56 years old | Male
A 56-year-old male with a remote history of intravenous drug use presents to an initial visit complaining of increased abdominal girth but denies jaundice. He drinks about 2 to 4 glasses of wine with dinner and recalls having had abnormal liver enzymes in the past. Physical exam reveals spider nevi, a palpable firm liver, mild splenomegaly, and shifting dullness consistent with the presence of ascites. Liver function is found to be deranged with elevated aminotransferases (aspartate aminotransferase [AST]: 90 U/L, alanine aminotransferase [ALT]: 87 U/L), and the patient is positive for anti-hepatitis C antibody.
intravenous drug use | increased abdominal girth | alcohol | abnormal liver enzymes | spider nevi | palpable firm liver | splenomegaly | shifting dullness | ascites | elevated aminotransferases | elevated AST | elevated ALT | hepatitis C
Liver Cirrhosis Biliary Cirrhosis Primary Biliary Cirrhosis
https://online.epocrates.com/diseases/27822/Cirrhosis/Common-Vignette
Rank |
Disease |
Weight |
---|---|---|
1 | Primary sclerosing cholangitis | 723.0 |
2 | Liver Cirrhosis | 695.0 |
3 | Biliary cirrhosis | 679.0 |
4 | Primary biliary cirrhosis | 630.0 |
5 | Autoimmune hepatitis | 570.0 |
6 | Alcoholic hepatitis | 556.0 |
7 | Chronic Hepatitis | 508.0 |
8 | Alcoholic Liver Cirrhosis | 485.0 |
9 | Hepatocellular carcinoma | 484.0 |
10 | Alcoholic Liver Disease | 444.0 |
11 | Alcoholic Fatty Liver | 419.0 |
12 | Gallstone pancreatitis | 409.0 |
13 | Acute Liver Failure | 376.0 |
14 | Hereditary hemochromatosis | 358.0 |
15 | Infectious mononucleosis | 355.0 |
16 | Cholangiocarcinoma | 315.0 |
17 | chronic acalculous cholecystitis | 311.0 |
18 | Klebsiella pneumoniae liver abscess | 301.0 |
19 | Tuberculous Peritonitis | 296.0 |
20 | Wilson disease | 277.0 |
21 | Acute intermittent porphyria | 277.0 |
22 | Hepatic Encephalopathy | 276.0 |
23 | Non-alcoholic Fatty Liver Disease | 274.0 |
24 | Ovarian Hyperstimulation Syndrome | 274.0 |
25 | Celiac Disease | 268.0 |
26 | Common cutaneous drug reactions | 268.0 |
27 | Budd Chiari Syndrome | 266.0 |
28 | Eclampsia | 257.0 |
29 | Acute Hepatitis | 256.0 |
30 | Chronic liver disease | 252.0 |
31 | Hepatorenal Syndrome | 246.0 |
32 | Pyogenic Liver Abscess | 243.0 |
33 | Primary Myelofibrosis | 242.0 |
34 | Acute Cholangitis | 241.0 |
35 | Liver disease | 222.0 |
36 | Breast Cancer | 220.0 |
37 | Choledocholithiasis | 217.0 |
38 | Acalculous Cholecystitis | 210.0 |
39 | Autosomal Recessive Polycystic Kidney Disease | 205.0 |
40 | Intrahepatic Cholestasis | 204.0 |
41 | Hemolytic uremic syndrome | 201.0 |
42 | biliary SOD | 201.0 |
43 | Gallbladder Dyskinesia | 200.0 |
44 | Graves Disease | 199.0 |
45 | Chronic atrial fibrillation | 197.0 |
46 | Crohn Disease | 194.0 |
47 | Acute heart failure | 193.0 |
48 | Familial Mediterranean fever | 191.0 |
49 | Non-small cell lung cancer | 186.0 |
50 | Acute Pancreatitis | 179.0 |
51 | Sarcoidosis | 179.0 |
52 | Acute Lymphocytic Leukemia in Adults | 178.0 |
53 | Autoimmune Pancreatitis | 172.0 |
54 | Acute fatty liver of pregnancy | 172.0 |
55 | Extraintestinal Entamoeba histolytica amebiasis | 171.0 |
56 | Malaria | 168.0 |
