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Splenomegaly

  • Common ddx

    • mono, normal variant
  • Serious ddx

    • hemolysis, infectious disease, cancer, lysosomal storage disease
  • Labs

    • monospot test
    • CBC, platelets, chem
    • BNP
    • ultrasound
  • Hyperplasia ddx

    • infection, RBC removal, hematopoiesis
  • Infection

    • mono, HIV, hepatitis, endocarditis, abscess, TB, malaria, trypanosomiasis, leishmaniasis, histoplasmosis
  • RBC removal

    • hemolytic anemia, sideroblastic anemia, thalassemia, polycythemia vera
  • Hematopoiesis

    • myelofibrosis, marrow dysfunction
  • Congestive

    • CHF, cirrhosis
  • Infiltrate

    • leukemia, lymphoma, cancer, amyloidosis
  • Lysosomal storage dz

    • Hurler's, Niemann-Pick, Gaucher's
  • Other

    • Grave's disease, TTP, SLE, Felty's syndrome, sarcoidosis
  • HPI

    • onset
    • triggering event
    • severity
    • associated pains
  • ROS

    • fever, fatigue, nightsweats, weight loss
    • skin: jaundice, rash
    • ENT: sore throat
    • cardio: chest pain, exertional dyspnea
    • pulm: cough
    • GI: nausea, vomiting, diarrhea, abdominal pain
    • endo: heat/cold sensitivity
  • PMH

    • CHF
    • rheumatoid arthritis
    • cancer
  • FH

  • SH

    • foreign travel
  • Meds

  • Allergies

  • Px

    • vitals
    • gen impression
    • skin: rash, jaundice, pallor
    • HEENT: thyroid, pharyngitis
    • cardio
    • pulm
    • abd: hepatomegaly, tenderness, mass
    • ext: splinter hemorrhage, peripheral edema
    • lymphadenopathy

  • Print | Citations

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