misc

Question 1

what is rovsings sign + where is it seen

Answer 1

appendicitis // palpate LLQ –> pain in RLQ

Question 2

what is murpheys sign + where is it seen

Answer 2

pain palpating RUQ on inspiration // cholecystitis

Question 3

what is cullens sign + where is it seen

Answer 3

bruising round umbilicus // pancreatitis (or intraa bleed)

Question 4

what is grey-turners sign + where is it seen

Answer 4

bruise in flank // pancreatitis (or retroperitoneal bleed)

Question 5

how many units of alcohol should a person not exceed a week

Answer 5

14

Question 6

how is a unit calculated

Answer 6

(ml x ABV) / 1000

Question 7

how does alcoholic ketoacidosis (HONK) occur

Answer 7

starvation –> breakdown ketones – > ketoacidosis

Question 8

presentation alc0holic ketoacidosis

Answer 8

met acidosis // eleveated ketone // normal (or low) glucose

Question 9

mx HONK

Answer 9

IV saline and thiamine

Question 10

what causes metabolic alkalosis (5)

Answer 10

vomiting or aspiration // diuretics // hypokalaemia // hyperaldosteronism // cushinhgs

Question 11

what other U+E issue can vomiting lead too

Answer 11

hypokalaemia

Question 12

what defines malnutrition (3)

Answer 12

BMI <18.5 // wt loss >10% in 3-6 months // BMI <20 + wt loss >5% in 3-6 months

Question 13

what does the MUST score take into account

Answer 13

BMI // recent weight chance // acute disease

Question 14

what is refeeding syndrome

Answer 14

increased carbs after long starvation (catabolic) periods

Question 15

what metabolic consequences occur in refeeding syndrome (4)

Answer 15

hypophosphate // hypokalamia // hypomagnesia // fluid shift –> arrhythmia

Question 16

what are fat soluble vitamens

Answer 16

ADEK

Question 17

what can cause fat soluble vitaman deficiency

Answer 17

steotohrroea

Question 18

what can vit A deficiency cause

Answer 18

night blindness (converted into retinal)

Question 19

what causes vit B1 (thiamine) deficiency

Answer 19

alcohol excess and malnutrition

Question 20

what conditions are assoc with vit B1 deficiency

Answer 20

wernicke // korsakoff // beri-beri

Question 21

symptoms wernicke

Answer 21

nystagmus // opthalmoplegia // ataxia

Question 22

symptoms korsakoffs

Answer 22

anmesia and confabulation

Question 23

symptoms dr vs wet beri beri

Answer 23

dry = peripheral neuropathy // wet = dilated cardiomyopathy

Question 24

what does vit B3 deficiency cause

Answer 24

pellegra: dermatits (brown scaly rash) , diarrhoea, dementia

Question 25

what can cause pellagra

Answer 25

isoniazids + alcohol

Question 26

what causes vit B6 (pyrodoxine) deficiency

Answer 26

isoniazide

Question 27

symptoms of vit B6 deficiency

Answer 27

peripheral neuropathy // sideroblastic anaemia

Question 28

what is Vit C deficiency (ascorbic acid) caused by

Answer 28

malnutrition // drug and alcohol // no fruiit or veg

Question 29

symptoms scurvy

Answer 29

easy bruising // poor wound healing // gingivitis // oedema // malaise

Question 30

what inheritance is peutz jeghers syndrome + what genes

Answer 30

autosomal dominant LKB1 or STK11

Question 31

symptoms peutz jeghers syndrome (5)

Answer 31

polyps in GI tract // SBO // intussusception // GI bleed // pigmented skin legions

Question 32

haemochromatosis inheritence + gene mitation

Answer 32

autosomal recessive // HFE

Question 33

primary symptoms haemochromatosis

Answer 33

fatigue // ED // arthalgia (hands) // bronze skin // DM // liver disease //

Question 34

what heart symtpoms does haemochromatosis cause

Answer 34

dilated cardiomyopathy + HF

Question 35

what endocrine symptoms does haemochromatosis cause

Answer 35

hypogonadism

Question 36

which features of haemochromatosis are reversible

Answer 36

cardiomyopathy + skin pigmentation

Question 37

which features of haemochromatosis are irreversible

Answer 37

cirrhosis / DM // hypogonadism // arthritis

Question 38

screening for haemochromatosis

Answer 38

raised transferrin saturation (> ferratin) // genetic HFE testing

Question 39

what bloods are seen in haemochromatosis

Answer 39

transferrin >55% (men) or >50% (women) // raised ferritin + iron // low total iron binding

Question 40

diagnostic test haemochromatosis

Answer 40

genetic testing + liver biopsy (Perl's stain)

Question 41

1st line mx haemochromatosis

Answer 41

venesection

Question 42

how is treatment of haemochromatosis monitered

Answer 42

keep transferrin <50% and ferritin <50

Question 43

2nd line mx haemochromatosis

Answer 43

desferrioxamine

Question 44

what can joint xrays show in haemochromatosis

Answer 44

chondrocalcinosis

Question 45

inheritence of wilsons + gene

Answer 45

autosomal recessive // ATP7B gene

Question 46

onset of wilsons

Answer 46

10-15

Question 47

initial presentation of wilsons in kids vs young adults

Answer 47

kids = liver // adults = neurological

Question 48

what excess is in wilsons

Answer 48

copper

Question 49

what organis are affected in wilsons

Answer 49

liver // neuro // cornea // renal tubules

Question 50

what neurological problems are seen in wilsons

Answer 50

basal ganglia degeneration --> psych problems // demention // parkinsons

Question 51

what is seen in the eyes in wilsons

Answer 51

kayser-fleischer rings: green rings in periphery of iris

Question 52

what hand feature is seen in wilsons

Answer 52

blue nails

Question 53

what initial investigations for wilsons

Answer 53

slit lamp // reduced serum caeruloplasmin // reduced serum copper // raised urine copper