Triads

Question 1

Whipple’s Triad

Answer 1

True hypoglycaemia when:
- Symptoms
- Low serum glucose
- Symptoms resolve when administered glucose

Question 2

Stable Angina Triad

Answer 2

1. Central crushing chest pain radiating to neck/jaw
2. Brought on with exertion
3. Relieved with 5 minutes rest and GTN spray
   (3/3 - stable, 2/3 - atypical 1/3 - non-typical)

Question 3

3 CARDINAL SIGNS OF HEART FAILURE

Answer 3

3 CARDINAL NON-SPECIFIC SIGNS:
- SOB
- ANKLE SWELLING (Pulmonary oedema)
- FATIGUE

Question 4

BECKS TRIAD

Answer 4

BECKS TRIAD = Cardiac tamponade
- hypotension (falling bp)
- increased JVP
- muffled S1 + S2 heart sounds

Question 5

ZOLLINGER ELLISON SYNDROME TRIAD

Answer 5

Zollinger-Ellison Syndrome (Gastrin secreting tumour TRIAD:)
- Pancreatic tumour
- Gastric acid hypersecretion
- Widespread peptic ulcers

Question 6

Acute mesenteric ischaemia TRIAD.

Answer 6

1. Acute, severe, abdominal pain = central/right iliac fossa
2. Diarrhoea and vomiting
3. Potential embolic source
   RAPID HYPOVOLAEMIC SHOCK

Question 7

Chronic mesenteric ischaemia triad

Answer 7

Central colicky abdominal pain after eating (starting around 30 minutes after eating and lasting 1-2 hours)
Weight loss (due to food avoidance, as this causes pain)
Abdominal bruit may be heard on auscultation

Question 8

CLASSIC TRIAD FOR APPENDICITIS = Murphys triad

Answer 8

Central abdominal pain which migrates to right iliac fossa,
Low-grade hyperpyrexia
Anorexia + Nausea and Vomiting

Question 9

Wernickes encephalopathy triad

Answer 9

Confusion
Ataxia: inability to coordinate voluntary movement
Ophthalmoplegia and nystagmus

Question 10

Chacot’s Triad

Answer 10

RUQ pain
Fever
Jaundice

Question 11

Reynaulds Phenomenon

Answer 11

Charcot Triad
+ hypotension
+ confusion

Question 12

Haemachromatosis classic triad

Answer 12

Bronze (slate grey skin)
Hepatomegaly
T2DM

Question 13

Felty’s syndrome

Answer 13

Triad of:
- Rheumatoid arthritis
- Granulocytopenia
- Splenomegaly
Life threatening risk of infection

Question 14

Cardinal signs of Parkinson’s

Answer 14

Bradykinesia
Tremor
Rigidity
Postural instability

Question 15

Charots neurological triad for MS

Answer 15

Dysarthria
Nystagmus
Intention tremor

Question 16

Cushings triad

Answer 16

bradycardia,
widened pulse pressure
irregular breathing

Question 17

Cushings reflex

Answer 17

HTN and bradycardia

Question 18

Fronto-temporal triad

Answer 18

Diagnostic criteria include two of:
- Visual hallucinations
- Parkinsonism
- Fluctuating mental state

Question 19

Pyelonephritis TRIAD

Answer 19

CLASSIC TRIAD:
- Fever
- Loin pain
- Pyuria

Question 20

Membraneous nephropathy

Answer 20

GOLD STANDARD: Renal biopsy: TRIAD:
- ‘Spike and dome pattern’ on electron microscopy due to GBM thickening and subepithelial electron-dense deposits
- Capillary wall thickening on light microscopy
- Fine granular, capillary loop staining for IgG with immunofluorescence

Question 21

RCC TRIAD

Answer 21

TRIAD:
- flank pain
- haematuria
- abdo mass

Question 22

Somter’s triad

Answer 22

Seen in Asthma
- nasal polyps
- asthma
- aspirin sensitivity (triggers prostaglandin production -> leukotriene production)

Question 23

Virchows triad

Answer 23

Virchows Triad:
- Change in vessel wall (endothelial injury)
- Change in blood flow = AF, Immobility
- Change in blood continuances (hyper coagulability) = sepsis (DIC), atherosclerosis, COCP, pregnant, malignancy

OR

HYPER COAGULABILITY
- Preggo, COCP, obesity, antiphospholipid syndrome, sepsis, DIC, malignancy
VENOUS STASIS
- Immobility (long flights, after surgery) = typically spread out clotting factors - laminar flow; stasis -> aggregation of clotting factors
ENDOTHELIAL INJURY
- smoking, trauma/surgery
- normally secretes anticoagulant chemicals, damaged endo CANNOT!