Passmed Met3a Flashcards
What’s the classical presentation of ascending cholangitis?
Constant RUQ pain, FEVER, JAUNDICE, pyrexial and raised inflammatory markers
What’s the classical presentation of acute cholecystitis?
Constant RUQ pain, pyrexial and raised inflammatory markers
Vitamin B1 deficiency may cause?
Peripheral neuropathy
A 35-year-old woman presents with pain on the right side of her back. This is constant and associated with fever and rigors . What’s the likely cause?
Acute pyelonephritis
What are signs of Wilson’s disease?
Liver: hepatitis, cirrhosis
Neurological: basal ganglia degeneration, speech and behavioural problems are often the first manifestations. Also: asterixis, chorea, dementia
Kayser-Fleischer rings
Renal tubular acidosis (esp. Fanconi syndrome)
Haemolysis
Blue nails
What is metaclopramide?
Anti-emetic (D2 receptor antagonist) used int he treatment of mechanical causes of nausea WITHOUT colic
What are the potential adverse effects of metaclopramide?
Extrapyramidal effects: oculogyric crisis (particularly a problem in children and young adults)
Hyperprolactinaemia
Tardive dyskinesia
Parkinsonism
Outline the features of Crohn’s that are different from UC.
Crohns = skip lesions, non-bloody diarrhoea, bowel obstruction, fistulae, transmural inflammations, perianal disease, cobble-stone appearance. Can affect small bowel too
Outline the features of UC that are different from Crohn’s.
Bloody diarrhoea, greater risk of PSC/uveitis/colorectal cancer, tenesmus, loss of haustration, lead pipe colon, superficial ulceration (pseudopolyps)
What’s the greatest cause of vitamin B1 (thiamine) deficiency?
Alcohol excess
What’s the choice of prophylaxis for preventing calcium renal stones?
Thiazide diuretic
What type of metabolic abnormality does diuretics most commonly cause?
Metabolic alkalosis
Anti-mitochondrial antibodies is/are most characteristically seen in what condition?
Primary biliary cirrhosis (PBC)
What’s the classical presentation of primary biliary cholangitis (PBC)?
Occurs in middle-aged women, fatigue, pruritus (itching skin)
What’s the treatment of choice for Wilson’s disease?
Penicillamine
What is tenesmus? (with regard to the symptom seen in those with UC)
Where there is a feeling of constantly needing to pass stools, despite an empty colon
When testing for hepatitis B, HBsAg positive, anti-HBs negative, IgG anti-HBc positive, IgM anti-HBc negative indicates what?
Chronic hepatitis B infection
When testing for hepatitis B, HBsAg positive, anti-HBs negative, IgM anti-HBc positive indicates what?
Acute hepatitis B infection
A 70-year-old man presents with anorexia, weight loss and painless jaundice is a stereotypical history of?
Pancreatic cancer
What type of metabolic abnormality does congenital adrenal hyperplasia most commonly cause?
Metabolic alkalosis
What are the causes of metabolic alkalosis?
Diuretics Vomiting / aspiration Congenital adrenal hyperplasia Hypokalaemia Bartter's syndrome Primary hyperaldosteronism Cushing's syndrome
