geeky medics conditions (UKMLA 311)

Question 1

Acute/ascending Cholangitis:

Answer 1

Is an infection of the biliary tree: caused by combination of both: biliary outflow obstruction+biliary infection
- Is life-threatening
- age 50-60 yrs old
-bile stays for too long in gallbladder: therefore increases chances of bacteria
- Features: Charcot’s triad: fever, RUQ pain, Jaundice
- Investigation(in order): US, CT, ERCP= is the gold standard investigation and management

Question 2

Acoustic Neuroma

Answer 2

• Unilateral sensorineural hearing loss
• +/- tinnitus
• Rinne’s test: air conduction more
• Weber’s test: sound lateralises to unaffected ear: therefore Sensorineural hearing loss.
• Inv: MRI head, Pure tone audiometry
  MX: Active observation, microsurgery, radiosurgery
  -is a rare, benign slow growing tumour

Question 3

Acute angle closure glaucoma:

Answer 3

• Inv: Gonioscopy: is gold standard and mandatory: assesses angle between iris and cornea
• Tonometry: measure Intraocular pressure: in AACG, pressure is more than 30
• is a EMERGENCY, and sight-threatening
• Mx: conservative: lie flat, oral analgesics and anti-emetics
  Specialist mx:
  1) Pressure reducing agents: Acetazolamide (IV/oral)
  2) beta blockers
  3) topical steroids to reduce inflammation
  4) Surgery: Peripheral Iridotomy- laser hole through iris: to allow a separate route for aqueous drainage other than through the pupil.