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​Symptoms and Signs – Differential Diagnosis of  Hepatomegaly, by Shape of Liver
DIFFUSELY ENLARGED AND SMOOTH
Massive
• Metastatic disease
• Alcoholic liver disease with fatty infiltration
• Myeloproliferative diseases (e.g., polycythemia rubra vera,
myelofibrosis)
Moderate
• The above causes
• Hemochromatosis
• Hematologic disease (e.g., chronic myeloid leukemia, lymphoma)
• Fatty liver (e.g., diabetes mellitus, obesity)
• Infiltrative disorders (e.g., amyloid)
Mild
• The above causes
• Hepatitis (viral, drugs)
• Cirrhosis
• Biliary obstruction
• Granulomatous disorders (e.g., sarcoid)
• HIV infection
DIFFUSELY ENLARGED AND IRREGULAR
• Metastatic disease
• Cirrhosis
• Hydatid disease
• Polycystic liver disease
LOCALIZED SWELLINGS
• Riedel’s lobe (a normal variant; the lobe may be palpable in the
right lumbar region)
• Metastasis
• Large simple hepatic cyst
• Hydatid cyst
• Hepatoma
• Liver abscess (e.g., amebic abscess)
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​Symptoms and Signs – Differential Diagnosis of Hepatic Granulomas
• Bacterial, spirochetal: TB and atypical mycobacterial infections, tularemia, brucellosis, leprosy, syphilis, Whipple’s disease, listeriosis
• Beryllium, parenteral foreign material (e.g., starch, talc, methyldopa, procainamide, allopurinol, α-silicone), phenylbutazone, phenytoin, nitrofurantoin, hydralazine
• Fungal: coccidioidomycosis, histoplasmosis, cryptococcal infections, actinomycosis, aspergillosis, nocardiosis
• Parasitic: schistosomiasis, clonorchiasis, toxocariasis, ascariasis, toxoplasmosis, amebiasis
• Primary biliary cirrhosis, granulomatous hepatitis, jejunoileal bypass
• Rickettsial: Q fever
• Sarcoidosis, Wegener’s granulomatosis, inflammatory bowel disease, Hodgkin’s disease, lymphoma
• Viral: mononucleosis, cytomegalovirus (CMV)
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​Symptoms and Signs – Differential Diagnosis of Acute Hepatitis 
• Acute Budd-Chiari syndrome
• Acute fatty liver of pregnancy
• Autoimmune
• Brucellosis
• Cytomegalovirus
• Drug induced
• Epstein-Barr virus
• Hepatitis A, B, C, D, G
• Herpes simplex virus
• HIV infection
• Ischemic
• Leptospirosis
• Lyme disease
• Q fever
• Syphilis
• Wilson’s disease
• Yellow fever
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​Symptoms and Signs – Differential Diagnosis of Hepatitis, Autoimmune
• Acute viral hepatitis (A, B, C, D, E; cytomegalovirus [CMV], Epstein-Barr virus, herpes)
• Chronic viral hepatitis (B, C)
• Hemochromatosis
• Nonalcoholic steatohepatitis
• Primary biliary cirrhosis
• Primary sclerosing cholangitis
• Systemic lupus erythematosus (SLE)
• Toxic hepatitis (alcohol, drugs)
• Wilson’s disease
• α1-Antitrypsin deficiency
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​Symptoms and Signs – Differential Diagnosis of Chronic Hepatitis 
• Alcoholic liver disease
• Autoimmune hepatitis and variant syndromes
• Chronic viral hepatitis
• Drug induced
• Drug-induced liver disease
• Fatty liver and nonalcoholic steatohepatitis
• Hepatic granulomas
• Hepatitis B
• Hepatitis C
• Hepatitis D
• Hereditary hemochromatosis
• Idiopathic
• Infectious
• Neoplastic
• Wilson’s disease
• α1-Antitrypsin deficiency
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​Symptoms and Signs – Differential Diagnosis of Hepatitis A
• Autoimmune hepatitis
• Brucellosis
• Cytomegalovirus (CMV) infection
• Drug-induced liver disease
• Herpes simplex virus infection
• Infectious mononucleosis
• Ischemic hepatitis
• Leptospirosis
• Other hepatitis virus (B, C, D, E)
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​Symptoms and Signs – Differential Diagnosis of Hepatic Cysts
• Ductal: localized dilatation, multiple cystic dilatations of intrahepatic ducts (Caroli’s disease)
• Inflammatory cysts: retention cysts, echinococcal cyst, amebic cyst
• Neoplastic cyst
• Parenchymal: solitary cyst, polycystic disease
• Peliosis hepatis
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​Symptoms and Signs – Differential Diagnosis of Hepatic Encephalopathy
• Alcohol withdrawal syndrome
• Cerebral anoxia
• Cerebrovascular accident, subdural hematoma
• Delirium caused by medications or illicit drugs
• Hypercalcemia
• Hypoglycemia
• Meningitis, encephalitis
• Metastatic neoplasm to brain
• Uremia
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Kembara Xtra 

Facts about medicine and its subtopic such as anatomy, physiology, biochemistry, pharmacology, medicine, pediatrics, psychiatry, obstetrics and gynecology and surgery.