BOF: 38
A fifty-five year old man is admitted with a history of
fatigue, weight loss and jaundice. His alcohol intake is sixty units a week.
On examination he has clubbing, Dupuytren’s
contracture, palmar erythema, flapping tremor, parotid enlargement, spider
naevi, gynaecomastia, hepatosplenomegaly.
Which of the following signs is indicative of a poor
prognosis:
a)
Clubbing
b)
Parotid Enlargement
c)
Gynaecomastia
d)
Flapping Tremor
e)
Splenomegaly
Answer:
d)
The patient has alcoholic liver disease with clinical
evidence of cirrhosis. The features of a poor prognosis are hepatic
encephalopathy, low serum albumin concentration, and low serum sodium and
prolonged prothrombin time.
