EMQ: 13
Causes of cirrhosis of the liver
a)
Haemochromatosis
b)
Wilson’s disease
c)
Primary biliary cirrhosis
d)
Osler-Rendu-Weber syndrome
e)
Alcohol
f)
Methotrexate
g)
Cardiac cirrhosis
h)
Budd-Chiari syndrome
i)
Alpha1 antitrypsin deficiency
j)
Cystic fibrosis
Match the physical signs below to the cause of cirrhosis
listed above
1) Parotid enlargement and Dupuytren’s contracture
Answer: e) alcohol
Parotid enlargement and Dupuytren’s contracture are
physical signs that are associated with alcohol abuse
2) Clubbing, coarse crepitations at both lung bases
Answer: j) cystic fibrosis
Clubbing and coarse crepitations at both lung bases
suggest that the patient has bronchiectasis. The association between
bronchiectasis and cirrhosis of the liver would be cystic fibrosis.
3) A middle-aged female with xanthelasma
Answer: c) primary biliary cirrhosis
Primary biliary cirrhosis is associated with raised
cholesterol levels and xanthelasma
4) Breathlessness, ankle oedema and a raised jugular
venous pressure
Answer: g) cardiac cirrhosis
A raised JVP would suggest that the liver is congested
and if this is long standing it could result in chronic liver disease (known
as nutmeg liver in pathology)
5) Multiple telangiectasiae around the lips
Answer: d) Osler-Rendu-Weber syndrome
Hereditary haemorrhagic telangiectasia or
Osler-Rendu-Weber syndrome may cause cirrhosis of the liver
Revision Tip
Learn about the physical signs that could indicate the
cause of cirrhosis of the liver ACES for PACES
page 306
