Hepatocellular carcinoma physical examination: Difference between revisions
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===Eyes=== | ===Eyes=== | ||
Icteric [[sclera]] | |||
===HEENT=== | |||
* Abnormalities of the head/hair may include thinning of hair on the scalp due to [[hyperestrogenism]] | |||
* '''[[Kayser-Fleischer ring]]s:''' dark rings that appear to encircle the [[iris (anatomy)|iris]] of the [[eye]] in [[Patient|patients]] with [[Wilson's disease]]<ref name="pmid28573989">{{cite journal |vauthors=Sridhar MS, Rangaraju A, Anbarasu K, Reddy SP, Daga S, Jayalakshmi S, Shaik B |title=Evaluation of Kayser-Fleischer ring in Wilson disease by anterior segment optical coherence tomography |journal=Indian J Ophthalmol |volume=65 |issue=5 |pages=354–357 |year=2017 |pmid=28573989 |pmc=5565897 |doi=10.4103/ijo.IJO_400_16 |url=}}</ref> | |||
*Icteric [[sclera]] | |||
* [[Parotid gland]] enlargement | |||
* [[Fetor hepaticus]]: severe portal-systemic shunting leads to increased levels of [[dimethyl sulfide]] leads to a sweet pungent smell in the breath | |||
===Lungs=== | ===Lungs=== | ||
Revision as of 15:49, 5 January 2018
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Hepatocellular carcinoma Microchapters |
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Differentiating Hepatocellular carcinoma from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Hepatocellular carcinoma physical examination On the Web |
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American Roentgen Ray Society Images of Hepatocellular carcinoma physical examination |
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Risk calculators and risk factors for Hepatocellular carcinoma physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]
Overview
Patients with hepatocellular carcinoma usually appear cachectic. Physical examination of patients with hepatocellular carcinoma is usually remarkable for jaundice, pruritus, ascites, splenomegaly, esophageal varices, and cachexia.
Physical Examination
Common physical examination findings of hepatocellular carcinoma are:
Appearance of the Patient
- The general appearance of the patient depends on the severity of the disease:
- The patient is often cachexic
- May appear anxious.
- Dyspnea if ascites is present
Vitals
Temperature
- Fever is usually present in advanced cases
Skin
- Jaundice : yellow discoloration of the skin, eyes, and mucus membranes due to increased bilirubin (at least 2-3 mg/dL or 30 mmol/L). Urine may also appear dark.
- Pallor
- Bruises
- Peripheral Edema
- Palmar erythema on the thenar and hypothenar eminences, due to altered sex hormone metabolism.
- Spider angiomata: Increased estradiol levels lead to the formation of vascular lesions consisting of central arterioles surrounded by smaller vessels [1]
Eyes
HEENT
- Abnormalities of the head/hair may include thinning of hair on the scalp due to hyperestrogenism
- Kayser-Fleischer rings: dark rings that appear to encircle the iris of the eye in patients with Wilson's disease[2]
- Icteric sclera
- Parotid gland enlargement
- Fetor hepaticus: severe portal-systemic shunting leads to increased levels of dimethyl sulfide leads to a sweet pungent smell in the breath
Lungs
- The signs of pleural effusion are noted in advanced disease
Abdomen
Significant abdominal findings are seen in advanced stages
- Hepatomegaly
- Splenomegaly
- Ascites
- Abdominal distention may be present
- Abdominal tenderness may be present
References
- ↑ Li CP, Lee FY, Hwang SJ; et al. (1999). "Spider angiomas in patients with liver cirrhosis: role of alcoholism and impaired liver function". Scand. J. Gastroenterol. 34 (5): 520–3. PMID 10423070.
- ↑ Sridhar MS, Rangaraju A, Anbarasu K, Reddy SP, Daga S, Jayalakshmi S, Shaik B (2017). "Evaluation of Kayser-Fleischer ring in Wilson disease by anterior segment optical coherence tomography". Indian J Ophthalmol. 65 (5): 354–357. doi:10.4103/ijo.IJO_400_16. PMC 5565897. PMID 28573989.