Laz book Flashcards
What is an austin flint murmur
Seen in severe aortic regurg- mid diastolic
What is a graham stell murmur heard in
Pulmonary regurg
What is a gibson murmur heard in
Patent ductus arteriosus
What is a carey coomb murmur associated with
Rheumatic fever
What are barlows murmurs
Mid systolic click and end systolic murmur assocaited with mitral valve prolapse
What is name of murmur heard in mitral valve prolapse
Barlow
How dogetses minimal change disease appear on light microscopy
No change to glomerulus
How does minimal change disease appear on electron microscopy
Loss of podocytes
What artery is involved in posterior MIs
Posterior descending
Extra articular manifestations of RA
Subcut nodules
Episcleritis
ILD
What is trigger finger seen in
RA
What is radial deviation of wrist seen in
RA
What is Z deformity of thumb seen in
RA
Iron studies of haemochromatosis
High serum Fe High ferrititin Low trasnferrin High transferrin saturation Low TIBC
Where is mutation in hereditary haemochromatosis
Hepcidin defiency leading to unregulated iron absorption in duodenum
Secondary causes of osteoporosis
Cushings
Hyperthyroidism
Hypogonadism
What is arons sign
Press on McBurneys and get epigastric pain
What is most common type of skin cancer
BCC
Where do skin SCCs appear
In sun exposed areas
What is a raised, everted edges with ulcerative centre and keratotic core
SCC
What is keratocanthoma
Variat of SSC that doesnt metastasise
What is skin lesion with raised edges and a fine telengiectasia on the surface
BCC
How thick should AAs be
2cm
How often should aortic aneurysms 3-4.5cm be checked
Every year
How often should aortic aneurysms 4.6-5.4cm be checked
Every 3 months
What organs can be involved in kaposi sarcomas
GI
Lungs
AIDS defining conditions
Kaposi sarcoma Candidiasis PCP Toxoplasmosis Burkitts lymphoma Cervical cancer
Drug for a benzo OD
Flumezanil
When is n acetyl cysteine administered
Paracetamol levels measured 4hrs post OD and if above a certain level give
Which atypical pneumonia causes red cell agglutination
Mycoplasma
What are grades of haemorrhoids
1- no prolapse
2- prolapse on defaecation but reduces spontaneously
3- prolapse that can be reduced manually
4- remains persitently prolapsed and cant be reduced
What are the types of rectal prolpse
Type 1- only the mucosa protrudes through
Type 2- all rectum layers protrude
How do type 2 prolapses feel
Concentric muscular rings
Symptoms of rectal prolapse
Faecal incontinence but can be constipation
Mucus discharge
What causes rectal prolapses
Lax anal tones- damage to pudendal nerve
Prolonged straining
What to think about when has pericarditis in PMH
Recent MI
If has been a few days then post MI pericarditis
If more than 2 weeks then is dressler syndrome
Primary HSV 1 infection
Pharyngitis
Gingivostomatitis
Herpetic whitlow
How does reactivated HSV 1 present
Lies dormant in trigeminal ganglia then when stress like cold, immunocompromised you get herpes labialis
How does costochondritis present
Pleuritic pain worse on exercise
Tender on palpation eother side of palpation
What causes molluscum contagiosum
Pox virus
Who does molluscum contagiosum normallu present in
Children
How is molluscum contagiosum transmitted
Skin to skin so adults normally sex
How does molluscum contagiosum present in adults
Dome shaped, firm and smooth will umbilicated centre on lower abdomen and genitals which lasts for 8 months
What organism causes syphillis
Treponema pallidum
How does syphilis present
Single painless genital ulcer followed by lymphadenopathy and widespread skin lesions
Dome shaped, firm and smooth will umbilicated centre on lower abdomen and genitals which lasts for 8 months
molluscum contagiosum
Single painless genital ulcer followed by lymphadenopathy and widespread skin lesions
syphilis
Earliest sign of HBV acute infection in blood
HBsAg
How is chronic HBV diagnosed
HBsAg in blood 6 months after infection
What antigens can be present in acute HBV infection
HBsAg
HBeAG
HBcAg
What is HBeAg
Associated with nucleocaspid
How does ank spond present
Lower back pain
Stiffness worse in morning
Improves with activity
What is done in schobers test