57 | Acetaminophen overdose | 167.0 |
58 | Gastritis | 166.0 |
59 | Kawasaki disease | 166.0 |
60 | Osteoporosis | 163.0 |
61 | Hereditary Angioedema | 160.0 |
62 | Systemic lupus erythematosus | 159.0 |
63 | Acute Lymphoblastic leukemia in children | 159.0 |
64 | Hypertriglyceridemia | 158.0 |
65 | Food poisoning | 156.0 |
66 | Systemic sclerosis | 154.0 |
67 | Foreign body ingestion | 153.0 |
68 | Inflammatory Bowel Diseases | 151.0 |
69 | Hyperthyroidism | 151.0 |
70 | Preeclampsia | 151.0 |
71 | Chronic Lymphocytic Leukemia | 150.0 |
72 | Typhoid infection | 149.0 |
73 | Mesenteric ischemia | 146.0 |
74 | Acute viral meningitis | 145.0 |
75 | Hyperprolactinemia | 144.0 |
76 | Brucellosis | 143.0 |
77 | Toxic Megacolon | 142.0 |
78 | Cystic Fibrosis | 142.0 |
79 | Ovarian Cancer | 140.0 |
80 | Ulcerative Colitis | 139.0 |
81 | Spontaneous bacterial peritonitis | 139.0 |
82 | Portal hypertension | 138.0 |
83 | Colorectal cancer | 137.0 |
84 | Intrahepatic cholestasis of pregnancy | 137.0 |
85 | Intestinal Obstruction | 135.0 |
86 | Psoas Abscess | 134.0 |
87 | Premenstrual syndrome | 132.0 |
88 | Mirizzi Syndrome | 132.0 |
89 | Pulmonary Embolism | 131.0 |
90 | Chronic Pancreatitis | 130.0 |
91 | Cholestasis | 130.0 |
92 | Short bowel syndrome | 128.0 |
93 | Sigmoid volvulus | 125.0 |
94 | Acute Myeloid Leukemia in children | 125.0 |
95 | Hypothyroidism | 124.0 |
96 | Ascites | 124.0 |
97 | Rocky Mountain spotted fever | 124.0 |
98 | Peutz-Jeghers Syndrome | 123.0 |
99 | Polyarteritis nodosa | 123.0 |
100 | Gallstones | 122.0 |
101 | Papillary thyroid cancer | 120.0 |
102 | Oropharyngeal cancer | 119.0 |
103 | Amebic Liver Abscess | 115.0 |
104 | Acute bacterial meningitis in adults | 110.0 |
105 | chronic biliary obstruction | 110.0 |
106 | Leiomyomas | 108.0 |
107 | Renal Cell Carcinoma | 108.0 |
108 | Toxic thyroid adenoma | 108.0 |
109 | Anthrax | 107.0 |
110 | Muscle Layer Eosinophilic gastroenteritis | 101.0 |
111 | Gallbladder cancer | 101.0 |
112 | Laryngeal Cancer | 101.0 |
113 | Bruxism | 101.0 |
114 | Adrenocortical carcinoma | 100.0 |
115 | Umbilical hernia | 100.0 |
116 | Ruptured ectopic pregnancy | 99.0 |
117 | Lung Cancer | 96.0 |
118 | Clostridium difficile infection | 95.0 |
119 | Prinzmetal angina | 95.0 |
120 | Shigellosis | 94.0 |
121 | subserosal eosinophilic gastroenteritis | 93.0 |
122 | Deep venous thrombosis | 93.0 |
123 | Giardiasis | 92.0 |
124 | Abdominal compartment syndrome | 91.0 |
125 | Acute Cholecystitis | 90.0 |
126 | Acute peritonitis | 88.0 |
127 | pancreatic SOD | 88.0 |
128 | Atypical pneumonia | 88.0 |
129 | Salmonella infection | 87.0 |
130 | pancreatic cancer | 86.0 |
131 | Dyspepsia | 85.0 |
132 | Extrahepatic Cholestasis | 84.0 |
133 | Glomerulonephritis | 84.0 |
134 | Bacterial pharyngitis | 83.0 |
135 | Chronic Myeloid Leukemia | 79.0 |
136 | Chronic Mitral regurgitation | 78.0 |
137 | Osteomalacia | 78.0 |
138 | Gastroparesis | 77.0 |
139 | Familial adenomatous polyposis syndrome | 75.0 |
140 | Emphysematous cholecystitis | 74.0 |
141 | Chronic heart failure | 74.0 |
142 | Pneumonia | 73.0 |
143 | Acute bacterial meningitis in children | 72.0 |
