4 January #2

Question 1

What are features of Rocky Mountain spotted fever?

Answer 1

Caused by Ticks
Rickettsia Rickettsii

Headache
Pyrexia
Followed by widespread rash

Treat with doxycycline

Question 2

What is the management of Giardia Lamblia?

Answer 2

Metronidazole

Question 3

What are features of Shoulder impingement/rotator cuff tendinopathy?

Answer 3

Subacromial pain- top and lateral aspect of shoulder
Pain worse on raising arm

Pain on abduction
Painful arc

Treat with analgesia, physio and consider steroid injections

Question 4

What are features of erythasma?

Answer 4

Skiw enlarging well circumscribed flat, pink-brown patches on thighs/groin

Aooear Cirak red under woods lamp

Treatment
1) Topical miconazole or clotrimazole if localised
2) Oral macrolide or tetracycline if extensive

Question 5

What are features of SIADH?

Answer 5

Euvolaemic
Hypotonic Hyponatraemia
Urine sodium >20 or urine osmolality >100

1st line fluid restriction

Question 6

What are features of acute tubular necrosis?

Answer 6

Causes
- rhabdomyolysis
-NSAIDS
- Ischaemia

Urinanalysis- muddy brown casts
- poor response to fluid challenge

Initial oliguria then polyuria then recovery

Question 7

What are features of Carcinoid syndrome?

Answer 7

Tumours secrete serotonin into circulation

Flushing
Diarrhoea
Wheeze
Mid diastolic murmur at LLSE- tricuspid stenosis

Urinary 5-HIAA increased

Treat with octreotide