Line drawn on L5 and 10cm above. When patient bends over should extend beyond 15cm. If less than 15cm indicates ank spond or any condition affection flexion of spine
What is best diagnostic test for prostate cancer
Transurethral biopsy of prostate
After high dose dexamethasone what is best way to differentaite between ectopic ACTH and adrenal adenoma
Give metyrapone
What is red reflex
When shine light in eye in fundoscopy can see a red reflection of this light
What causes loss of red reflex physiologically
Something blocking retina
What causes loss of red reflex adults
Cataracts
What causes loss of red reflex children
Retinoblastoma
What is seen in eye anterior uveitis
Red ring around eye
What is subclavian steal syndrome
Stenosis of subclavian proximal to vertebral artery means blood leaks out of vertebral artery into the subclavian often when arm is being used extensively
Causes of subclavian steal syndrome
Cervical rib
Takayasus
Atherosclerosis
What drug is blurred vision often associated with
Anti-muscarinics like atropine
What drug is a tremor often associated with
Beta agonists
How is synovial fluid described in septic arthritis
Turbid
What causes vitiligo
Autoimmune attack of melanocytes
Why do you get vitiligo in addisons
Autoimmune conditions often go hand in hand
If cause TB then wouldnt see vitiligo
Gastric cancer presentation
Dyspepsia Early satiety Vomiting Bloating Malaena
Difference in presentation between right and left colon cancer
Right- pain and anaemia signs, Will be later
Left- change in habits, PR bleeding. Will be earlier
What is supplied by PCA
inferior portions of temporal lobe
Occipital lobes
Presentation of PCA stroke
Prosopagnosia
Visual agnosia
Sensory deficits
Visual defects
What does MCA supply
Subcortical structures
Internal capsule
Lateral parietal and temporal lobes
Cause of secondary HTN in young person
Coarctation of aorta
What area of leg goes meralgia parasthetica affect
Outside of thigh
What causes meralgia parasthetica
Weightgain leading to tight clothes compressing lateral femoral cutaneous nerve
Why is there raised cholesterol in liver disease
Liver role to break down cholesterol
Examination finding of PBC
Raised cholesterol signs RUQ tenderness Excoriation marks Jaundice Hepatosplenomegaly
What conditions is PBC associated with
Sjogrens
RA
Coeliac
What is ramsay hunt syndrome
Reactivation of zaricella zoster in the facial nerve causing a type of shingles
How does ramsay hunt sydrome present
Facial nerve palsy
Altered taste
Dry eyes and mouth
Vesicular rash in the ear
Histological appearance on duodenal biopsy of coeliac
Subvillous atropy
Crypt hyperplasia
What are rouleaux formations seen in
Myeloma
What are rouleaux formations
Stacks of red cells that in myelomas form due to high numbers of Igs
What are granulocytes with absent granulation and hyposegmentation seen in
Myelodysplastic disorders
In pancreatitis what is first line investigation in terms of imaging
US
What can be seen on US pancreatitis
Pancreatic inflammation
Calcification
Free fluid
If patient has renal insufficiency what investigation is done second line for pancreatitis
MRCP as cant tolerate contrast
Why cant you exclude pancreatitis on basis of normal or slightly elevated pancreatitis
Has half life of 12 hours
What can kussmal sign be seen in
Constrictive pericarditis
Hypertrophic cardiomyopathy
Why are venturi masks used in COPD
Most accurate at delivering O2
Management of PEA and asystole
CPR while getting paddles ready Defibrillate CPR 2 mins Defibrillate second time IV adrenaline Repeat every every 3-5mins IV amiodarone after 3rd defibrillation
When is IV amiodarone given in PEA management
After 3rd defibrillation
What happens to varicoceles when lie down
Reduce only visible or palpable when standing or in valsava movements
If patient has arcuate fasiculus lesion what will speech disorder be
Cant repeat speech told to them
B sx of lymphoma
Fever
Night sweats
Weight loss
What are 4 tests for h.pylori
Urease breath test
Blood antibody
Stool antigen
CLO test
How is CLO test done
Done on biopsy
What is uptake of iodine in de quervains
No uptake as cells damaged
Pathophysiology of de quervains
