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asterixis (liver flap)

Sometimes referred to as a 'liver flap'. Etiology: - may be seen in any diffuse encephalopathy related to a) drug intoxication b) organ system failure, especially 1] hepatic encephalopathy [3] 2] renal failure 3] pulmonary insufficiency {especially with hypercarbia} c) CNS infection Clinical manifestations: - brief, arrhythmic interruptions of sustained voluntary muscle contraction, usually observed as a brief lapse of posture of wrists in dorsiflexion with arms outstretched

General

sign/symptom

References

  1. Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 38
  2. Guide to Physical Examination & History Taking, 4th edition, Bates, B, JB Lippincott, Philadelphia.
  3. Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025