Stigmata of Liver Disease Author: Bernard Karnath, MD Questions 1 and 2 refer to the following case study. A 50-year-old woman with alcoholism presents with a 2-month history of abdominal distention with lower extremity edema. She has gained 30 pounds over the same period of time. You suspect ascites.
	1. Which of the following physical examination maneuvers is considered the most sensitive for the detection of ascites? Bulging flanks Flank dullness Fluid wave Shifting dullness Click here to compare your answer. 2. Which of the following physical examination maneuvers is considered the most specific for the detection of ascites? Bulging flanks Flank dullness Fluid wave Shifting dullness Click here to compare your answer. 3. A 20-year-old woman presents with jaundice. She had a recent respiratory infection that started about 1 week ago. The physical examination is significant for mild scleral icterus. She denies any darkening of her urine. This patient most likely has which of the following conditions causing her jaundice? Biliary obstruction Cirrhosis Hemolytic anemia Viral hepatitis Click here to compare your answer.		4. A 40-year-old man with cirrhosis of the liver presents with a 2-day history of altered mental status. On physical examination, he is lethargic with inappropriate behavior. Asterixis is obvious. You conclude that the patient has hepatic encephalopathy. Based on the patientís clinical presentation, how would you grade the hepatic encephalopathy? Grade 1 Grade 2 Grade 3 Grade 4 Click here to compare your answer. 5. A 40-year-old man with cirrhosis of the liver presents with gynecomastia. Which of the following medications is likely to contribute to the development of gynecomastia in this cirrhotic patient? Furosemide Neomycin Propranolol Spironolactone Click here to compare your answer.
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