Thyroid cells get damaged causing release of T4 in short run but then after a few days become hypo when stores run out
First line management of TIA
Aspirin 300mg
Management of GORD
Lifestyle- avoid spicy food, lose weight, small regular meals before bed,
Medical- daily PPI-> twice if not improved
What drugs shouldnt be used in dysphagia
TCA
Nitrates
Anti-cholinergics
How should bladder cancer be investigated
Cystoscopy
Biopsy
What is ruddy red complexion a feature of
Polycythaemia vera
What ABs present in AI hepatitis
ANA
ASMA
ALKM
What are ALKM Abs
Anti liver kidney microscopic
Murmurs on examination of cor pulmonale
Pan-systolic- tricuspid regurg
Graham steell
What are 5 presentations of psoriatic arthritis
DIP disease Spondyloarthropathy- axial skeleton affected Symmetrical polyarthritis Arthritis mutilans Asymmetrical oligoarthritis
What is see before a partial seizure
Aura
What is seen during a generalised seizure
Tongue biting
Limb jerking
Incontinence
How does time of syncope differentiate seizure from other cause
Seizure lasts minutes
How are you after a seizure
Takes a while to recover
Very confused
How are you before a vasovagal syncope
Sweating
Pallor
Nausea
How are you after a vasovagal episode
Rapid recovery on sitting or lying
What are symptoms of PCOS
Amenorrhoea
Hirsutism
Acne
Male pattern hair loss
What is most common cause of infertility in women
PCOS
What is PCOS assocaited with
Hyperlipidaemia
Obesity
Insulin resistance
Genetic inheritance of PCOS
Autosomal dominant
How to differentiate bacterial conjunctivitis from viral
Yellow crust
3 types of cardiomyopathy
Restrictive
Hypertrophic
Dilated
What is restrictive cardiomyopathy
Ventricles are stiff so dont contract in response to filling
Causes of restrictive cardiomyopathy
Amyloidosis
Sarcoid
Haemochromatosis
What are general Sx of cardiomyopathy
Angina
Syncope
HF sx
Examination findings of HOCM
Jerky carotid pulse
Ejection systolic murmur
Double apex beat
What is most commonly used drug in alcohol withdrawal
Chlordiazepereoxide
What are auer rods seen in
AML
Who does ALL occur in
Children
What are smear and smudge cells seen in often
CLL
What blood cancer are warm agglutins seen in
CLL
What causes painful lymph nodes after drinking alcohol
Hodgkins lymphoma
What are painless enlarging lymph nodes seen in
Non hodgkins lymphoma
What are ringed sideroblasts seen in
Myelodysplasia
What blood cancer is no splenomegaly seen in
Myelodysplasia
Symptoms of gastritis
Epigastric pain
Haematemesis
Bloating
Belching
Triad of normal pressure hydrocephalus
Gait disturbance
Confusion/dementia
Urinary incontinence
What is Tinels sign often associated with
Carpal tunnel syndrome
What is L’hermittes sign
If flex neck causes shooting pain down neck
What is also known as barber seat sign
L’hermitte
Where does pancreatic cancer often metastasise to
Liver
Local lymph nodes
Options for PRN AF
Flecainide
Sotalol
Which blood cancer is pruritus often associated with
hodgkins
Blood findings of ALL
Pancytopenia
Examination findings of ALL
Hepatosplenomegaly
Lymphadenopathy
Easy bruising
Testicular swelling
What blood cancer is associated with testicular swelling
ALL
Investigation findings for ALL
FBC- pancytopenia
Blood film- elevated lymphoblasts
BM aspirate- Hypercellular bone marrow of over 20% of cells being lymphoblasts
What else can be measured in urine for phaeochromocytomas
VMA- vanillylmendelic acid
What does facial flushing often suggest in SBAs
Carcinoid syndrome
Causes of horners syndrome
Pancoast
Stroke
MS
Carotid dissection
Causes of high SAAG
Constrictive pericarditis CHF Cirrhosis Budd chiari hepatic venous obstruction
Causes of low SAAG
Nephrotic syndrome Infection Cancer Pancreatitis BO
What time does haemophilia prolong
APTT
What are storage Sx also known as
Irritative
How can haemophilia present
Painful bleeding into muscles
Painful bleeding into joints
Excessive bleeding following trauma
Random bleeding
What can be used to visualise an abdo aorta
US
Contrast CT needed tho to determine if leaking
What is hamptons hump
Wedge opacity
What is westermark sign
Regional oligoaemia
What is fleischner sign
Enlarged pulmonary artery
