50 years old | Male
A 50-year-old man presents to his primary-care clinic physician with complaints of fatigue for 2 months. The patient also notes distention of his abdomen and shortness of breath beginning 2 weeks ago. His wife reports that the patient has been having episodes of confusion lately. The patient has a significant medical history of chronic heavy alcohol consumption of about a half pint of vodka daily for around 20 years. On physical exam the patient is noted to have scleral icterus, tremors of both hands, and spider angiomata on the chest. There is abdominal distention with presence of shifting dullness, fluid waves, and splenomegaly. Laboratory examination shows low hemoglobin, low platelets, low sodium, aspartate aminotransferase (AST) elevation > alanine aminotransferase (ALT) elevation, and high prothrombin time (PT) and international normalized ratio (INR). Ultrasound of the abdomen shows liver hyperechogenicity, portal hypertension, splenomegaly, and ascites.
fatigue | 2 months | abdominal distention | shortness of breath | confusion | heavy alcohol consumption | scleral icterus | tremors of hands | spider angiomata on the chest | shifting dullness | fluid waves | splenomegaly | low hemoglobin | low platelets | low sodium | AST greater than ALT | elevated prothrombin time | elevated INR | liver hyperechogenicity | portal hypertension | ascites
Alcoholic liver disease Alcoholic Hepatitis Alcoholic Fatty Liver
https://online.epocrates.com/diseases/111622/Alcoholic-liver-disease/Common-Vignette
Rank |
Disease |
Weight |
---|---|---|
1 | Alcoholic Liver Cirrhosis | 804.0 |
2 | Alcoholic hepatitis | 798.0 |
3 | Alcoholic Liver Disease | 778.0 |
4 | Liver Cirrhosis | 777.0 |
5 | Biliary cirrhosis | 776.0 |
6 | Primary biliary cirrhosis | 774.0 |
7 | Autoimmune hepatitis | 697.0 |
8 | Alcoholic Fatty Liver | 668.0 |
9 | Primary sclerosing cholangitis | 646.0 |
10 | Acute Liver Failure | 635.0 |
11 | Budd Chiari Syndrome | 607.0 |
12 | Hepatocellular carcinoma | 581.0 |
13 | Acute Lymphoblastic leukemia in children | 579.0 |
14 | Cholangiocarcinoma | 534.0 |
15 | Hereditary hemochromatosis | 534.0 |
16 | Hepatic Encephalopathy | 506.0 |
17 | Primary Myelofibrosis | 490.0 |
18 | Chronic heart failure | 486.0 |
19 | Gastritis | 484.0 |
20 | Short bowel syndrome | 467.0 |
21 | Pyogenic Liver Abscess | 466.0 |
22 | Acute Lymphocytic Leukemia in Adults | 458.0 |
23 | Non-alcoholic Fatty Liver Disease | 446.0 |
24 | Cystic Fibrosis | 437.0 |
25 | Rocky Mountain spotted fever | 437.0 |
26 | Common cutaneous drug reactions | 428.0 |
27 | Klebsiella pneumoniae liver abscess | 417.0 |
28 | Tuberculous Peritonitis | 409.0 |
29 | Acute Myeloid Leukemia in adults | 400.0 |
30 | Sarcoidosis | 398.0 |
31 | Acute Hepatitis | 391.0 |
32 | Systemic sclerosis | 385.0 |
33 | Hepatorenal Syndrome | 384.0 |
34 | pancreatic cancer | 379.0 |
35 | Wilson disease | 367.0 |
36 | Systemic lupus erythematosus | 351.0 |
