Random Flashcards
What organ problems can cause pain at the scapula tp?
Gallbladder
Where does reteric pain localise?
Inguinal canal
What is the diagnosis in an old person with painless jaundice until proven otherwsie?
Pancreatic cancer
Symptom when one recurrent laryngeal nerve damaged?
Hoarse voice
What is the function of the recurrent laryngeal nerve?
What roots can be damaged with Erbs palsy?
C5,C6,C7
How can you tell if a neck lump is involved with the thyroid?
If it moves on swallowing, it is thyroid involved
What sort of neck lump is it if it moves with tongue protrusion?
Thyroglossal cyst
What is a thyroglossla cyst?
What is a neck lump if it moves on swallowing but not on tongue protrusion>
Thyroid enlargement/goitre
What is T3 and T4
T3= triiodothyroxine
T4 - Thyroxine
What is a myxoedema crisis?
What does a myxoedema crisis cause?
Heart failure, perfusions, decreased consciousness, hypoglycasemia
How to treat a myxoedema crisis
T3 doses
Steroids, fluids
What are normal glucose levels?
4 to 6 mmol
Four is the lfoor
glucose cappilary level under 4 = hypoglycaemic
Sympotms of hypoglycaemia
Confusion
Sweaty
Stroke like - speech difficulty, odd behaviour, incoordination
Shaky
Drowsy
Palpitations
What type of symptoms occue first with hypoglycaemia and why
Adrenergic - ‘warning’ @ 3.6-3.9mmol
Neuroglycopneic only occr under 2.8mmol
Variation in patients
Which patients do neuroglycopenic symptoms dominate in?
T1DM longer duration, 10+ years - may feel have ‘lost’ hypoglycaemic warning, ask in hisotry
2 causes of hypoglycaemia
Glucose entering system at slower rate - congenital enxzyme deficinecyes
Glucose leaving bloodstream at higher rate, more common
When do adrenergic symptoms of a hypo not occur? Who is this the greatest risk to?
While sleeping
Ovedrnight hypos more dangerous, significatn morality and morbidity in those who have lost their counter regulatory response and have hypoglycaemia unawareness.
What treatment would you give a sevverely hypo collapsed paitent with a cannula in situ?
IV Glucose 20% 100mls
If no canula, 1mg IM glucagon
What to give if patient conscious and why dont give chocolate biscuit
Fruit juice or glucogel
Fat slows absorption of glucose
What is erythema nodu=osum seen in?
Crohns
Parameters for hypovolaemia
Systolic BP under 90
HR over 100
CRT over 2 secs
Cold peripheries
RR over 20
Parameters for hypovolaemia
Systolic BP under 100
HR over 90
CRT under 2 secs
Cold peripheries
RR over 20
CUSHINGOID acronym for corticosteroids side effects
C – Cataracts
U – Ulcers
S – Striae, Skin thinning
H – Hypertension, Hirsutism
I – Immunosuppression, Infections
N – Necrosis of femoral heads
G – Glucose elevation
O – Osteoporosis, Obesity
I – Impaired wound healing
D – Depression/mood changes
What is pretibial myxoedema?
Hyperthyroidism skin condition - waxy discolouration of skin
Why is loperamide contraindicated in GE?
Keeps bacteria inside GI tract -> toxic megacolon
What differntials have from/causing long lie
Sepsis
Delirium
Rhabdomyolysis
Posionning
Thyroid dysfunction
What disease is H pylori mst strongly ass with
Duodenal ulcer
Also can cause gastric adenocarcinoma, atrophic gastritis