What determines if do primary anastamosis or hartmanns
If bowel is inflamed must do Hartmanns
What is CA 15-3 a marker for
Breast
What is CA 125 a marker for
Ovarian
Can be gastric
What is S100 a marker for
melanoma
What is calcitonin a marker for
Medullary thyroid cancer
What is thyroglobulin a marker for
Thyroid cancer
What is aFP a marker for
Liver cancer
Non seminoma testicular cancer
What is bHCG a marker for
Germ cell tumours
Choriocarcinoma
Where does spinal canal stenosis most commonly occur
Lumbar spine
What can cause spinal canal stenosis
Osteophytes from osteoarthritis or pagets
Disk herniation
Intrinsic cord tumours
Trauma
What does stooped posture suggest
Spinal canal stenosis
How will a spinal canal stenosis patient be sat
Stooped over
What walking makes spinal canal stenosis worse
Walking downhill
Difference in signs between acute CES and chronic spinal canal stenosis
UMN in spinal canal stneosis
LMN in acute chord compression
What is UMN problem of bladder function
Detrusor hyperreflexia and sphincter dyssnergia
What is LMN problem of bladder involvement
Overflow incontinence
What is sphincter dyssnergia
Poor coordination between detrusor muscle and sphincter where detrusor contracts but instead of relaxing, the spincter contracts
What is the criteria for rheumatic fever
Jones
How does the jones criteria work
Need evidence of recent strep infection plus either 2 major criteria or 1 major and 2 minor
Major criteria in jones criteria
Arthritis Carditis Subcut nodules Erythema marginatum Sydenhams chorea
Minor jones criteria
Arthralgia Fever Raised CRP/ESR Prolonged PR Previous rheumatic fever
What is kussmals breathing
Deep sighing breaths
What is cheynes stokes breathing seen in
Brainstem damage or herniation
How can para aortic node testicular cancer mets present
Back pain
Which type of RF can fibrosis cause
T2 RF
Important distinction when have rectal bleeding
Work out if on paper, streaked on stool or within the stool
Where is blood in anal fissure
Blood streaked onto paper or
Who are anal fissures often seen in
Crohns patients
Where is blood in colorectal cancer
Mixed with the stool
What bleeding is UC
Painless
What happens to BNP in HF
Up
What is Giemsa stain used in
Malaria
Most common cause of travellers diarrorhoea
E coli
How does giardia present
Not with dysentery!
Abdo cramps
Foul smelling flatulence
Belching
What happens if give ACEi to patient with bilateral renal artery stenosis
AKI
What tends to cause acute tubular necrosis
Hypovolaemia
Nephrotoxic drugs
What does acute interstitial nephritis present with
Nausea and vomiting
Fever
Rash
AKI
What are other names given to tonic clonic seizures and absence seizures
tonic clonic- grand mal
absence- petit mal
What normally happens in absence seizures
Look blankly into distance
Can be chewing or blinking rhymically
Lasts a few seconds
When do mycoclonic seizures often occur
When wake up
Can be in clusters
What happens in a tonic clonic seizure
Go stiff and drop to floor
Then start shaking, bladder incontinence, difficulty breathing
Wake up confused and exhausted
What is platypnoea
SOB improved by lying flat
What is hepatopulmonary syndrome
When in liver disease there is reduced clearance of vasodilators leading to microscopic vasodilation in lungs. This causes hyperperfusion and hypoxaemia
What does platypnoea often present in
Hepatopulmonary syndrome
Right to left shunts like patent foramen ovale
Triad for behcets
Mouth ulcers
Penile ulcers
Uveitis
What are triphasic parts of churg strauss syndrome
Allergic
Eosinophilic
Vasculitic
What happens in allergic phase of churg strauss
Asthma
Allergic rhinitis
What happens in eosinophilic phase of churg strauss
Very high eosinophils
What happens in vasculitic phase of churg strauss
Myocardial inflammation
Reduced blood flow to heart leading to potential death
What are 3 types of gangrene
Wet
Dry
Gas
What is gas gangrene
When infection produces gas within gangrenous tissues
What is difference between dry and wet gangrene
Wet is infection
Most common cause of gas gangrene
S perfringens
What happens in gas gangrene
Large black sores which can have necrotic bullae
