Hepatocellular Carcinoma

Inspect:
- emaciated
- jaundice +/- pallor
- signs of chronic hepatic disease

• clubbing
• palmar erythema
• spider naevi (>5)
• distended abd veins

- distended Abd

Palpate:
- non-tender, no rebound, no guarding
- RUQ mass
- irregular border
- firm consistency
- cannot get above it
- moves with respiration

- not attached to skin
- describe size (at mid clavicular point)
- dull on percussion
- +/- spelnomegaly (portal hypertensions)

- shifting dullness - ascites

- virchow's node
- goin LN and generalised lymphadenopathy
- PR exam