CCC 5

Question 1

what are the causes of bloody diarrhoea?

Answer 1

infection- infectious colitis
inflammation- ulcerative colitis
ischaemic colitis

Question 2

how does portal hypertension present?

Answer 2

ascites
SBP
hepatic encephalopathy
variceal bleed

Question 3

what will be findings and symptoms in someone with HUS?

Answer 3

haemolysis= shistocytes on blood film
uraemia= high creatinine
recent diarrhoea and malaise

Question 4

whats the triad for HUS?

Answer 4

haemolytic anaemia
uraemia
thrombocytopenia

Question 5

what are the 3 hereditary haemolytic anaemias and what defects do they have?

Answer 5

G6PD deficiency- deficiency in the enzyme causes breakdown of RBCs
hereditary spherocytosis- defect in the cell membrane causes breakdown of RBCs
sickle cell/thalassaemia- haemoglobinopathy

Question 6

what are the acquired causes of haemolytic anaemia?

Answer 6

autoimmune
MAHA
drugs
infection

Question 7

what is the difference between small and large bowel obstruction on x ray?

Answer 7

small bowel= valvulae conniventes

large bowel= haustra

Question 8

what are the cuases of hypovolemic hyponatraemia?

Answer 8

vomitting
diarrhoea
diuresis

Question 9

how do you identify hypovolemic hyponatraemia?

Answer 9

you have to do a urine sodium not serum

Question 10

what are the causes of euvolemic hyponatraemia?

Answer 10

SIADH

hypothyrodisim

Question 11

why does hypothyroidism cause euvolemic hyponatraemia?

Answer 11

hypothyroidism causes reduced cardiac output
this causes increased release of ADH
higher levels of ADH will cause more sodium excretion

Question 12

what are the causes of hypervolemic hypontraemia?

Answer 12

liver, heart and kidney failure

Question 13

how do you differentiate hypovolemic and hypervolemic hyponatraemia using ix?

Answer 13

hypovolemic= high urine sodium
hypervolemic= low urine sodium

Question 14

what are the micro, macro and metolbic complications of diabetes?

Answer 14

micro= retinopathy, nephropathy, neuropathy
macro= stroke, MI, PVD
metab= DKA, HHS, hypoglycaemia

Question 15

what are the 2 sources of ALP?

Answer 15

lung and bone

Question 16

what will ALP level be in myeloma?

Answer 16

normal

Question 17

what are the causes of cavitating lung lesions?

Answer 17

infection= klebsiella, staph aureus, TB
inflammation= rheumatoid arthritis
malignancy
ischaemia= PE

Question 18

what should you think if someone has recurrent GI and nosebleeds?

Answer 18

hereditary telangiectasia

Question 19

what are the 3 components of FBC?

Answer 19

Hb
WCC
platelets

Question 20

what acronym is used to remember the causes of macrocytic anaemia?

Answer 20

alcoholics may have liver failure: 
alcohol
myelodysplasia
hypothyroidism
liver failure 
folate/b12 deficiency

Question 21

what are symptoms of polycythaemia vera?

Answer 21

headache 
tinnitus 
pruritus after a hot bath
thrombosis 
DVT
blurred vision

Question 22

what are the 4 main presentations of sickle cell (acutely) and how are they managed?

Answer 22

acute painful crisis= o2, analgesia, abx, IV fluids 
sequestration crisis (bone pain)= if repeated do splenectomy 
cholecystitis= do a cholecystectomy 
stroke= exchange blood transfusion

Question 23

what are the 4 presentations of sickle cell?

Answer 23

acute painful crisis
cholecystitis
sequestration crisis
stroke

Question 24

how do you manage a stroke due to sickle cell?

Answer 24

exchange blood transfusion

Question 25

what are the crab features of multiple myeloma and how do they present?

Answer 25

c- hypercalcaemia= polyuria, polydipsia and constipation r-renal failure= high urea and creatinine a- anaemia=SOB, pallor b- bone pain

Question 26

if there is anaemia with low reticulocytes, what might be the cause?

Answer 26

parvovirus B aplastic crisis with sickle cell blood tranfusion

Question 27

what will you see on an uptake scan in thyroid cancer?

Answer 27

cold nodules

Question 28

what are rf for thyroid cancer?

Answer 28

irradiation fhx lymphadenopathy

Question 29

how do you treat a bitemporal hemianopia first line?

Answer 29

cabergoline not surgery

Question 30

how is prolactinoma managed first line and why?

Answer 30

cabergoline not surgery | surgery is very risky

Question 31

when diagnosing cushings what should you look for and what can help you differentiate it?

Answer 31

if they are just depressed and have gained weight this is not cushings look for purple striae, bruising, thin skin, young onset diabetes/hypertension/ osteoporosis

Question 32

what is the relationship between potassium and glucose?

Answer 32

potassium drives glucose into cells therefore hypokalemia causes diabetes

Question 33

what are the causes of oligo/amenorrhea and how do you remember?

Answer 33

go from head to toe: hypothalamus (excess exercise or low BMI) pituitary (excess prolactin/lack of FSH or LH) thyroid (do TFTs) PCOS (hyperandrgenism causes lack of negative feedback)

Question 34

what 3 blood tests should you do for polyuria and polydipsia and why?

Answer 34

blood glucose, potassium and calcium low potassium and calcium cause diabetes

Question 35

what causes hypernatraemia if there is high urine osmolality?

Answer 35

dehydration, HHS or T2DM

Question 36

what causes hypernatraemia if there is low urine osmolality?

Answer 36

diabetes insipidus

Question 37

what should you think when you see high calcium with low PTH?

Answer 37

malignancy or myeloma

Question 38

what is active urine sediment?

Answer 38

blood and protein in urine

Question 39

how does renal artery stenosis present?

Answer 39

asymmetrical kidneys

Question 40

what ix is done for renal artery stenosis?

Answer 40

magnetic resonance angiography

Question 41

what are features of BCC?

Answer 41

pearly rolled edges surface telangiectasia rolled edges