Gangrene with crepitus
Gas
What often causes necrotising fasciitis
S pyogenes
S aureus
Most common causes of cellulitis
S pyogenes
S aureus
Most common cause of orbital cellulitis
H influenzae
Bacteria causing biofilms on catheters and surgical implants
S epidermis that is normally commensal on skin
What scar is done in swim wear models in appendicectomy
Lanz as along bikini line
Which patients may have regular US to look for stones
Primary hyperaparathyroidism
What gives prurulent mucous
Lung abscesses
Bronchiectasis
How do lung abscess present
Swingnig fever
Prurulent cough
Why isnt tensilon test used that much
Risk of bradycardia
Pnemonic for microcytic anemia
TAILS Thalassaemia ACD IDA Lead poisoning Sideroblastic anemia
Pnemonic for normocytic anaemia
MR I CALM Marrow failure Renal failure IDA early Anaemia of Chronic disease Aplastic anaemia Leukaemia Myelofibrosis
What causes acanthosis nigricans
T2DM
Cushings
PCOS
Paraneoplastic syndrome from gastro cancers
Why is acanthosis nigricans relevant to gastro exam
Paraneoplastic syndrome from gastro cancers
How does daibetic dermopathy appear
Slightly depressed reddish-brown patches which occur on the shins
Rash on shins with areas of reddened hardened skin with yellow centre
Necrobiosis lpoidica diabeticorum
Causes of gynaecomastia drugs
Cimetidine
Oestrogens
Digoxin
Spironolactone
What causes intermittent claudication of the buttocks
Leriche syndrome- compression of the iliac arteries around area they branch off of aorta
What is presentation of leriche syndrome
Erectile dysfunction
Claudication of buttocks
Examination finding of leriche syndrome
Absent distal pulses
What relieves critical limb ischaemia pain
Dangling legs off end of bed
What causes pain in legs on walking or standing for too long
Spinal canal stenosis
Parkinsons gait
Narrow feet
Shuffling feet
Reduced arm swinging
Complications of UC
Toxic megacolon
Adenocarcinoma
Complications of crohns
Abscesses Fistula Adhesions Strictures Obstruction Perforation
Barium follow through of crohns
Rose-thorn ulcers
Cobblestone mucosa
How does aspirin OD present in SBAs
Hyperventilation Tinnitus Deafness Fever Sweating
What is it called when fever of hodgkins lymphoma is cyclical
Pel ebstein
What is tumour lysis syndrome
Occurs when chemo treatment leads to lysis of lots of tumour cells releasing their electrolytes
What does TLS most commonly occur in
Lymphoma and leukaemia
What are metabolic findings of tumour lysis syndrome
High K+
High PO4
High uric acid
Low Ca
Where in oesophagus do varices occur
Lower 1/3
What is duct ectasia
When a duct benignly grows outwards blocking other ducts
What produces cheesy yellow discharge from nipple
Duct ectasia
Cavitating lesions in lung causes
Infections- staph aureus, TB, mycetoma, klebsiella
Inflammatory- wegners
Cancer- SqCC
4 components of general AKI management
Protecting from hyperkalaemia
Optimising fluid balance
Assessing need for dialysis
Stopping any nephrotoxic drugs
Most common preceding infection of GBS
Campylobacter
Most common causes of SBP
Ecoli
Klebsiella
Presentation of staph aureus pneumonia
Normally proceeds a flu like illness that weakens the lungs
Where do melanomas normally develop from
A naevus- described as mole like
What test is diagnostic for UTI
MSU as UTI defined as pure growth of over 10 ^5 colonies of units per ml of MSU
What is difference between NF1 and 2
NF1 is more peripheral and affects skin
NF2 affects centrally causing gliomas, meningiomas and vestibular schwannomas
Tumours associated with NF2
gliomas, meningiomas and bilateral vestibular schwannomas
How do vestibular schwannomas present
Tinnitus
Hearing loss
What does NF1 present with
Cafe au lait spots
Axillary freckles
Neurocutaneous fibromas
5 As of ankylosing spondylitis
Aortic regurg Achilles tendonitis Anterior uveitis Apical lung fibrosis Amyloidosis
Pnemonic for erythema nodosum causes
LOST BUSH
Causes of erythema nodosum
Lymphoma (non-hodgkins), leukaemia Oral pill Sarcoidosis, sulphonamides TB, toxoplasmosis Behcets UC (crohns too) Salmonella, strep infections Histoplasmosis
2 reasons UTIs more common in women
Short urethra
Closer to anus where bacteria can migrate
