METABOLIC

Question 1

What are the features of Hypocalcaemia?

Answer 1

TAP CT
Tetany
Abdominal cramps
Perioral parasthesiae
Chvoteck’s sign: tapping on facial nerve = spasm
Trousseau’s sign (carpal spasm after occlusion with BP cuff)

Question 2

What is Familial Hypercholesterolaemia?

Answer 2

A.D
1/500
High LDL
May lead to CVD

Simon Broome:

• TC >7.5
• LDL >4.9
• Tendon Xanthoma
• DNA evidence
• Young MI FHx

Question 3

How is Familial Hypercholesterolaemia managed?

Answer 3

Maximum dose of potent statin (stop in pregnancy)

Screening of first degree relatives %50%) chance including children >10 years

Question 4

How is Hypercholesterolaemia managed?

Answer 4

Pirmary preventione (QRISK2 10 year CV risk >10%) OR type 1 diabetics OR CKD if eGFR <60
give ATORVASTATIN 20mg OD (if non-HDL has not fallen by 40% or more titrate up to 80mg OD)

Secondary prevention: known Cardio, Cerebral or Peripheral Arterial give ARTORVASTATION 80mg OD

2nd line therapy: fibrates (bezafibrate)

Also:
Cardioprotective diests
Physical activity
Weight loss
Reduce alcohol 
Stop smoking

Question 5

What are the 4 lipoproteins?

Answer 5

VLDL

Chylomicrons

LDL: mainly cholesterol

HDL: mainly phospholipid