Cases in general internal medicine- haem, endo, renal and rheum Flashcards
Atypical organisms causing pneumonia
Mycoplasma pneumoniae
• Chlamydia pneumoniae
• Legionella pneumophila
• Implicated in up to 40% of CAP
Microcytic anaemia
Haematinics • Coeliac screen* (TTG Ab) • Remember red flags • Top & Tail • Order depends on upper/lower GI symptoms
How do you confirm coeliac
*Diagnosis confirmed on duodenal biopsy: villous atrophy
What would you give AF less than 4hrs
DC cardioversion, after 48hr? give digoxin
Causes of blood diarroea
- Infection: infective colitis
- Inflammation: ulcerative/Crohn’s colitis (younger pts)
- Ischaemia: ischaemic colitis (older pts)
- Malignancy
- Diverticulitis
Haemolytic uraemic syndrome
…..
What is microangipathic haemolytic anaemia causes
DIC (Disseminated Intravascular Coagulation)
What happens to the following things in DIC;
Platelets, fibronogen, PT/APTT, D-dimer, fibrin degradation products
DOWN: platelets & fibrinogen – UP: PT/APTT – UP: D‐dimer/ fibrin degradation products
What happens to the following in HUS:
Hb, bilirubin, urea, platelets
HUS:
– Haemolysis (reduced Hb, increased bilirubin) – Uraemia – reduced plts
What is TTP
• TTP (Thrombotic Thrombocytopenic Purpura)
– HUS + fever + neurological manifestations
Haemolytic anaemia, hereditary and aquired causes
• Hereditary – Red cell membrane (hereditary spherocytosis) – Enzyme deficiency (G6PD deficiency) – Haemoglobinopathy (Sickle cell disease, Thalassaemias) • Acquired – Autoimmune – Drugs – Infection – MAHA
What do valvulae conniventes mean
Small bowel obstruction
Look at the hyponatraemia framework
Is there hypovolaemia, euvolaemia and hypervolaemia
Causes of hyponatrameia if patient is hypvolaemic
Diarrhoea
Vomiting
Diuretics
Clinically hypovolaemic
Low urine sodium
(measure off diuretics)
Causes of hyponatrameia if patient is euvolaemic
Hypothyroidism
Adrenal insufficiency
SIADH
TFTs
Short Synacthen test
Plasma & urine osmolality
