Chronic conditions Flashcards
How will BPH normally present
LUTS
How is LUTS scored in BPH
IPSS
International prostate symptom score
Two key examinations in BPH
DRE
Abdominal exam for masses and palpable bladder
(PSA, dipstick)
Two types of drugs to treat BPH
Alpha blockers (tamsulosin) - rapid improvements 5-alpha reductase inhibitors (finasteride) - slow improvement
What type of drug is finasteride
5 alpha reductase inhibitor
Key side effect of tamsulosin
Postural hypotension
Key side effect of finasteride
Sexual dysfunction
Side effects from TURP other than bleeding and infection
Urinary incontinence ED Retrograde ejaculation Strictures Failure
Common mets in RCC
Canonball metastases
PNP syndromes in RCC
Polycythemia (EPO)
Hypercalcemia (PTH)
HTN (renin secretion)
Stauffers syndrome (abnormal LFTs without liver mets)
What is Stauffers syndrome
Abnormal LFTs in RCC without liver mets
Management of RCC if tumour less than 7cm
Partial nephrectomy
Most common type of renal stone
Calcium oxalate
Key thing to remember about uric acid stones
Not visible x-rays
First line investigation in renal stones
KUB CT within 24 hours
3 most common cancers at causing hypercalcaemia
Myeloma, breast and lung (squamous)
Two medications that can reduce risk of renal stone formation
Potassium citrate - calcium oxalate stones and raised ca
Thiazides - calcium oxalate stones and raised ca
Only condition GPs can refer for a direct access CT abdo
Pancreatic cancer
Over 60 with weight loss and back pain
CT abdo within 2 weeks for ?pancreatic cancer
Same for diarrhoea, abdo pain, N and V, constipation
Prognosis and treatment in mesothelioma
Very poor
Chemotherapy can improve survival but essentially palliative
Why would a patient with lung cancer present with a horse voice
Tumour compressing recurrent laryngeal nerve
Triad of Horners syndrome
Ptosis, anhidrosis and miosis
What is limbic encephalitis
PNP of small lung cancer
Immune system creates antibodies against limbic system (loss of short term memory, hallucinations, confusion)
Associated with anti-hu antibodies
Any patient over 40 with what factors can have an urgent CXR
Clubbing
Lymphadenopathy
Recurrent chest infection
Thrombocytosis
60 year old smoker presents with fatigue, what investigation do they need
CXR within 2 weeks
Should lung CTs be contrast enhanced
Yes
Treatment for small vs non small
Non small - surgery (then radio)
Small - chemo and radio
What type of gene is BRCA
Tumour supressor
