Deck 5 Flashcards
Why does metformin cause lactic acidosis?
Mitochondrial toxicity + impaired gluconeogenesis (impairs pyruvate carboxylase which normally converts pyruvate into oxaloacetate)
What can be used as an antidote for excessive beta blockade?
IV glucagon
What are some features of lead poisoning?
Abdominal pain
Motor neuropathy
Basophilic stippling
Why is furosemide not effective in hypoalbuminaemic states?
It is highly protein bound and require protein binding in order to be secreted into the filtrate at the proximal convoluted tubule.
Other causes of reduced protein binding of furosemide include the presence of competing highly protein-bound drugs like phenytoin and warfarin.
What are the presenting features of lateral medullary syndrome?
Ipsilateral facial sensory loss
Contralateral body sensory loss
Cerebellar features (dysphagia, dysarthria, vertigo, nystagmus)
NOTE: due to PICA aneurysm/stroke
What is a major side-effect of ribavirin therapy?
Haemolytic anaemia
Which antibiotic causes a worsening of muscle weakness in Guillain Barre symptoms?
Ciprofloxacin
How is severe lithium overdose treated?
Haemodialysis (especially if level is > 4 mmol/L)
Name a long-acting opioid receptor antagonist used to prevent relapse in people who abuse opioids.
Naltrexone
List some common drugs that can increase serum lithium concentration.
Metronidazole NSAIDs ACE inhibitors and ARBs Thiazide diuretics Steroids
Describe the main features of pseudoxanthoma elasticum.
SKIN: yellow papules over neck, puckered skin
VASCULAR: PVD, mitral valve prolapse, GI bleed, visual loss (retinal angioid streaks)
NOTE: it is a hereditary disorder of elastic tissue
Which HLA types are associated with Coeliac disease?
HLA DQ2 and DQ8
Which type of lupus is ANA negative?
Discoid lupus
What are the two main types of porphyria and what is the difference?
Acute intermittent porphyria (no photosensitivity) Variegate porphyria (photosensitivity)
NOTE: both present with abdominal pain and hypertension
What is oral hairy leukoplakia caused by?
EBV
What are the features of theophylline toxicity?
Severe vomiting Seizures Hyperthermia Hypokalaemia Hyperglycaemia Tachyarrhythmia
How is ITP managed?
Oral Prednisolone –> IVIG
Splenectomy and immunosuppressive drugs (e.g. cyclophosphamide) may also be used
What is Evans syndrome?
AIHA + ITP
NOTE: it is treated with steroids
What is the issue with using iodine-containing contrast in patients with hyperthyroidism?
It can worsen hyperthyroidism caused by toxic multinodular goitre
It can improve hyperthryoidism in Graves’ disease
NOTE: a thyroid uptake scan would be recommended
What are the features of lithium overdose?
Decreased consciousness Neuromuscular excitability (tremor) Confusion Abdominal pain Vomiting AKI ECG Changes (TWI, QT prolongation)