37 | Acute fatty liver of pregnancy | 348.0 |
38 | Toxic Megacolon | 346.0 |
39 | Ovarian Hyperstimulation Syndrome | 344.0 |
40 | Acute Pancreatitis | 340.0 |
41 | Pneumonia | 337.0 |
42 | Eclampsia | 336.0 |
43 | Chronic Hepatitis | 335.0 |
44 | Addison Disease | 335.0 |
45 | Hemolytic uremic syndrome | 325.0 |
46 | Acute Myeloid Leukemia in children | 322.0 |
47 | Chronic liver disease | 319.0 |
48 | Celiac Disease | 318.0 |
49 | Liver disease | 315.0 |
50 | Adrenal crisis | 314.0 |
51 | Amebic Liver Abscess | 313.0 |
52 | Thrombotic thrombocytopenic purpura | 313.0 |
53 | Gallstone pancreatitis | 313.0 |
54 | Graves Disease | 311.0 |
55 | Autosomal Recessive Polycystic Kidney Disease | 301.0 |
56 | Brucellosis | 298.0 |
57 | Malaria | 293.0 |
58 | Multiple Myeloma | 293.0 |
59 | mucosal Eosinophilic gastroenteritis | 289.0 |
60 | Non-small cell lung cancer | 287.0 |
61 | Crohn Disease | 286.0 |
62 | Acetaminophen overdose | 284.0 |
63 | Ascites | 282.0 |
64 | Infectious mononucleosis | 281.0 |
65 | Hypothyroidism | 278.0 |
66 | Mitral Stenosis | 278.0 |
67 | Heparin-induced thrombocytopenia | 278.0 |
68 | Hypertriglyceridemia | 276.0 |
69 | Disseminated intravascular coagulation | 274.0 |
70 | Acute intermittent porphyria | 268.0 |
71 | Hypogammaglobulinemia | 266.0 |
72 | Anthrax | 264.0 |
73 | Chronic Myeloid Leukemia | 263.0 |
74 | Food poisoning | 263.0 |
75 | Colorectal cancer | 260.0 |
76 | Abnormal uterine bleeding | 258.0 |
77 | Preeclampsia | 251.0 |
78 | Ovarian Cancer | 250.0 |
79 | Foreign body ingestion | 242.0 |
80 | Spontaneous bacterial peritonitis | 240.0 |
81 | Ulcerative Colitis | 239.0 |
82 | Acute bacterial meningitis in adults | 239.0 |
83 | Chronic Lymphocytic Leukemia | 235.0 |
84 | Anemia of chronic disease | 234.0 |
85 | Hereditary Angioedema | 233.0 |
86 | Hyperprolactinemia | 227.0 |
87 | Shigellosis | 226.0 |
88 | Mesenteric ischemia | 221.0 |
89 | Kawasaki disease | 220.0 |
90 | Lung Cancer | 216.0 |
91 | Diabetic Ketoacidosis | 215.0 |
92 | Extraintestinal Entamoeba histolytica amebiasis | 213.0 |
93 | Rheumatoid Arthritis | 212.0 |
94 | Acute bacterial meningitis in children | 212.0 |
95 | Granulomatosis with polyangiitis | 207.0 |
96 | Chronic Mitral regurgitation | 206.0 |
97 | Chronic Pancreatitis | 205.0 |
98 | Choledocholithiasis | 205.0 |
99 | Amyloidosis | 203.0 |
100 | Muscle Layer Eosinophilic gastroenteritis | 200.0 |
101 | Premenstrual syndrome | 200.0 |
102 | Intestinal Obstruction | 197.0 |
103 | Hyperosmolar Hyperglycemic state | 195.0 |
104 | Subdural hematoma | 194.0 |
105 | Stable ischemic heart disease | 191.0 |
106 | Acute bacterial meningitis in neonates | 191.0 |
107 | Chronic atrial fibrillation | 190.0 |
108 | Portal hypertension | 189.0 |
109 | Cryptococcosis | 189.0 |
110 | Typhoid infection | 188.0 |
111 | Adrenocortical carcinoma | 187.0 |
112 | Non-cholera Vibrio infections | 187.0 |
113 | Acute Cholangitis | 186.0 |
114 | Autoimmune Pancreatitis | 182.0 |
