Diseases

Question 1

Type 1 diabetes
The body is unable to produce insulin due to autoimmune destruction of beta cells in the pancreas
Onset usually several days to weeks
Odq: GI problems
If known diabetic ask about the type of diabetes
If taking insulin ask about whether injection or pump

Answer 1

Signs:
Polyuria with severe nocturnal urination
Polydipsia
Unexplained weight loss due to breakdown of body muscle (wasting)
Excessive eating
Fatigue
Nausea
Blurred vision
Diagnosis:
- fasting plasma glucose levels
- screening
- random plasma glucose levels

Question 2

Atrial fibrillation

Answer 2

Bh

Question 3

Mitral regurgitation

Answer 3

By

Question 4

Aortic regurgitation

Answer 4

Bh

Question 5

Congestive heart failure

Answer 5

Bipedal oedema

Question 6

Hepatomegaly

Answer 6

B

Question 7

Spleenomegaly

Answer 7

G

Question 8

Hepatomegaly with ascites

Answer 8

Hb

Question 9

Chronic liver disease

Answer 9

Ch

Question 10

Hepatocellular carcinoma

Answer 10

Bbs

Question 11

Liver cirrhosis

Answer 11

Big

Question 12

Hemiparesis

Answer 12

Do

Question 13

Paraplegia

Answer 13

Bd

Question 14

Pneumonia

Answer 14

Ah

Question 15

Copd

Answer 15

Sb

Question 16

Asthma

Answer 16

B

Question 17

Pleural oedema

Answer 17

B

Question 18

Stroke

Answer 18

Bad

Question 19

Sickle cell disease

Answer 19

D

Question 20

Focused diabetes

• Is the patient’s diabetes generally well controlled, with near-normal blood glucose levels? (Patients with poorly controlled blood glucose levels heal more slowly and are at increased risk for infection and other complications)
• Does the patient have severe hypoglycemic reactions? (If the patient has episodes of severe hypoglycemia and therefore is at risk for losing consciousness, this possibility must be addressed, especially if the patient drives)
• Does the patient self-monitor his or her blood glucose levels? (Note the frequency and range of values at each time of day; an increasing number of patients monitor with continuous sensors)
• foot examination

Answer 20

Regarding hypoglycemia and hyperglycemia

• Has the patient experienced recent polyuria, polydipsia, nocturia, or weight loss?
• Has the patient had episodes of unexplained hypoglycemia? If so, when, how often, and how does the patient treat these episodes?
• Does the patient have hypertension? What medications are taken?
• Has the patient had a stroke or transient ischemic attack?

Question 21

Diabetes differential diagnosis

Answer 21

• diabetic ketoacidosis
• type 2 diabetes
• insulin resistance
• diabetic nephropathy
• lead nephropathy
• cystic fibrosis
• drugs eg glucocorticoids

Question 22

Ddx of hyperacusis

Answer 22

• paralysis of the stapedius muscle due to Bell’s palsy
• tinnitus
• Ménière’s disease
• migraine headache
• temporal lobe epilepsy
• Lyme disease

Question 23

Ddx of stroke in elderly patients

Answer 23

Non modifiable: sex, genetics, age
Modifiable: hypertension, diabetes mellitus, dyslipidemia, obesity, smoking, alcohol

Question 24

Ddx in younger patients stroke

Answer 24

• oral contraceptives
• hypercoagulable states such as protein C and S deficiency,
• vasoactive drug use such as cocaine, amphetamine
• polycythemia Vera
  Sickle cell disease