Passmed Flashcards
What is stigaliptin?
DDP-4 inhibitor
How do you investigate diabetes insipidus?
water deprivation test
What is the 1st line drug for hypertension in diabetes?
ACEi or A2RBs - regardless of age
In gestational diabetes, what happens if blood glucose targets are not met with metformin or diet?
add insulin (short acting)
What are the sick day rules for T1DM?
Aim to drink 3L of fkuid
Check blood glucose more regularly
Measure ketones
Do not substitute main meals for sugar containing foods
What is the treatment for myxoedemic coma (in hypothyroidism)?
IV thyroxine and hydrocortisone
What is the risk of over replacement with thyroxine?
osteoporosis
What can affect the absorption of levothyroxine?
Iron and calcium carbonate tablets
What are the features of a myxoedemic coma (hypothyroidism)?
Hypothermia, hyporeflexia, bradycardia, seizures
What are the features of pernicious anaemia?
Lethargy, pallor, SOB
Neurological - peripheral neuropathy, subacute combined degeneration of the spinal cord and neuropsychiatric disorders (progressive weakness, ataxia and paresthesia), memory loss, poor concentration, confusion, depression, irritability
glossitis, described as a red and enlarged tongue
Features of primary hyperaldosteronism
hypertension, hypernatraemia, and hypokalemia
What is given before an appendicectomy?
Prophylactic IV abx
What is the 1st line investigation for appendicitis in a female?
US abdo
What sign is classic of early appendicitis?
Peri umbilical pain
How does a ruptured AAA present?
Shock - low BP, tachycardia
Abdo pain radiating to back
Pulsatile mass
How does a complete hydatidiform mole present?
Uterus greater than expected
Abnormally high bhCG
How does diverticulitis present?
Left lower quadrant pain (iliac fossa)
Low grade fever
Elderly patient
Hx of chronic constipation predisposes
Blood in stools
Raised inflammatory markers
What causes pancreatitis?
Alcohol, gallstones, drug induced (mesalazine) for UC
What is the presentation of mesenteric infarction?
Sudden onset severe abdo pain
Raised WCC and lactate
Hypertension, T2DM, AF risk factors
What does an unrecordable blood glucose mean and when is this seen?
High blood sugar
DKA in children - drowsy and confused
What is the significance of the whirlpool sign?
Seen on US - characteristic of ovarian torsion or volvulus
What are the features of an Addisonian crisis?
Hyponatraemia
Hyperkalaemia
Hypoglycaemia
Surgery - precipitate acute adrenal deficiency
Unable to have steroids for prolonged period e.g. for polymyalgia rheumatica
What is characteristic of a ruptured ovarian cyst?
Sudden onset unilateral pelvic pain precipitated by strenuous activity or intercourse
How does an iliopsoas abscess present?
Fever
Pain on movement on hip joint
IV drug user
What are the classic sx of IBS?
Abdominal pain
Bloating
Change in bowel habit
