Haematology

  Basic Physician Training MCQs
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Exam technique

Lymphadenopathy


What is the differential diagnosis for the causes of generalised lymphadenopathy?
  • Haematological:
    • CLL very common
    • Lymphoma - hogkins vs non-hogkins 
    • Myeloproliferative, although will normally have massive splenomegaly
  • Other malignancy
  • Infective
    • Granulomatous - MTB, MAC
    • non-granulomatous - HIV, EBV, CMV, Q-fever
  • Connective Tissue
    • SLE
    • RA
  • Infiltrative
    • sarcoidosis
  • Drugs
    • phenytoin
  • Other:
    • Angiofollicular lymph node hyperplasia (Castleman's disease) 
    • Kawasaki disease​

Splenomegaly


General comments
  • This could be a case of examine the abdomen and proceed - in which case you would be expected to quickly identify the presence of hepatomegaly and/ or splenomegaly and decide whether this is part of a haematological problem or a chronic liver disease case. It is normally going to be a haematological examination as stems for chronic liver disease arise are usually "please examine the gastrointestinal system"
General inspection
  • Always comment on nutritional state - is this patient well nourished or is this patient cachectic
  • Comment on the presence of anaemia
  • Mention the presence or absence of encephalopathy as it is an important consideration in acute fulminant hepatic failure
Differential diagnosis of tender hepatomegaly
  • This is limited and it is important to elicit as it has its own set of differentials
  • Tender hepatomegaly is clinically caused by anything that has recently caused stretch of the hepatic capsule
  • This include alcoholic hepatitis, NASH, malignancy, viral hepatitis, vascular liver disease (budd-chiari syndrone), hepatic congestion
What is the differential diagnosis of hepatomegaly without splenomegaly
  • Liver disease causing hepatomegaly without secondary portal hypertension
  • glycogen storage disease
  • infiltrative disease (amyloidosis, sarcoidosis)
  • polycystic liver disease 
  • infectious causes, including toxoplasmosis, hydatid cyst, pyogenic liver abscess and amoebic liver abscess
  • vascular liver disease - budd-chiari syndrome
  • hepatic congestion secondary to right heart failure, constrictive pericarditis and restrictive cardiomyopathy
​
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  • About
  • Written
    • Respiratory Medicine
    • Medical Oncology >
      • Colorectal Cancer
      • Lung Cancer
      • Urogenital Cancers
      • Emergencies
      • Melanoma
      • Breast
    • Haematology >
      • Anaemia
      • Coagulation
      • Malignancy
    • Cardiology >
      • General Cardiology
      • Coronary Artery Disease
      • Heart Failure
      • Valvular Heart Disease
      • Arrhythmia
    • Endocrinology >
      • General Endocrinology
      • Reproduction
      • Pituitary
      • Diabetes
    • Clinical Immunology
    • Clinical Toxicology
    • Genetics
    • Geriatrics
    • General Medicine
    • Statistics
    • Gastroenterology >
      • Pancreas
      • Inflammatory Bowel Disease
      • Oesophageal Diseases
      • Stomach and Small Intestine
      • Liver
    • Infectious Diseases >
      • Viruses
      • Bacteria
      • Parasites
      • Fungus
    • Neurology >
      • Anatomy
      • Nystagmus
      • Myopathies
      • Stroke
      • Neurodegenerative Disorders
      • Neuropathy
    • Nephrology >
      • Glomerulonephritis
      • General Nephrology
      • Chronic Kidney Disease
    • Psychiatry
    • Palliative Care
    • Pharmacology
    • Rheumatology >
      • Rheumatoid Arthritis
      • Connective Tissue Diseases
      • Spondyloarthropathies
      • Crystal Arthropathy
  • Clinical
    • Short Cases >
      • Haematology
      • Endocrine
      • Neurology
      • Rheumatology
      • Renal
      • Gastroenterology
      • Cardiology
      • Respiratory
    • Long Cases >
      • Addiction & Psychiatry
      • Cardiology
      • Endocrinology
      • Geriatrics
      • Gastroenterology
      • Renal
      • Haematology
      • Infectious Diseases
      • Oncology
      • Rheumatology
      • Respiratory
      • Neurology
      • Set pieces
  • Medical Students
  • Respiratory
    • Asthma >
      • Acute Exacerbation
    • COPD >
      • Exacerbations
    • Lung Cancer >
      • Targeted therapy
    • Tobacco
    • Questionnaires