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Gold standard case presentation
Hepatomegaly is pathological enlargement of the liver beyond its normal size. An enlarged liver can be palpated near to the lower edge of the ribs on the right side. The associated symptoms and clinical signs depend upon the underlying disease that has caused hepatomegaly. Some common symptoms are fever, malaise, nausea, vomiting, jaundice, poor apetite, weight loss, secondary splenomegaly, and abdominal pain.
After history, examination of the patient and after measuring their liver span, some tests are run. Complete blood count and liver function profile are the basic laboratory tests that should be carried out. The liver function tests will show any abnormally increased enzymes of the liver that might point out towards a disease. Further investigations include imaging studies to check for any abnormality or mass lesion by ultrasound abdomen and CT scan. These imaging studies will show any other structural pathology that is present to rule out the etiology of hepatomegaly.
Liver is the metabolic center of the body and has a lot of activities going on in it. Since, it is involved in many functions of the body, it is affected by many medical conditions. Some of the diseases leading to hepatomegaly are:
- Glycogen storage Disease
- Congestive heart failure
- Alcoholic liver disease
- Hepatocellular carcinoma
- Infectious mononucleosis
- Niemann-Pick disease
- Primary biliary Cirrhosis
- Reye syndrome
- Hydatid cyst
- Liver abscess
- Leptospirosis etc
Since hepatomegaly is not a diagnosis but a sign of a disease it can only be treated if the underlying disease is known. If the disease is infectious, antibiotics or anti viral therapy should be started whereas if the case is of a tumor, then appropriate management option must be opted. It could be surgery, chemotherapy or radiation therapy depending upon the type of tumor.
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Question 1 of 5
1. Question1 point(s)
What clinical sign is displayed in this encounter?CorrectIncorrect
Question 2 of 5
2. Question1 point(s)
The commonest causes of liver enlargement in the MRCP PACES are referred to as the “Three C’s”. What are they?
The commonest causes are , and .
Question 3 of 5
3. Question1 point(s)
Two other causes of hepatomegaly begin with the letter “I”.
These are and .
Question 4 of 5
4. Question1 point(s)
A 55 year old obese female, with known diabetes for 10 years, on oral hypoglycemic presents with pain in right upper abdomen for 1 year off and on along with nausea and vomiting. She also complaints of a fullness in her abdomen. Her baseline blood tests demonstrate mildly elevated ALP (alkaline phosphatase) and ALT (alanine transaminase) along with hyperlipidaemia. She denies any history of smoking or excessive alcohol consumption. She is cardiovascularly stable, afebrile. Abdominal examination is suggestive of enlarged liver. What is the most likely cause of her hepatomegaly?CorrectIncorrect
Question 5 of 5
5. Question1 point(s)
What is the mainstay of management of non-alcoholic fatty liver disease?CorrectIncorrect