Irritable bowel Flashcards
what initial investigations would you do for someone with lower abdominal symptoms but no red flags
FBC coeliac serology faecal calprotein stool culture CRP
what are abdominal red flags
over 60 rectal bleeding anaemia weight loss fam hx colorectal cancer abdo/rectal mass woman over 50 with persistant bloating (Ca ovaries)
What are the symptoms of IBS
abdo pain bloating altered bowel habit colicky pain associated with bowel movement either diarrhoea or constipation predominant
what is faecal calprotectin
IBD test
what type of visual disturbance might you have with a large pituitary tumour
bitemporal hemianopia
what might you see on a CT head with a piturity tumour
eroding of the putitary fossa
what arteries supply the adrenal glands
superior suprarenal artery from inferior phrenic
middle suprarenal artery from the abdominal aorta
inferior suprarenal artery from the renal artery
why are metastases to the adrenal glands common
rich blood supply
what is psuedohyponatraemia
caused by lab error
how can you differentiate between pituitary and adrenal cushings
plasma ACTH levels
how can you screen for cushings
low dose overnight dexamethasone supression test
urinary free cortisol
48 hr low dose dexamethason supression test
late night salivary cortisol
in a patient with cushings, what imaging would you do if ACTH was raised
pituitary
if ACTH is not raised then image the adrenal glands
how do you differentiate between pituitary and ectopic sources of excess ACTH
inferior petrosal sinus sampling
what is a common source of ectopic ACTH
lungs
-do CXR
what enzyme does metryropone block
11 beta hydroxylase
