misc Flashcards
what is rovsings sign + where is it seen
appendicitis // palpate LLQ –> pain in RLQ
what is murpheys sign + where is it seen
pain palpating RUQ on inspiration // cholecystitis
what is cullens sign + where is it seen
bruising round umbilicus // pancreatitis (or intraa bleed)
what is grey-turners sign + where is it seen
bruise in flank // pancreatitis (or retroperitoneal bleed)
how many units of alcohol should a person not exceed a week
14
how is a unit calculated
(ml x ABV) / 1000
how does alcoholic ketoacidosis (HONK) occur
starvation –> breakdown ketones – > ketoacidosis
presentation alc0holic ketoacidosis
met acidosis // eleveated ketone // normal (or low) glucose
mx HONK
IV saline and thiamine
what causes metabolic alkalosis (5)
vomiting or aspiration // diuretics // hypokalaemia // hyperaldosteronism // cushinhgs
what other U+E issue can vomiting lead too
hypokalaemia
what defines malnutrition (3)
BMI <18.5 // wt loss >10% in 3-6 months // BMI <20 + wt loss >5% in 3-6 months
what does the MUST score take into account
BMI // recent weight chance // acute disease
what is refeeding syndrome
increased carbs after long starvation (catabolic) periods
what metabolic consequences occur in refeeding syndrome (4)
hypophosphate // hypokalamia // hypomagnesia // fluid shift –> arrhythmia
what are fat soluble vitamens
ADEK
what can cause fat soluble vitaman deficiency
steotohrroea
what can vit A deficiency cause
night blindness (converted into retinal)
what causes vit B1 (thiamine) deficiency
alcohol excess and malnutrition
what conditions are assoc with vit B1 deficiency
wernicke // korsakoff // beri-beri
symptoms wernicke
nystagmus // opthalmoplegia // ataxia
symptoms korsakoffs
anmesia and confabulation
symptoms dr vs wet beri beri
dry = peripheral neuropathy // wet = dilated cardiomyopathy
what does vit B3 deficiency cause
pellegra: dermatits (brown scaly rash) , diarrhoea, dementia
what can cause pellagra
isoniazids + alcohol
what causes vit B6 (pyrodoxine) deficiency
isoniazide
symptoms of vit B6 deficiency
peripheral neuropathy // sideroblastic anaemia
what is Vit C deficiency (ascorbic acid) caused by
malnutrition // drug and alcohol // no fruiit or veg
symptoms scurvy
easy bruising // poor wound healing // gingivitis // oedema // malaise
what inheritance is peutz jeghers syndrome + what genes
autosomal dominant LKB1 or STK11
symptoms peutz jeghers syndrome (5)
polyps in GI tract // SBO // intussusception // GI bleed // pigmented skin legions
haemochromatosis inheritence + gene mitation
autosomal recessive // HFE
primary symptoms haemochromatosis
fatigue // ED // arthalgia (hands) // bronze skin // DM // liver disease //
what heart symtpoms does haemochromatosis cause
dilated cardiomyopathy + HF
what endocrine symptoms does haemochromatosis cause
hypogonadism
which features of haemochromatosis are reversible
cardiomyopathy + skin pigmentation
which features of haemochromatosis are irreversible
cirrhosis / DM // hypogonadism // arthritis
screening for haemochromatosis
raised transferrin saturation (> ferratin) // genetic HFE testing
what bloods are seen in haemochromatosis
transferrin >55% (men) or >50% (women) // raised ferritin + iron // low total iron binding
diagnostic test haemochromatosis
genetic testing + liver biopsy (Perl’s stain)
1st line mx haemochromatosis
venesection
how is treatment of haemochromatosis monitered
keep transferrin <50% and ferritin <50
2nd line mx haemochromatosis
desferrioxamine
what can joint xrays show in haemochromatosis
chondrocalcinosis
inheritence of wilsons + gene
autosomal recessive // ATP7B gene
onset of wilsons
10-15
initial presentation of wilsons in kids vs young adults
kids = liver // adults = neurological
what excess is in wilsons
copper
what organis are affected in wilsons
liver // neuro // cornea // renal tubules
what neurological problems are seen in wilsons
basal ganglia degeneration –> psych problems // demention // parkinsons
what is seen in the eyes in wilsons
kayser-fleischer rings: green rings in periphery of iris
what hand feature is seen in wilsons
blue nails
what initial investigations for wilsons
slit lamp // reduced serum caeruloplasmin // reduced serum copper // raised urine copper
