Live Lecture - Cases. Flashcards
- Beautician, Tiredness for the last three months. Adrenal mass found upon ultrasound.
What is the differential diagnosis.
Cushing’s syndrome.
Conn’s syndrome.
Phaechromocytoma.
What three hormones could be produced by an adrenal mass.
Cortisol (Cushing’s).
Adrenaline (Phaeochromocytoma).
Aldosterone (Conn’s).
Where do phaeochromocytomas occur in the adrenals.
Medulla.
Where do cortisol producing tumours occur.
Cortex fasciculata.
What do cortisol producing tumours cause.
Cushing’s syndrome.
Where do aldosterone producing tumours occur.
Cortex glomerulosa.
What do aldosterone producing tumours cause.
Conn’s syndrome.
What drugs do you use to treat phaeochromocytomas.
Alpha blockers (Phenoxybenzamine). Beta blockers (Propanolol).
When treating a phaeochromocytoma, what do you give first.
Alpha blocker.
Then add a beta blocker.
When treating Cushing’s, what drugs do you use to treat.
Ketoconazole.
Metyrapone.
When treating Conn’s, what drugs do you use to treat.
Spironolactone.
What are the biggest adrenal tumours.
Phaeochromocytoma.
What do you use to treat Graves disease.
Propanolol.
Carbimazole.
What are the two biggest complaints in a patient with Conn’s syndrome.
Hypokalaemia.
Hypertension.
Patient presents with breathlessness that is worse on lying flat.
Pulmonary oedema (orthopnoea).
Patient has a continuous productive cough for 3 months each year, starting in December, and is always coughing over Christmas.
Chronic bronchitis (COPD).
33 Year old pregnant female presents with breathlessness and a tender swelling in her right leg.
Pulmonary embolus secondary to DVT.
70 year old smoker. Examination reveals dullness and increased tactile vocal fremitus on the right.
Pneumonia.
69 year old smoker. Examination revealed dullness and reduced tactile vocal fremitus on the right.
Pleural Effusion.
What does consolidation indicate.
Pneumonia.
What is the causes of pleural effusions in smokers.
Usually due to malignancy.
Where is the fluid present in pulmonary oedema.
Within the vasculature.
Where is the fluid present in pleural effusion.
Outside the vasculature.
What do you hear upon percussion of a patient with pulmonary oedema.
No change in percussion or tactile vocal fremitus.
Is pulmonary oedema unilateral or bilateral.
Bilateral crackles.
14 year old schoolboy who presents with breathlessness, deep sighing respiration and has started bedwetting again.
Diabetic Ketoacidosis.
What age is the peak onset for T1DM.
14.
What type of breathing do you get in DKA.
Deep sighing respiration.
Why do you get deep sighing respiration in DKA.
To clear CO2.
What is the most common cause of DKA.
Non-compliance of insulin. Due to various causes (eg, poor control, illness, etc…)
25 year old tall thin and. On examination, there were absent breath sounds and hyper resonance on the right side.
Tension pneumothorax.
On what type of CXR can you not comment on heart size.
AP film.
Who are AP films usually done in.
Very sick people who are unable to stand for the CXR for any reason.
What murmur will you hear if the mitral valve leaks.
Pansystolic murmur.
What is the condition called when the mitral valve leaks.
Mitral regurgitation.
What murmur do you hear with atrial stenosis.
An ejection systolic murmur.
What type of murmur is it if you hear the murmur in type with the pulse in the carotid.
Systolic murmur.
What are the two conditions causing systolic murmurs.
Atrial stenosis.
Mitral regurgitation.
What are the two systolic murmurs.
Pansystolic murmurs.
Ejection systolic murmurs.
What is the characteristic of an ejection systolic murmur.
Crescendo decrescendo between S1 and S2.
What is the characteristic of a pansystolic murmur.
Constant turbulent sound between S1 and S2.
