Misc 2

Question 1

^What are some symptoms of haemochronatosis?

Answer 1

fatigue, erectile dysfunction and arthralgia.

Presenting features

early symptoms include fatigue, erectile dysfunction and arthralgia (often of the hands)

‘bronze’ skin pigmentation

diabetes mellitus

liver: stigmata of chronic liver disease, hepatomegaly, cirrhosis, hepatocellular deposition)

cardiac failure (2nd to dilated cardiomyopathy)

hypogonadism (2nd to cirrhosis and pituitary dysfunction - hypogonadotrophic hypogonadism)

arthritis (especially of the hands)

Question 2

What is Waterhouse Friedrich syndrome?

Answer 2

Waterhouse–Friderichsen syndrome (WFS) is defined as adrenal gland failure due to bleeding into the adrenal glands, commonly caused by severe bacterial infection. Typically, it is caused by Neisseria meningitidis.

Question 3

What is initial drug administration for ACS?

Answer 3

Initial drug therapy

aspirin 300mg

oxygen should only be given if the patient has oxygen saturations < 94% in keeping with British Thoracic Society oxygen therapy guidelines

morphine should only be given for patients with severe pain

previously IV morphine was given routinely

evidence, however, suggests that this may be associated with adverse outcomes

nitrates

can be given either sublingually or intravenously

useful if the patient has ongoing chest pain or hypertension

should be used in caution if patient hypotensive

Question 4

What does erythromycin and macrloides cause?

Answer 4

Torsade de pointes

Question 5

What is syringomyelia?

Answer 5

Syringomyelia is a condition whereby fluid filled cavities develop within the spinal cord. Pressure can increase resulting in compression of the spinal cord tracts. The syrinx can extend to and damage the anterior horn cells, thereby resulting in lower motor neurone features. The spinothalamic tract axons decussate to the other side of the spinal cord via the anterior white commissure, and they are particularly susceptible to damage from the syrinx. Pain and temperature sensation are lost due to spinothalamic tract damage, and one side may be affected more than the other.

Question 6

What drug is used for oseophageal varices?

Answer 6

Terlipressin

Question 7

How is primary hyperaldosteronism treated?

Answer 7

Spirnolactone

Question 8

What drug/s is used in alcohol withdrawal?

Answer 8

Chlordiazepoxide and pabrinex

Question 9

What is considered if someone has abdominal infection but does not respond to oral vancomycin?

Answer 9

Oral fidaxomicin is considered in Clostridium difficile cases not responding to oral vancomycin. Therefore this answer is correct as it is second-line. Oral vancomycin remains the first-line antibiotic for the first episode of mild, moderate or severe Clostridium difficile infection.