CCC 5 Flashcards
what are the causes of bloody diarrhoea?
infection- infectious colitis
inflammation- ulcerative colitis
ischaemic colitis
how does portal hypertension present?
ascites
SBP
hepatic encephalopathy
variceal bleed
what will be findings and symptoms in someone with HUS?
haemolysis= shistocytes on blood film
uraemia= high creatinine
recent diarrhoea and malaise
whats the triad for HUS?
haemolytic anaemia
uraemia
thrombocytopenia
what are the 3 hereditary haemolytic anaemias and what defects do they have?
G6PD deficiency- deficiency in the enzyme causes breakdown of RBCs
hereditary spherocytosis- defect in the cell membrane causes breakdown of RBCs
sickle cell/thalassaemia- haemoglobinopathy
what are the acquired causes of haemolytic anaemia?
autoimmune
MAHA
drugs
infection
what is the difference between small and large bowel obstruction on x ray?
small bowel= valvulae conniventes
large bowel= haustra
what are the cuases of hypovolemic hyponatraemia?
vomitting
diarrhoea
diuresis
how do you identify hypovolemic hyponatraemia?
you have to do a urine sodium not serum
what are the causes of euvolemic hyponatraemia?
SIADH
hypothyrodisim
why does hypothyroidism cause euvolemic hyponatraemia?
hypothyroidism causes reduced cardiac output
this causes increased release of ADH
higher levels of ADH will cause more sodium excretion
what are the causes of hypervolemic hypontraemia?
liver, heart and kidney failure
how do you differentiate hypovolemic and hypervolemic hyponatraemia using ix?
hypovolemic= high urine sodium hypervolemic= low urine sodium
what are the micro, macro and metolbic complications of diabetes?
micro= retinopathy, nephropathy, neuropathy macro= stroke, MI, PVD metab= DKA, HHS, hypoglycaemia
what are the 2 sources of ALP?
lung and bone
what will ALP level be in myeloma?
normal
what are the causes of cavitating lung lesions?
infection= klebsiella, staph aureus, TB
inflammation= rheumatoid arthritis
malignancy
ischaemia= PE
what should you think if someone has recurrent GI and nosebleeds?
hereditary telangiectasia
what are the 3 components of FBC?
Hb
WCC
platelets
what acronym is used to remember the causes of macrocytic anaemia?
alcoholics may have liver failure: alcohol myelodysplasia hypothyroidism liver failure folate/b12 deficiency
what are symptoms of polycythaemia vera?
headache tinnitus pruritus after a hot bath thrombosis DVT blurred vision
what are the 4 main presentations of sickle cell (acutely) and how are they managed?
acute painful crisis= o2, analgesia, abx, IV fluids sequestration crisis (bone pain)= if repeated do splenectomy cholecystitis= do a cholecystectomy stroke= exchange blood transfusion
what are the 4 presentations of sickle cell?
acute painful crisis
cholecystitis
sequestration crisis
stroke
how do you manage a stroke due to sickle cell?
exchange blood transfusion
what are the crab features of multiple myeloma and how do they present?
c- hypercalcaemia= polyuria, polydipsia and constipation
r-renal failure= high urea and creatinine
a- anaemia=SOB, pallor
b- bone pain
if there is anaemia with low reticulocytes, what might be the cause?
parvovirus B
aplastic crisis with sickle cell
blood tranfusion
what will you see on an uptake scan in thyroid cancer?
cold nodules
what are rf for thyroid cancer?
irradiation
fhx
lymphadenopathy
how do you treat a bitemporal hemianopia first line?
cabergoline not surgery
how is prolactinoma managed first line and why?
cabergoline not surgery
surgery is very risky
when diagnosing cushings what should you look for and what can help you differentiate it?
if they are just depressed and have gained weight this is not cushings
look for purple striae, bruising, thin skin, young onset diabetes/hypertension/ osteoporosis
what is the relationship between potassium and glucose?
potassium drives glucose into cells therefore hypokalemia causes diabetes
what are the causes of oligo/amenorrhea and how do you remember?
go from head to toe:
hypothalamus (excess exercise or low BMI)
pituitary (excess prolactin/lack of FSH or LH)
thyroid (do TFTs)
PCOS (hyperandrgenism causes lack of negative feedback)
what 3 blood tests should you do for polyuria and polydipsia and why?
blood glucose, potassium and calcium
low potassium and calcium cause diabetes
what causes hypernatraemia if there is high urine osmolality?
dehydration, HHS or T2DM
what causes hypernatraemia if there is low urine osmolality?
diabetes insipidus
what should you think when you see high calcium with low PTH?
malignancy or myeloma
what is active urine sediment?
blood and protein in urine
how does renal artery stenosis present?
asymmetrical kidneys
what ix is done for renal artery stenosis?
magnetic resonance angiography
what are features of BCC?
pearly
rolled edges
surface telangiectasia
rolled edges
