MedEd data 2

Question 1

what is your top differential for painless jaundice with a palpable gallbladder?

Answer 1

cancer of head of pancreas

Question 2

what 2 things do hepatocytes produce?

Answer 2

albumin

hepatocytes

Question 3

what are the full names of ALT, AST, GGT, and ALP

Answer 3

ALT= alanine transaminase 
AST= aspartate transaminase
GGT= gamma-glutamyl transferase
ALP= alkaline phosphatase

Question 4

what is the AST:ALT ratio in alcoholic liver disease? how do you remember this

Answer 4

2:1

spirits are stronger than lagers

Question 5

what is seen in an addisonian crisis?

Answer 5

hypotension
hypoglycaemia
abdo pain
vomitting

Question 6

the absence of what hormone causes an addison’s crisis?

Answer 6

aldosterone

Question 7

what electrolyte abnormality is seen in an addisonian crisis?

Answer 7

hyperkalemia

Question 8

what are some causes of hyperkalemia?

Answer 8

addison's disease
renal failure 
rhabdomyolysis 
antihypertensives  
metabolic acidosis

Question 9

how is hyperkalemia managed?

Answer 9

ECG
10ml 10% calcium gluconate 
salbutamol nebs 10mg 
10 units insulin 
monitor with VBGs

Question 10

what are causes of hypovolemic hyponatraemia?

Answer 10

vomitting

diuretics

Question 11

what are causes of euvolemic hyponatraemia?

Answer 11

hypothyroidism
adrenal insufficiency
SIADH

Question 12

what are causes of hypervolemic hyponatraemia?

Answer 12

heart, liver and renal failure

Question 13

what are signs of hypovolemic hyponatraemia?

Answer 13

dry mucous membranes 
reduced skin turgor
confusion
reduced urine output 
postural hypotension

Question 14

describe what happens in hypovolemic hyponatraemia

Answer 14

you loose water by vomiting
ADH rises
water is reabsorbed
sodium is not reabsorbed with it

Question 15

what are some causes of hypernatraemia?

Answer 15

dehydration
diabetes insipidus
hyperaldosteronism

Question 16

what happens if sodium is replaced to quickly in a patient with hyponatraemia?

Answer 16

central pontine myelinolysis

Question 17

what is central pontine myelinolysis? when does it ari

Answer 17

osmotic demyelination of the myelin sheath in the pons (brainstem)
arises if you give someone with hyponatraemia salt too quickly