115 | subserosal eosinophilic gastroenteritis | 182.0 |
116 | Drowning | 182.0 |
117 | Pulmonary Embolism | 180.0 |
118 | Abdominal compartment syndrome | 178.0 |
119 | Hyperthyroidism | 177.0 |
120 | Acute respiratory failure | 176.0 |
121 | Aortic stenosis | 170.0 |
122 | Inflammatory Bowel Diseases | 169.0 |
123 | Laryngeal Cancer | 169.0 |
124 | Viral pharyngitis | 168.0 |
125 | Non-diabetic hypoglycemia | 168.0 |
126 | Non-ST-elevation myocardial infarction | 168.0 |
127 | Peutz-Jeghers Syndrome | 167.0 |
128 | Acromegaly | 166.0 |
129 | Liver Abscess | 165.0 |
130 | Acute disseminated encephalomyelitis | 163.0 |
131 | Gastric cancer | 158.0 |
132 | Fungal meningitis | 158.0 |
133 | Bacterial pharyngitis | 157.0 |
134 | Familial adenomatous polyposis syndrome | 157.0 |
135 | Polyarteritis nodosa | 155.0 |
136 | Osteoporosis | 155.0 |
137 | Fibromyalgia | 155.0 |
138 | Obstructive Sleep Apnea | 154.0 |
139 | Acute peptic ulcer | 154.0 |
140 | Anaphylaxis | 154.0 |
141 | Ankylosing spondylitis | 152.0 |
142 | Deep venous thrombosis | 150.0 |
143 | Foodborne E coli infection | 149.0 |
144 | Ruptured ectopic pregnancy | 149.0 |
145 | chronic biliary obstruction | 149.0 |
146 | Renal Cell Carcinoma | 145.0 |
147 | Familial Mediterranean fever | 143.0 |
148 | Aortic coarctation | 142.0 |
149 | Chronic Clonorchiasis | 140.0 |
150 | Acute peritonitis | 139.0 |
151 | Chronic Kidney Diseases | 139.0 |
152 | anterior ischemic optic neuropathy | 138.0 |
153 | Clostridium difficile infection | 138.0 |
154 | Chronic bacterial prostatitis | 137.0 |
155 | Leiomyomas | 137.0 |
156 | Giardiasis | 136.0 |
157 | Amphetamine use disorder | 136.0 |
158 | Gastric Outlet Obstruction | 135.0 |
159 | Von willebrand disease | 135.0 |
160 | Acute viral meningitis | 134.0 |
161 | Oropharyngeal cancer | 132.0 |
162 | Gallbladder cancer | 131.0 |
163 | Hypercalcemia | 130.0 |
164 | COPD Exacerbation | 129.0 |
165 | Stevens-Johnson syndrome | 129.0 |
166 | Sigmoid volvulus | 129.0 |
167 | Prinzmetal angina | 129.0 |
168 | End Stage Renal Disease | 128.0 |
169 | Hiatus hernia | 124.0 |
170 | Umbilical hernia | 124.0 |
171 | Analgesic nephropathy | 123.0 |
172 | Renal and perinephric abscess | 123.0 |
173 | Multiple Sclerosis | 123.0 |
174 | Glomerulonephritis | 123.0 |
175 | Cushing syndrome | 123.0 |
176 | Meckel diverticulum | 122.0 |
177 | Clonorchiasis | 120.0 |
178 | Influenza | 119.0 |
179 | Aseptic meningitis | 119.0 |
180 | Hemorrhagic stroke | 117.0 |
181 | Ischemic stroke | 117.0 |
182 | Lactose intolerance | 115.0 |
183 | Pheochromocytoma | 115.0 |
184 | Painless thyroiditis | 115.0 |
185 | Acute heart failure | 115.0 |
186 | Eosinophilic gastroenteritis | 114.0 |
187 | Diverticulitis | 114.0 |
188 | Mallory-Weiss syndrome | 112.0 |
189 | Primary hypogonadism | 111.0 |
190 | Diabetic Kidney Disease | 108.0 |
191 | Acute Cholecystitis | 107.0 |
192 | Acute Clonorchiasis | 106.0 |
193 | COVID19 | 105.0 |
194 | Salmonella infection | 105.0 |
