Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Organ | Cause | Tests | Management |
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Liver (Hepatomegaly) | Fatty Liver Disease (NAFLD) |
- Liver function tests (LFTs): May show elevated ALT and AST.
- Abdominal ultrasound: Shows increased liver echogenicity. - Liver biopsy (in severe cases) for confirmation. |
- Lifestyle modifications: Weight loss, diet, exercise.
- Manage associated conditions (e.g., diabetes, hyperlipidaemia). - Regular monitoring with liver function tests and imaging. |
Cirrhosis |
- LFTs: Elevated bilirubin, ALT, AST, and alkaline phosphatase.
- Ultrasound or CT: Nodular liver appearance. - Liver biopsy for definitive diagnosis. |
- Treat underlying cause (e.g., alcohol cessation, antiviral therapy for hepatitis).
- Manage complications (e.g., ascites, varices, hepatic encephalopathy). - Consider liver transplant in advanced cases. |
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Liver Malignancy (Primary or Metastatic) |
- LFTs: Elevated liver enzymes and alpha-fetoprotein (AFP) for hepatocellular carcinoma.
- CT or MRI of the liver. - Biopsy or fine-needle aspiration for histopathology. |
- Surgical resection if operable.
- Chemotherapy, radiotherapy, or targeted therapy for advanced/metastatic disease. - Palliative care for inoperable cases. |
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Hepatitis (Viral or Autoimmune) |
- LFTs: Elevated ALT, AST, bilirubin.
- Serology for viral hepatitis (HBV, HCV) or autoimmune markers (ANA, anti-SMA). - Liver biopsy in chronic cases. |
- Antiviral therapy for hepatitis B or C.
- Immunosuppressants for autoimmune hepatitis. - Monitoring for cirrhosis or hepatocellular carcinoma. |
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Spleen (Splenomegaly) | Infectious Mononucleosis |
- Full blood count (FBC): Lymphocytosis.
- Monospot test or EBV serology for diagnosis. - Ultrasound for splenic size. |
- Supportive care (rest, hydration, analgesia).
- Avoid contact sports to reduce risk of splenic rupture. - Recovery usually occurs within weeks. |
Haematological Malignancies (Leukaemia, Lymphoma) |
- FBC: May show anaemia, leukocytosis, or thrombocytopenia.
- Bone marrow biopsy for leukaemia or lymph node biopsy for lymphoma. - CT or PET scan for staging. |
- Chemotherapy or targeted therapy based on subtype.
- Radiation or bone marrow transplant in selected cases. - Supportive care, including blood transfusions if required. |
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Portal Hypertension (Cirrhosis) |
- LFTs: Abnormal liver enzymes.
- Doppler ultrasound: Shows portal vein pressure. - Endoscopy: To detect oesophageal varices. |
- Manage underlying liver disease (e.g., cirrhosis).
- Beta-blockers to reduce portal pressure. - Consider transjugular intrahepatic portosystemic shunt (TIPS) in severe cases. |
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Infections (Malaria, Leishmaniasis) |
- Blood smear for malaria parasites.
- Serology or PCR for Leishmania. - FBC: Anaemia, thrombocytopenia. |
- Antimalarial drugs (e.g., artemisinin-based combination therapy for malaria).
- Amphotericin B or pentavalent antimonials for leishmaniasis. - Supportive care with fluids and blood transfusions if necessary. |
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Kidney (Nephromegaly) | Polycystic Kidney Disease |
- Renal ultrasound or CT: Shows multiple cysts in kidneys.
- Genetic testing for autosomal dominant polycystic kidney disease (ADPKD). - Serum creatinine and blood urea nitrogen (BUN) to assess renal function. |
- Blood pressure control (ACE inhibitors or ARBs).
- Monitor for complications (e.g., renal failure, infections, aneurysms). - Dialysis or renal transplantation in end-stage disease. |
Hydronephrosis (Obstruction) |
- Renal ultrasound: Dilated renal pelvis and ureters.
- CT or MRI to identify the site of obstruction. - Serum creatinine to assess kidney function. |
- Relieve the obstruction (e.g., ureteric stent or nephrostomy).
- Treat underlying cause (e.g., stones, tumours). - Surgery may be necessary in severe cases. |
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Renal Tumours (e.g., Wilms Tumour, Renal Cell Carcinoma) |
- Abdominal ultrasound, CT, or MRI for tumour visualization.
- FBC, renal function tests. - Biopsy or surgical resection for histological diagnosis. |
- Surgical excision (nephrectomy) for operable tumours.
- Chemotherapy and radiotherapy in selected cases. - Targeted therapy for advanced renal cell carcinoma. |