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Liver Diseases

Examination for Liver Disease

  • Liver + brain
  • Liver + chest wall
  • liver + hands
  • Liver + abdomen
  • other liver disease findings

Findings in the Head with Liver Disease

  • Fetor hepaticus {sweet, musty, or sulfurous odor on a person's breath, urine, or sweat, caused by severe liver disease}
  • Constructional apraxia
    • Patients cannot reproduce simple designs (e.g. a star of David)
  • Drowsiness and confusion
  • Parotid gland enlargement
  • Spider angiomas
  • Icterus

Findings in the Chest with Liver Disease

  • Diminished axillary hair
  • Spider angioma
  • Gynecomastia in a male

Findings in the Hands with Liver Disease

  • Asterixis / flapping Tremor
  • Palmar erythema (PALE HAND WITH ISLANDS OF REDNESS OVER THENAR AND HYPOTHENAR EMINENCE)
  • Duputryen’s contracture
  • Clubbing (only in biliary cirrhosis)
  • Terry’s “half & half” nails { a pink band at end of white nails }

Duputryen's contracture (Credit)


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Terry's nails alt text

Findings in the Abdomen with Liver Disease

  • ascites
  • Poratla HTN

Other Findings in Liver Disease

  • Petechiae and echymosis
  • Scratch marks
  • Edema

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