Consultation Flashcards
Acromegaly investigations
Baseline insulting like growth factor will be raised
Glucose tolerance test - failure or suppression of growth hormone
MRI - pituitary views
Which systems are affected in acromegaly?
Cardiac - cardiomyopathy, IHD
HTN
T2DM
Visual impairment
Carpal tunnel
Visual impairment in acromegaly
Bitemporal hemianopia
Compression of the adenoma on the optic chiasm
Treatment for acromegaly
Surgery which is transphenoidal and aims to be curative
Medical therapy is somatostatin analogis i.e. octreotide and second line agents is bromocriptine
Radiotherapy to pituitary
Risk of surgery for acromegaly
Risk of panhypopituitarism
Scoring system for OSA
Epworth
STOP bang questionnaire
Osteogenesis imperfecta inheritance
8 types
Most commonly dominant
Spontaneous is more severe
Ehlers Danlos heart murmur
MV prolapse or MR
For investigating lymphoma is a biopsy of a lymph node or FNA more appropriate
For lymphoma you need histology so biopsy needed as FNA does not provide enough information (FNA fine for cytology only)
Cholesterol target for stroke
Fasting LDL <1.8
Or 2.5 if non fasting
Treatment for anti phospholipid
Warfarin over doac
Differentials for the appearance of retinitis pigmentosa
Diabetic retinopathy
Laser treatment scars
Toxoplasmosis
Rubella
Inheritance of R pigmentosa
30% de novo
Can be dominant recessive or x linked
Why does R pigmentosa happen and how does it affect vision
Build up of pigment
Night time vision first affected then they get tunnel vision
What type of arthritis does gonococcal usually cause?
Septic arthritis
