pneumovax
  • Look for complications
    • 6-monthly USS and AFP for HCC
    •  Endoscope
      • Varices plus C-P grade C get beta-blocker
    • ABx following SBP
    • Liver transplant
      • 6 months abstinence, age <65

 Question 2.

Why do patients get oedema in liver disease?

  • 1. Low albumin
  • 2. Stimulation of RAAS leads to fluid retention

 Question 3.

What are signs of alcohol dependence

  • Cachexia
  • Cerebellar dysfunction
  • Peripheral neuropathy and myopathy
  • Parotid enlargement
  • Dupytrens

Question 4.

What are the causes of decompensation in liver disease

  • Infection
  • Spontaneous bacterial peritonitis
  • GI bleeding
  • Sedatives
  • HCC

Question 5.

How do grade the severity of liver liver disease?

  • Child-Pugh (severity and prognosis)
    • Bilirubin, PT, albumin
    • Ascites, encephalopathy
  • Score 5-6 = A (90% 5-year survival)
  • Score 7-9 = B (80% 5-year survival)
  • Score 10 and up = C (33% 1 year)

Click here for all the clinical examinations: how to examine, what to look for and how to present your findings