old persons 17/10

Question 1

By what route is C.diff transmitted

Answer 1

Faecal-oral route

Question 2

Why is C. diff sporulation very unique?

Answer 2

The spores are formed inside of the cells.

Question 3

Is C diff gram -ve?

Answer 3

C. diff is a spore-forming, Gram-positive anaerobic bacillus that produces two exotoxins: toxin A and toxin B.

Question 4

C. diff can lead to?

Answer 4

Toxic megacolon

Question 5

C diff diarrhoea?

Answer 5

Can be watery and may be green

Question 6

Whats the serology test for coeliac disease?

Answer 6

Check the serum immunoglobulin (Ig)A tissue transglutaminase antibody (tTGA) and total IgA first-line.

Question 7

Most common cause of hypertension? And percentage?

Answer 7

Essential hypertension, equates for 95% of hypertension cases.

Question 8

Three broad catergory causes of secondary hypertension:

Answer 8

Renal causes
- intrinsic renal disease
- renovascular disease

Endocrine causes

Other

Question 9

Examples of renal causes of secondary hypertension:

Answer 9

Intrinsic renal disease:
Any cause of GN, polyarteritis nodosa, systemic sclerosis, chronic pyelonephritis, polycystic kidneys.
Renovascular disease:
Renal artery stenosis

Question 10

How does glomerulonephritis cause hypertension?

remeber glomerulonephritis is a syndrome (any cause of GN can cause HTN)

Answer 10

I am unsure (and the internet seems to be too),

Intrinsic renal disease (renal hypertension)

look in renal book: Priniciples of renal physiology

Question 11

How do renal mechanisms cause secondary hypertension?

Answer 11

Either or both:
1) Impaired sodium and water excretion, thereby increasing blood volume
2) Stimulation of renin release

Question 12

3 stimuli respondsible for renin release:

Answer 12

Primarily it is regulated by the rate of renal blood flow

1)Sympathetic nerve stimulation
2)Decrease stretch of afferent arteriole
3)Signals generated by macula densa in response to low NaCl delivery

https://teachmephysiology.com/urinary-system/regulation/the-renin-angiotensin-aldosterone-system/

Question 13

Binding of Angiotensin II causes what

Answer 13

Site Main Action
Arterioles = Vasoconstriction
Kidney = Stimulates Na+ reabsorption
Sympathetic nervous system= Increased release of noradrenaline (NA)
Adrenal cortex = Stimulates release of aldosterone
Hypothalamus = Increases thirst sensation and stimulates anti-diuretic hormone (ADH) release

Question 14

Can most kidney diseases cause hypertension?

Answer 14

Yes most can.
Intrinsic kidney diseases can (though I am not sure of the mechanism).
Renovascular diseases can also (can be explained due to reduced perfusion, raas etc)

Question 15

Endocrine causes of secondary hypertension:

Answer 15

Cushings syndrome, Conns syndrome, hyperparathyroidism, acromegaly

Question 16

Other causes of secondary hypertension

Answer 16

Coarctation of the aorta, Obstructive sleep apnea, drug-induced hypertension, pregnancy, scleroderma

Question 17

Nephrotic syndrome

Answer 17

Triad of
More than 3.5grams of protein in urine over 24 hours.
Serum albumin less than 30g/l
Oedema

Question 18

First line for C. diff infection

Answer 18

Vancomycin orally

Question 19

Second line for C. diff infection

Answer 19

Fidaxomicin