195 | Prolactinoma | 104.0 |
196 | Endometrial cancer | 104.0 |
197 | Gastroparesis | 104.0 |
198 | Biliary cyst | 104.0 |
199 | Emphysematous cholecystitis | 103.0 |
200 | Candidal intertrigo | 102.0 |
201 | Candida Balanitis | 102.0 |
202 | Oropharyngeal and esophageal candidiasis | 102.0 |
203 | Vulvovaginal candidiasis | 102.0 |
204 | Oral candidiasis | 102.0 |
205 | Angiodysplasia of the colon | 101.0 |
206 | Bruxism | 101.0 |
207 | Autoimmune hemolytic anemia | 100.0 |
208 | Type 1 Diabetes mellitus | 100.0 |
209 | Insomnia in adults | 100.0 |
210 | Toxic thyroid adenoma | 100.0 |
211 | Breast Cancer | 100.0 |
212 | Acute Appendicitis | 99.0 |
213 | Intrahepatic cholestasis of pregnancy | 99.0 |
214 | Osteoarthritis | 98.0 |
215 | posteriorischemic optic neuropathy | 98.0 |
216 | Graves ophthalmopathy | 98.0 |
217 | Irritable Bowel Syndrome | 97.0 |
218 | Kartagener syndrome | 96.0 |
219 | Psoas Abscess | 96.0 |
220 | Chronic pyelonephritis | 95.0 |
221 | Acute perforated appendicitis | 94.0 |
222 | Acne fulminans | 94.0 |
223 | Campylobacter infection | 94.0 |
224 | Abetalipoproteinemia | 93.0 |
225 | Rotor syndrome | 92.0 |
226 | Intrahepatic Cholestasis | 92.0 |
227 | Gastrointestinal Hemorrhage | 91.0 |
228 | Lower gastrointestinal hemorrhage | 91.0 |
229 | Upper gastrointestinal hemorrhage | 91.0 |
230 | ST-elevation myocardial infarction | 91.0 |
231 | Pancreatic Pseudocyst | 90.0 |
232 | Parkinson disease | 90.0 |
233 | Asthma | 90.0 |
234 | Gastric Volvulus | 90.0 |
235 | Intussusception | 87.0 |
236 | Stable angina | 86.0 |
237 | Multiple endocrine neoplasia 2A | 86.0 |
238 | Dyspepsia | 86.0 |
239 | Chronic fatigue syndrome | 85.0 |
240 | Cholera | 85.0 |
241 | biliary SOD | 85.0 |
242 | Stroke | 84.0 |
243 | Splenic Rupture | 84.0 |
244 | Duodenal Ulcer | 83.0 |
245 | Gastric Ulcer | 83.0 |
246 | Gallstones | 83.0 |
247 | Autosomal Dominant Polycystic Kidney Disease | 82.0 |
248 | Bullous pemphigoid | 82.0 |
249 | Alzheimer disease | 81.0 |
250 | Immune thrombocytopenia | 81.0 |
251 | Limited cutaneous systemic sclerosis | 81.0 |
252 | Transient ischemic attack | 80.0 |
253 | Recurrent aphthous stomatitis | 80.0 |
254 | Hyperparathyroidism | 79.0 |
255 | chronic acalculous cholecystitis | 79.0 |
256 | Travelers diarrhea | 78.0 |
257 | Motion Sickness | 78.0 |
258 | Ileus | 78.0 |
259 | Hypoparathyroidism | 76.0 |
260 | Gilbert syndrome | 76.0 |
261 | Atopic dermatitis | 76.0 |
262 | Primary ciliary dyskinesia | 75.0 |
263 | Intestinal Pseudo Obstruction | 75.0 |
264 | Pharyngitis | 74.0 |
265 | STI HIV Pharyngitis | 74.0 |
266 | Herpes pharyngitis | 74.0 |
267 | Insect bites and stings | 74.0 |
268 | Empyema | 73.0 |
269 | Allergic rhinitis | 73.0 |
270 | Chronic pelvic pain in women | 73.0 |
271 | Secondary hypogonadism | 73.0 |
272 | Goiter | 72.0 |
273 | Diffuse nontoxic goiter | 72.0 |
274 | Toxic multinodular goiter | 72.0 |
275 | Obstructive cervical goiters | 72.0 |
