Causes

Local

Cardiac – Towards evening

Liver – Ascites

Kidney – Periorbital oedema in morning

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CLCD

Can you answer:

1. Causes of Cirrhosis ?

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⭕ History taken
⭕ Class by Consultant
⭕ Read K&C

✅ ⭕

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Format

• Specific Symptoms
• D-SAC
• Sample History
• Ix and Mx
• Theory (Anatomy, Physiology and Pathology)

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Specific Symptoms

BATMAN … ?

Bleeding PR … ?

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Hx of Present Complaint (D-SAC)

• SOCRATES-P

• Aetiology (risk factors, family hx)

🅷🅴🅿🅰🆃🅸🅲

H = Haemochromatosis (Gut has a switch to control Fe absorption. Fe can only be lost as bleeding. When gut’s control of Fe absorption fails Fe is deposited)

E = Ethanol / NASH

P = Primary Sclerosing Cholangitis (Males ; S = SoB) and PRimary Biliary Cirhosis (Female  ; B = Bitches)

A = Alpha 1 anti-trypsin deficinecy (Enzyme is produced in liver but can’t get out to act on lungs. COPD + Cirrhosis)

T = Tumor – Hepatoma

I = Infection (Hep B = STD, Hep C = IV drug abuse)

C = Copper (Wilson’s Disease. Basal ganglia = Chorea, Eyes = Kayser Fleischer rings, Liver = Cirrhosis)

 

• Complications (Local, locoregional and distant spread)

 

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History

Mr. Jamis … ?

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Examination

General ….

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Ix and Mx

• Investigations
• Management

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Theory

• Anatomy
• Physiology
• Pathology