Bedside Stuffs

Question 1

CAUSES OF HEPATOMEGALY

Answer 1

VIRAL:
• Hepatitis B and C virus • Cytomegalovirus
• Epstein Barr Virus CVS:
• Congestive Cardiac Failure • Hepatic Vein Thrombosis TOXINS AND DRUGS: Anti-Kochs

NEOPLASMS:
• Primary Liver Cell Carcinoma
• Fibrolamellar Carcinoma
• Secondary Metastasis
• Benign liver tumours (like haemangiomas and adenomas)
• Leukaemia
• Lymphoma

• Hepatic cyst
• Gaucher’s disease
• Autoimmune chronic hepatitis METABOLIC DISEASES:
• Non-alcoholic Fatty Liver Disease • Haemochromatosis
• Wilson’s disease
• Alpha 1 antitrypsin deficiency

Question 2

CAUSES OF SPLENOMEGALY

Answer 2

1) CONGESTIVE: Liver Cirrhosis,Stenosis or malformation of portal or splenic vein, Hepatic vein occlusion, Portal vein thrombosis, Chronic CCF.
2) INFECTIVE: Endorcatis, Septicaemia, TB, Septicaemia, Brucellosis, Salmonellosis, Hepatitis virus, CMV, EBV,Malaria, Leishmaniasis, Trypanosomiasis.
3) INFLAMMATORY: Felty’s syndrome, Sarcoidosis, SLE
4) HEMATOLOGIC: Hereditary sphreocytosis,Autoimmune hemolytic anemia, CML, Myelofibrosis, Essential thrombocythaemia, Leukemia, Lymphoma.
5) GENETIC: Lysomal storage disease like Gaucher’s disease

Question 3

CAUSES OF PULSUS PARADOXUS

Answer 3

Cardiac tamponade
• Pericardial effusion
• Constrictive pericarditis
• Restrictive cardiomyopathy • Pulmonary embolism
• Acute myocardial infarction • Cardiogenic shock
• Obstructive sleep apnea
• COPD exacerbations

Question 4

CAUSE OF PULSUS ALTERANS

Answer 4

• Left Ventricular Systolic impairment

Question 5

CAUSES OF RADIO-FEMORAL DELAY

Answer 5

• Normal Anatomical variations • Thoracic inlet syndrome
• Scalene syndrome
• Aneurysm of the aorta
• Pre-subclavian coarctation
• Supra-valvular aortic stenosis
• Pulseless disease (Takayasu’s disease)
• Peripheral embolism
• Atherosclerosis of aorta
• Pressure over axillary artery by tumour

Question 6

CAUSES OF COLLAPSING PULSE

Answer 6

PHYSIOLOGICAL:
• Fever
• Pregnancy
CARDIAC LESIONS
• Aortic regurgitation
• Patent Ductus Arteriosus
• Systolic hypertension
• Bradycardia
• Aorto-pulmonary window • Aneurysm of sinus vasalva

Anaemia
• Cor Pulmonale
• Cirrhosis of liver
• Beri beri
• Thyrotoxicosis OTHERS:
• Chronic alcoholism

Question 7

COMPLICATIONS OF DM

Answer 7

1) ACUTE
Hyperglycaemia 
DKA
Hyperosmolar Hyperglycaemic State • Hypoglycaemia
Lactic Acidosis

2) CHRONIC: vascular:

• Macrovascular
CNS: Cerebro-vascular disease
Heart: Coronary Artery Disease
Vessels: peripheral vascular disease, diabetic foot ulcers
• Microvascular :Diabetic Neuropathy Diabetic Nephropathy Diabetic Retinopathy

Non-vascular: infections (malignant otitis media, emphysematous pyelonephritis), cataract, glaucoma, periodontal diseases,boils,carbuncles, cellulitis, vaginal infection

Question 8

ANAEMIA CLASSIFICATION

Answer 8

Based on RBC morphology
• Microcytic anaemia
Iron deficiency
 Thalasaemia
Lead poisoning
Anaemia of chronic disease Sideroblastic anaemia

• Macrocytic anaemia
Megaloblastic Alcoholism

• Based on severity: normal, mild, moderate, severity
• Based on aetiology: blood loss, nutritional, bone marrow failure, haemolytic, infections/infestations, secondary to systemic disease

Question 9

CAUSES OF PLEURAL EFFUSION

Answer 9

• CCF
• CKD
• Nephrotic Syndrome • CLD
• Lung CA/metastasis • Pneumonia
• TB
• SLE
• Rheumatoid Athritis
• Pulmonary Embolism • Peritoneal Dialysis
• Lymphoma
• Meig’s syndrome
• Ascites
• Intra-abdominal abscess • Asbestosis
• Mesothelioma