View source for Archive:Extrahepatic manifestations of liver disease

==NEUROLOGICAL==
*LOC, delirium, coma 
*asterixis (arms out, dorsiflexed hands, eyes closed → hepatic encephalopathy)

==BREATHING==
*Cheyne-Stokes (encephalopathy)
*Kussmaul (metabolic acidosis)
*fetor hepaticus (musty liver breath)

==EYES==
*scleral icterus

==MOUTH==
*sublingual jaundice
*parotid gland enlargement, tenderness

==NECK==
*spider angiomata 
**blanching, necklace distribution, can be in the back
**up to 2 in men and 5 in women is normal

==HANDS==
*nails (clubbing, leukonychia, Lindsay’s, Terry’s nails)
*palmar erythema (ulnar)
*Dupytren’s contracture
*thenar muscle wasting

==TRUNK==	
*jaundice
*clotting
**ecchymosis (prothrombin deficiency)
**purpura/petechiae (platelet deficiency)
*↑ estrogen (gynecomastia, testicular atrophy, loss of axillary and pubic hair)

==ABDOMEN==
*caput medusa
*ascities
**bulging flanks 
**shifting dullness
**fluid wave
*hepatomegaly (initially large and firm, liver later shrinks)
*splenomegaly

==LOWER LEGS==
*lower extremity edema
**be reluctant to diagnose ascites without seeing swollen legs
==Other OSCE modules==
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[[Category: Gastroenterology]][[Category:OSCE]]