144 | Chronic Clonorchiasis | 72.0 |
145 | Non-cholera Vibrio infections | 71.0 |
146 | Amyloidosis | 71.0 |
147 | Drowning | 71.0 |
148 | Eosinophilic gastroenteritis | 70.0 |
149 | mucosal Eosinophilic gastroenteritis | 70.0 |
150 | Chronic Cholecystitis | 70.0 |
151 | Viral pharyngitis | 70.0 |
152 | Graves ophthalmopathy | 69.0 |
153 | Osteomyelitis | 68.0 |
154 | Painless thyroiditis | 68.0 |
155 | Chronic Kidney Diseases | 68.0 |
156 | Acute peptic ulcer | 67.0 |
157 | Lactose intolerance | 66.0 |
158 | Rheumatoid Arthritis | 66.0 |
159 | Gestational diabetes mellitus | 66.0 |
160 | Ileus | 65.0 |
161 | Gastric Outlet Obstruction | 65.0 |
162 | Mitral Stenosis | 65.0 |
163 | Non-diabetic hypoglycemia | 65.0 |
164 | Primary hypogonadism | 63.0 |
165 | Infertility in women | 63.0 |
166 | Meckel diverticulum | 62.0 |
167 | Clonorchiasis | 61.0 |
168 | Mallory-Weiss syndrome | 60.0 |
169 | Thrombotic thrombocytopenic purpura | 58.0 |
170 | Campylobacter infection | 57.0 |
171 | Testicular cancer | 56.0 |
172 | Intraperitoneal bleeding | 53.0 |
173 | biliary obstruction | 53.0 |
174 | Anemia of chronic disease | 53.0 |
175 | Diverticulitis | 52.0 |
176 | Gastric cancer | 52.0 |
177 | Foodborne E coli infection | 52.0 |
178 | Intussusception | 51.0 |
179 | Cellulitis | 50.0 |
180 | Intestinal Pseudo Obstruction | 50.0 |
181 | Endometrial cancer | 50.0 |
182 | Travelers diarrhea | 50.0 |
183 | Hypogammaglobulinemia | 50.0 |
184 | Cataract | 50.0 |
185 | Psoriasis | 50.0 |
186 | Alzheimer disease | 50.0 |
187 | Hyperosmolar Hyperglycemic state | 50.0 |
188 | Insomnia in adults | 50.0 |
189 | Addison Disease | 50.0 |
190 | Splenic abscess | 50.0 |
191 | Splenic Rupture | 50.0 |
192 | Ankylosing spondylitis | 48.0 |
193 | Fungal meningitis | 47.0 |
194 | Cryptococcosis | 47.0 |
195 | Ovarian Torsion | 46.0 |
196 | Guillain-Barre syndrome | 45.0 |
197 | Heparin-induced thrombocytopenia | 45.0 |
198 | Kidney stones | 45.0 |
199 | COVID19 | 44.0 |
200 | Inguinal hernia | 44.0 |
201 | Acute pericarditis | 43.0 |
202 | Autosomal Dominant Polycystic Kidney Disease | 41.0 |
203 | Acute disseminated encephalomyelitis | 41.0 |
204 | Gastric Volvulus | 40.0 |
205 | End Stage Renal Disease | 40.0 |
206 | Renal and perinephric abscess | 40.0 |
207 | Acute Appendicitis | 39.0 |
208 | Irritable Bowel Syndrome | 37.0 |
209 | Acute Clonorchiasis | 37.0 |
210 | Gingivitis | 37.0 |
211 | Chronic Renal vein thrombosis | 36.0 |
212 | Hyperparathyroidism | 36.0 |
213 | Malt lymphoma | 35.0 |
214 | Hiatus hernia | 34.0 |
215 | Acute perforated appendicitis | 34.0 |
216 | Urinary Tract Obstruction | 34.0 |
217 | Intestinal malrotation | 34.0 |
218 | Exocrine pancreatic insufficiency | 34.0 |
219 | Gout | 34.0 |
220 | Hypoparathyroidism | 34.0 |
221 | Rosacea | 34.0 |
222 | Acute respiratory failure | 34.0 |
223 | Prolactinoma | 33.0 |
224 | Central retinal artery occlusion | 32.0 |
225 | Acromegaly | 32.0 |
226 | Subdural hematoma | 32.0 |
227 | Splenic Infarction | 32.0 |
228 | Liver Abscess | 31.0 |
229 | Secondary hypogonadism | 31.0 |
230 | Type 2 Diabetes mellitus | 30.0 |
231 | Acne fulminans | 30.0 |
232 | Immune thrombocytopenia | 29.0 |
233 | Phenylketonuria | 28.0 |