276 | Cervical goiter | 72.0 |
277 | Gestational diabetes mellitus | 72.0 |
278 | Hyperaldosteronism | 71.0 |
279 | Migraine | 70.0 |
280 | Epilepsy | 70.0 |
281 | Ovarian Torsion | 67.0 |
282 | Annular pancreas | 66.0 |
283 | Anaplastic thyroid cancer | 66.0 |
284 | Multiple endocrine neoplasia 2B | 66.0 |
285 | Psoriasis | 65.0 |
286 | Extrahepatic Cholestasis | 65.0 |
287 | Premature labor | 65.0 |
288 | Splenic abscess | 64.0 |
289 | Psychogenic polydipsia | 63.0 |
290 | Acute bacterial rhinosinusitis | 62.0 |
291 | Unstable angina | 61.0 |
292 | Intestinal Entamoeba histolytica amebiasis | 61.0 |
293 | Acute pyelonephritis in adults | 61.0 |
294 | Migraine headache in adults | 61.0 |
295 | Ruptured ovarian cyst | 61.0 |
296 | Inguinal hernia | 60.0 |
297 | Aortic Dissection | 59.0 |
298 | Type 2 Diabetes mellitus | 59.0 |
299 | Esophagitis | 59.0 |
300 | Guillain-Barre syndrome | 59.0 |
301 | Adrenal Suppression | 57.0 |
302 | Central hypothyroidism | 56.0 |
303 | Central diabetes insipidus | 54.0 |
304 | Milk-alkali syndrome | 54.0 |
305 | Acute Milk-alkali syndrome | 54.0 |
306 | Chronic Milk-alkali syndrome | 54.0 |
307 | Menopause | 54.0 |
308 | Splenic Infarction | 54.0 |
309 | Priapism | 54.0 |
310 | Systemic vasculitis | 53.0 |
311 | Intraperitoneal bleeding | 53.0 |
312 | Intestinal malrotation | 52.0 |
313 | Balanitis | 51.0 |
314 | Acute Rhinosinusitis | 50.0 |
315 | Acute viral rhinosinusitis | 50.0 |
316 | Cataract | 50.0 |
317 | Infertility in women | 50.0 |
318 | Mirizzi Syndrome | 50.0 |
319 | Cholestasis | 50.0 |
320 | Acalculous Cholecystitis | 49.0 |
321 | Croup | 49.0 |
322 | Endometriosis | 48.0 |
323 | Herpes zoster | 48.0 |
324 | Acute pericarditis | 48.0 |
325 | Acute Mitral regurgitation | 48.0 |
326 | Ischemic optic neuropathy | 48.0 |
327 | Gastroesophageal reflux disease | 48.0 |
328 | Chlamydia pneumoniae infection | 48.0 |
329 | Atypical pneumonia | 48.0 |
330 | Gout | 48.0 |
331 | Optic neuritis | 47.0 |
332 | Neuropapillitis | 47.0 |
333 | Erectile dysfunction | 47.0 |
334 | Amebiasis | 47.0 |
335 | Urinary Tract Obstruction | 46.0 |
336 | Pseudohypoparathyroidism | 46.0 |
337 | Thyroid lymphoma | 46.0 |
338 | Varicose veins | 46.0 |
339 | cholestatic liver disease | 45.0 |
340 | Male factor infertility | 45.0 |
341 | Endometritis | 44.0 |
342 | Sunburn | 44.0 |
343 | Malt lymphoma | 44.0 |
344 | Viral Gastroenteritis | 43.0 |
345 | Ruptured Tuboovarian abscess | 43.0 |
346 | Churg-Strauss Syndrome | 43.0 |
347 | Achalasia | 43.0 |
348 | Bed bugs | 42.0 |
349 | Dubin-Johnson syndrome | 42.0 |
350 | Phenylketonuria | 41.0 |
351 | Choledochal Cyst | 41.0 |
352 | Bladder Cancer | 40.0 |
353 | Penis Carcinoma | 40.0 |
354 | Gallbladder Dyskinesia | 40.0 |
355 | pancreatic SOD | 40.0 |
356 | Essential Tremor | 36.0 |
357 | Acute atrial fibrillation | 35.0 |
358 | Henoch-Schonlein purpura | 35.0 |
359 | Nasal polyps | 34.0 |
360 | Exocrine pancreatic insufficiency | 34.0 |
361 | Rosacea | 34.0 |
