Pastest diseases I got wrong Flashcards
30 year old man complaining of pleuritic chest pain and breathlessness. He is tall and thin with a history of hypermobile joints. He smokes cigarettes.
Pneumothorax- he fits the phenotype. Being a smoker, being tall and thin are massive risk factors for a spontaneous pneumothorax.
Treatment options include conservative management with high flow oxygen, aspiration or chest drain.
20 year old women with type 1 diabetes has been vomiting for three days. She hasn’t been taking her insulin and is clinically dehydrated.
Metabolic acidosis (diabetic ketoacidosis)
Due to her lack of insulin.
Kassuals breathing to decrease paco2.
A 42 year old women presents with increasing breathlessness, her fingers show tight shiny skin. What external sign of respiratory failure is this?
Schlerodactyly
This women may have features of limited cutaneous sclerodoma. This can pre-dispose to pulmonary hypertension and fibrosis.
A 54 year old man complains of weight loss and drooping of the right eye associated with reduced sweating on the same side of the face. He is a smoker. What is wrong?
Horner syndrome is a cluster of signs of symptoms where everything is considered ‘down’. e.g. eyelid down, pupil size down, sweating down. Horner syndrome suggests the sympathetic nervous system has been effected on its course up the ipsilateral side of the neck. An apical pancoast tumour can invade the sympathetic ganglion causing this.
A 22 year old women complains of weight loss, a cough productive of sputum and night sweats. She has tender well defined nodules on the backs of her shins bilaterally.
Erythema Nodosum-
NODOSUM spelt backwards reveals some important features of it, starting with the most common first
M- mycobacteria tuberculosis (common cause)
U- Ulcerative colitis- Crohn’s disease
S- sarcoidosis
O- Other infections (streptococcus)
D- drugs including oral contraceptive pill and sulphonamides
O- occult malignancy
N-no cause found
A 30 year old patient presents with shortness of breath and a productive cough. On examination the pulse is 90, BP 130/78, saturations 96%, resp rate 25min. Chest radiograph shows consolidation at the left base. What treatment should you give him.
Oral amoxicillin- antibiotics to tackle lobar pneumonia.
Typical features of acute sarcoidosis.
Afro-Caribbean heritage. typical features include erythema nosadum(tender nodules on the back of the shins), bilateral hilar lymphadenopathy (a disease affecting the lymph nodes)
26 year old man with recurrent upper respiratory tract infections. Presents with increasing weakness and numbness in his legs. On examination he looks unwell and has low grade fever. He has 3/5 lower limb weakness and light touch below the knee. Increasingly dysnpopnic at rest.
Guillian-Barre syndrome- gentleman has developed type 2 resp failure indicated by hypoxia, hypercapnia and resp acidosis. Underlying cause is Guillian Barre syndrome, secondary to his resp failure. Patients admitted with distal limb numbness must be closely monitored.
61 year old with worsening shortness of breath on exertion. Clubbing of the finger nails and fine crepatations at the bases of the lungs.
Idiopathic pulmonary oedema.
Shown by finger clubbing, crepatations and resp failure. Associated hypoxia classically worsens on exertion. Diagnosis may be confirmed by respiratory function testing, bronchoscopy, alveolar lavage.