234 | Hyperaldosteronism | 28.0 |
235 | Pressure ulcer | 27.0 |
236 | Abnormal uterine bleeding | 27.0 |
237 | Menopause | 26.0 |
238 | Diabetes Mellitus | 25.0 |
239 | Type 1 Diabetes mellitus | 25.0 |
240 | Chronic pelvic pain in women | 25.0 |
241 | Psychogenic polydipsia | 25.0 |
242 | Transient ischemic attack | 25.0 |
243 | Intestinal Entamoeba histolytica amebiasis | 24.0 |
244 | Influenza | 24.0 |
245 | Pseudohypoparathyroidism | 24.0 |
246 | Gastroesophageal reflux disease | 23.0 |
247 | Pancreatic Pseudocyst | 23.0 |
248 | Aseptic meningitis | 23.0 |
249 | Goiter | 23.0 |
250 | Diffuse nontoxic goiter | 23.0 |
251 | Toxic multinodular goiter | 23.0 |
252 | Obstructive cervical goiters | 23.0 |
253 | Cervical goiter | 23.0 |
254 | Peptic Ulcer | 22.0 |
255 | Duodenal Ulcer | 22.0 |
256 | Gastric Ulcer | 22.0 |
257 | Acute Myeloid Leukemia in adults | 22.0 |
258 | Abetalipoproteinemia | 20.0 |
259 | Epilepsy | 20.0 |
260 | Sexual abuse and assault | 20.0 |
261 | Central diabetes insipidus | 20.0 |
262 | Recurrent aphthous stomatitis | 20.0 |
263 | Gilbert syndrome | 19.0 |
264 | Animal bites | 18.0 |
265 | Achalasia | 18.0 |
266 | Diabetic Kidney Disease | 18.0 |
267 | Annular pancreas | 17.0 |
268 | Diabetic Ketoacidosis | 17.0 |
269 | Cushing syndrome | 17.0 |
270 | Acute atrial fibrillation | 16.0 |
271 | ST-elevation myocardial infarction | 16.0 |
272 | Diabetic Neuropathy | 15.0 |
273 | Anaphylaxis | 15.0 |
274 | Stroke | 15.0 |
275 | Premature labor | 15.0 |
276 | Male factor infertility | 15.0 |
277 | Optic neuritis | 14.0 |
278 | Neuropapillitis | 14.0 |
279 | Acute bacterial meningitis in neonates | 14.0 |
280 | Amphetamine use disorder | 14.0 |
281 | Multiple endocrine neoplasia 2B | 13.0 |
282 | Hypercalcemia | 13.0 |
283 | Cholera | 13.0 |
284 | Disseminated intravascular coagulation | 13.0 |
285 | Granulomatosis with polyangiitis | 13.0 |
286 | Insect bites and stings | 13.0 |
287 | Acute cervical spine trauma | 13.0 |
288 | Analgesic nephropathy | 12.0 |
289 | Multiple Myeloma | 12.0 |
290 | COPD Exacerbation | 12.0 |
291 | Ichthyosis | 12.0 |
292 | anterior ischemic optic neuropathy | 11.0 |
293 | Ischemic stroke | 11.0 |
294 | Discogenic low back pain | 11.0 |
295 | Bullous pemphigoid | 11.0 |
296 | Intra-abdominal abscess | 10.0 |
297 | Dubin-Johnson syndrome | 10.0 |
298 | Henoch-Schonlein purpura | 8.0 |
299 | Common cold(adults) | 8.0 |
300 | Psoriatic arthritis | 8.0 |
301 | Thyroid lymphoma | 8.0 |
302 | Anaplastic thyroid cancer | 8.0 |
303 | Herpes zoster | 7.0 |
304 | Non-ST-elevation myocardial infarction | 7.0 |
305 | Hemorrhagic stroke | 6.0 |
306 | Acute Bronchitis | 5.0 |
307 | Alopecia areata | 5.0 |
308 | Periorbital and orbital cellulitis | 3.0 |
309 | Multiple Sclerosis | 2.0 |
310 | Bed bugs | 2.0 |
311 | Migraine headache in adults | 2.0 |
312 | endocarditis | 2.0 |
313 | Musculoskeletal lower back pain | 0.0 |
314 | Allergic rhinitis | 0.0 |
315 | Bell palsy | 0.0 |
316 | Stevens-Johnson syndrome | 0.0 |
317 | Hodgkin lymphoma | 0.0 |
318 | Measles | 0.0 |
319 | Visceral leishmaniasis | 0.0 |
320 | Pulmonary regurgitation | 0.0 |
321 | Parkinson disease | 0.0 |