362 | Animal bites | 34.0 |
363 | Tinnitus | 34.0 |
364 | chronic cholestatic liver disease | 33.0 |
365 | Gingivitis | 33.0 |
366 | Substernal goiter | 33.0 |
367 | Labyrinthitis | 33.0 |
368 | Peptic Ulcer | 32.0 |
369 | Intra-abdominal abscess | 32.0 |
370 | Peritoneal dialysis associated peritonitis | 30.0 |
371 | Common cold(adults) | 29.0 |
372 | Renal Artery Stenosis | 29.0 |
373 | Cellulitis | 29.0 |
374 | Miliaria | 29.0 |
375 | Listerial gastroenteritis | 27.0 |
376 | Acute otitis media | 27.0 |
377 | Ovarian and fallopian tube torsion | 27.0 |
378 | Paraneoplastic Syndromes | 26.0 |
379 | Testicular cancer | 26.0 |
380 | Chronic Renal vein thrombosis | 26.0 |
381 | Pelvic inflammatory disease | 25.0 |
382 | Acute pelvic inflammatory disease | 25.0 |
383 | Kidney stones | 25.0 |
384 | Diabetes Mellitus | 25.0 |
385 | Osteomyelitis | 24.0 |
386 | Periorbital and orbital cellulitis | 24.0 |
387 | Mitral Valve Prolapse | 24.0 |
388 | Acute Bacterial Prostatitis | 23.0 |
389 | Bacterial gastroenteritis | 22.0 |
390 | biliary obstruction | 22.0 |
391 | Hemorrhoids | 21.0 |
392 | Gallbladder Empyema | 21.0 |
393 | Genital herpes | 20.0 |
394 | Charcot-Marie-Tooth Disease | 20.0 |
395 | Zollinger-Ellison Syndrome | 20.0 |
396 | Sphincter of Oddi Dysfunction | 20.0 |
397 | Papilledema | 20.0 |
398 | Chronic meningitis | 20.0 |
399 | biliary colic | 19.0 |
400 | Pyelonephritis | 19.0 |
401 | Secondary hyperparathyroidism | 18.0 |
402 | Musculoskeletal sprains and strains | 18.0 |
403 | Medullary thyroid cancer | 18.0 |
404 | Barrett esophagus | 18.0 |
405 | Panic disorder in adults | 18.0 |
406 | Ichthyosis | 18.0 |
407 | Chronic Cholecystitis | 18.0 |
408 | Meniere disease | 18.0 |
409 | Angle Closure Glaucoma | 17.0 |
410 | Bacterial conjunctivitis | 15.0 |
411 | Viral conjunctivitis | 15.0 |
412 | Diabetic Neuropathy | 15.0 |
413 | Sexual abuse and assault | 15.0 |
414 | Dystonia | 15.0 |
415 | Secondary Peritonitis | 14.0 |
416 | Rotator Cuff Tears | 14.0 |
417 | Nephrogenic diabetes insipidus | 14.0 |
418 | Acute cervical spine trauma | 14.0 |
419 | Discogenic low back pain | 11.0 |
420 | Benign Prostatic Hyperplasia | 11.0 |
421 | Acute Bronchitis | 9.0 |
422 | Sialadenitis | 9.0 |
423 | Psoriatic arthritis | 8.0 |
424 | Gastroenteritis | 7.0 |
425 | Common cold(children) | 6.0 |
426 | Epiploic appendagitis | 6.0 |
427 | Pityriasis rosea | 5.0 |
428 | Alopecia areata | 4.0 |
429 | Diabetic Amyotrophy | 3.0 |
430 | endocarditis | 2.0 |
431 | Acute Cystitis(Men) | 0.0 |
432 | Carpal Tunnel Syndrome | 0.0 |
433 | Bell palsy | 0.0 |
434 | Orthostatic hypotension | 0.0 |
435 | Pulmonary regurgitation | 0.0 |
436 | Tetanus | 0.0 |
437 | Congenital Myasthenic Syndromes | 0.0 |
438 | Neonatal Myasthenia Gravis | 0.0 |
439 | Myasthenia Gravis | 0.0 |
440 | Hodgkin lymphoma | 0.0 |
441 | Measles | 0.0 |
442 | Visceral leishmaniasis | 0.0 |
443 | Acute epididymitis | 0.0 |
444 | Musculoskeletal lower back pain | 0.0 |