What is best test to visualise extent of small bowel involvement in crohns
Barium follow through
Skin findings in TB
Erythema nodosum
Lupus vulgaris
What is lupus vulgaris
Cutaneous TB finding with crusted lesions all over face
What is lupus vulgaris seen in
TB
Cardiac causes of clubbing
Congenital cyanotc heart disease
Atrial myxoma
Subacute bacterial endocarditis
Tetralogy of fallot
What is tuberous sclerosis
Occurs when multiple benign tumours develop all over the body
What causes a haemopericardium
MI
Trauma
Aneurysm rupture
What is most common cause of septic arthritis in children
H influenzae
What commonly causes septic arthrits in the elderly
E coli
What commonly causes septic arthritis in IV drug users
E coli
When do CKD symptoms tend to present
When GFR is less than 30
Common CKD symptoms
Anorexia N&V Fatigue Pruritus Muscle cramps Pulmonary oedema
What test is used to diagnose SVC syndrome
Pembertons
Why do you get pulsus alternans in left ventricular failure
When failing left ventricle there is small ejection fraction so large end diastolic volume that causes increased stretching of heart muscle and so strong next contraction
What is buffalo hump another word for
Interscapula fat pad
Why are NSAIDS contraindicated in chronic HF
Can cause sodium and water reabsorption
Also can be nephrotoxic leading to even more damage to hypperfused kidneys
Example of ling term nitrate used in afrocarribeans with HF
Isoborbide nitrate
Does digoxin improve mortality in HF
no
What are 4 antibodies seen in AIH
ANA
ASMA
ASLA- type 1
ALKM 1- type 2
What is ASLA
Anti soluble liver antigen
What is ALKM1
Anti liver kidney microsome 1
How does pagets disease of the breast present
Eczema like hardening of the skin over the nipple
What causes eczema like hardening over the breast
Pagets disease of the breast normally secondary to underlying breast cancer
What causes pagets disease of the breast
Underlying cancer
What normally causes TIAs
Atrial fibrillation
Carotid athersoclerosis
Valve vedgetations from artificial valves or infective endocarditis
DVT with atrial septal defect
What is a paradoxical embolism
When DVT goes through atrial septal defect leading to TIA/stroke
What are you looking for in echo of TIA
Vedgetations on heart valves
Atrial septal defect
Drugs causing pancreatitis
Thiazides
Azathioprine
Sodium valproate
How is PCP diagnosed
Sputum microscopy
BAL
How does PCP present
Fever
Dry cough
SOBOE especially noted when walking using pulse oximeter
What are spherocytes seen in
Hereditary spherocytosis
Haemolysis
What is waterlow scoring system used for
Pressure sores
What can be used on top of abx for meningitis treatment
Dexamethasone to reduce swelling
Other than cancer what else is tenesmus felt in
UC in exacerbations
What is pyoderma gangrenosum seen in
Wegners
Myeloma
IBD
RA
Associated features around venous ulcers
Stasis excema
Haemosediren deposition
Liodermatosclerosis
What ulcers are calloused edges seen in
Neuropathic
What gene is sarcoidosis linked to
HLA B27
What is cervical spondylosis
Degenerative process in intervertebral discs and cervical vertebra
Presentation of cervical spondylosis
Weakness in arms
Neck and arm pain
What is a jacksonian march
When an area of electrical stimulation in cerebral cortex marches across the brain and consequently is felt as a marching across your body
What can severe B12 deficiency result in
Psyciatric effects like depression and psychosis
What is lupus anticoagulant
Antibody produced against phospholipids in platelets
What 2 antibodies are tested for in antiphospholipid syndrome
Lupus anticoagulant
Anti cardiolipin
What clotting time does lupus anticoagulant affect
APTT
What clotting time does APL syndrome affect
APTT
What is sign called when nodding head
De mussets
In triple therapy for H pylori how often must medication be taken
Twice daily
If triple therapy doesnt work for peptic ulces what is second line tx
Different variation of Abx or bismuth compound
Most common lung cancer in smokers
Small cell carcinoma
2 best tests for cystic fibrosis
Sweat test showing high chloride
Faecal elastase showing loss of pancreatice exocrine function
