massive spleen

today i went to the ward to practice my clinical skills yg berkarat. so, jus wanna share what i learnt today. let's practice SAQ. medical students, sape nk tolong jawab, u r very welcome!! :)




78 y/o man came with complains of body weakness and loss of appetite for the past 6 months. On examination of the abdomen, there was massive splenomegaly and hepatomegaly.




a) what further history u would like to elicit to come to the diagnosis?

b) what other clinical examination(s) u want to perform? why?

c) what are the common causes of MASSIVE splenomegaly? differential diagnosis la..

d) what r the investigations u would like to carry out?


hm.. soalan2 ni direka je, so i dun have the skema jawapan ye :)
the splenomegaly is really mega (at least from my humble experience). it was extending towards Rt iliac fossa passes the umbilicus. before this is I only palpated mild splenomegaly, usually in Thalassaemic patients. so this morning i was like, 'gile besar spleen ni'... hmm...


~exam fever mode~