Medicine (N&V/Abdo Pain)

Question 1

Name 3 things to ask about when someone presents with N&V

Answer 1

1. Onset and duration
2. Volume and content of vomit
3. Relation to food

Question 2

Which 2 systems examinations may be important in N&V?

Answer 2

Abdominal

Neurological

Question 3

What is the diagnostic criteria for DKA?

Answer 3

Glucose >11 or known diabetes

Acidosis pH>7.3 or bicarbonate <15

Ketones: >3mmol/l or ++ on urine dip

Question 4

What does an increased anion gap indicate?

Answer 4

Metabolic acidosis due to the ingestion or increased production of acid

Question 5

Give 4 causes of an increased anion gap

Answer 5

Methanol
Uraemia
DKA
Ethylene glycol

Question 6

Name 3 triggers of DKA

Answer 6

Infection
MI
Missed/insufficient insulin

Question 7

Which 2 pathological mechanisms contribute to DKA

Answer 7

Hyperglycaemia

Ketone body formation

Question 8

What happens to K+ in DKA?

Answer 8

K+ displaced and moves out of cells

Excess K+ in blood is excreted by kidneys so serum K appears normal but K+ in cells in deplete

Question 9

Give 4 presenting symptoms of DKA

Answer 9

Altered mental state
Polyuria
Polydipsia
N&V

Question 10

What are the 4 main management components in DKA?

Answer 10

1. Fluid replacement
2. IV insulin
3. IV dextrose
4. Correction of hypokalaemia

Question 11

Name 2 signs on examination of Addison’s disease

Answer 11

Buccal hyperpigmentation

Dehydration

Question 12

Name the 6 hormones which the anterior pituitary secretes

Answer 12

Growth Hormone 
FSH
LH
TSH
ACTH
Prolactin

Question 13

Name the 2 hormones which the posterior pituitary secretes

Answer 13

Oxytocin

Vasopressin

Question 14

Name 3 pituitary stalk causes of hypopituitarism

Answer 14

Trauma
Surgery
Mass lesion

Question 15

Name 3 pituitary gland causes of hypopituitarism

Answer 15

Tumour
Inflammation
Ischaemia

Question 16

Which blood test is used to diagnose Addison’s disease?

Answer 16

Short synthacthen test