Clinical Conditions Flashcards by Tomini Fashina

Describe the following for acute kidney injury:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – pharmacological
Differential diagnosis

Pathophysiology: abrupt decline in actual GFR, disruption of ECF volume, electrolyte and acid-base homeostasis
Aetiology: pre-renal failure (dehydration/hypotension), intrinsic renal failure (sepsis/glomerular disease/nephritis), post-renal failure (obstruction)
Clinical presentation: nausea, lethargy, hypotension
Diagnostic results: hyperuricaemia, high creatinine (hyperkalaemia, hyponatraemia, low HCO₃^-, proteinuria, haematuria)
Treatment – lifestyle factors: restrict water and Na⁺, stop K⁺ sparing diuretics (ACEi, ARB)
Treatment – pharmacological: dialysis, sodium bicarbonate tablets, calcium gluconate
Differential diagnosis: CKD, renal cancer, glomerulonephritis

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Describe the following for chronic kidney disease:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

Pathophysiology: irreversible & progressive loss of renal function, renal injury leads to replacement of tissue by ECM
Aetiology: diabetes, hypertension, glomerulonephritis, pyelonephritis
Clinical presentation: elderly, co-morbid, ethnic minority, reduced appetitie, nausea & vomiting, pruritis, fatigue
Diagnostic results: low GFR, proteinuria, hyperuricaemia, metabolic acidosis, hyperkalaemia, anaemia
Treatment – lifestyle factors: exercise, stop smoking, lose weight, stop PPIs
Treatment – drug actions and side effects: sodium bicarbonate, ARBs (↑K⁺), ACEi (cough, ↑K⁺), iron tablets, dialysis, transplant
Differential diagnosis: Nephritic syndrome, AKI

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Describe the following for alcoholic liver disease:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

- Pathophysiology: acetaldehyde accumulation leads to liver damage and changes in liver metabolism (excess NADH & Acetyl-CoA)

- Aetiology: prolonged and excessive alcohol consumption

- Clinical presentation: jaundice, gout, fatigue, weight gain

- Diagnostic results: lactic acidosis, hyperuricaemia, hypoglycaemia, raised ALT, raised gamma GT

- Treatment – lifestyle factors: reduce alcohol consumption, support groups

- Treatment – drug actions and side effects: disulfram (hangover feeling)

Differential diagnosis: cirrhosis, hepatitis

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Describe the following for cirrhosis:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

Pathophysiology: liver fibrosis produces a shrunken hard nodular liver, impaired excretion, portal hypertension and portosystemic shunting results
Aetiology: alcohol, fatty liver disease, viral hepatitis
Clinical presentation: fatigue, weakness, jaundice, weight loss, ascites, malaena, haematemesis
Diagnostic results: low albumin, raised bilirubin, prolonged PT (all may be normal)
Treatment – lifestyle factors: reduce alcohol intake
Treatment – drug actions and side effects: painkillers, symptomatic treatment, transplant (only cure)
Differential diagnosis: hepatitis, liver failure

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Describe the following for anaemia:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects

Pathophysiology: low haemoglobin (symptom of underlying condition)
Aetiology: splenectomy, acute blood loss, pregnancy, thalassaemia, SCA, anaemia of chronic disease, haemolysis, bone marrow failure
Clinical presentation: systolic murmur, pallor, tachycardia, dizziness, headaches, fatigue
Diagnostic results: low haemoglobin
Treatment – lifestyle factors: reduce coffee/tea intake, eat more citrus fruits
Treatment – drug actions and side effects: iron supplements (tarry black stools), therapeutic phlebotomy
Differential diagnosis: hypovolaemia, dehydration

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Describe the following for atrial fibrillation:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – drug actions and side effects
Differential diagnosis

Pathophysiology: multiple atrial foci send chaotic signals to SAN, leading to uncoordinated atrial contraction and possible thrombus formation
Aetiology: mitral valve stenosis, left atrium dilation, AMI
Clinical presentation: 90% asymptomatic, dyspnoea, fatigue, palpitations
Diagnostic results: no p waves, wavy baseline, pulse and heart rate are irregularly irregular
Treatment – drug actions and side effects: quinidine/flecainide (GI effects), amiodarone (photosensitivity, thyroid disease), warfarin (teratogenic, bruising, epistaxis)
DIfferential diagnosis: supraventricular tachycardia, Wolff-Parkinson-White syndrome

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Describe the following for cerebrovascular disease (TIA):

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

Pathophysiology: distant emboli temporarily disrupts blood supply to brain
Aetiology: diabetes mellitus, hypertension, hyperlipidaemia (risk factors)
Clinical presentation: loss of motor/sensory function, slurred speech, drooping face < 24 hours
Diagnostic results: clear CT
Treatment – lifestyle factors: stop smoking, exercise, lose weight, reduce alcohol intake, eat healthier
Treatment – drug actions and side effects: warfarin (teratogenic, bruising, epistaxis), statins (CNS & GI effects), ACEi (cough)
Differential diagnosis: stroke, hypoglycaemia

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Describe the following for cerebrovascular disease (stroke):

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

Pathophysiology: haemorrhagic stroke (ruptured aneurysm) / ischaemic stroke (occluded vessel)
Aetiology: diabetes mellitus, hypertension, hyperlipidaemia (risk factors)
Clinical presentation: loss of sensory/motor function, slurred speech, drooping face
Diagnostic results: occluded artery / haemmorhage on head CT
Treatment – lifestyle factors: stop smoking, exercise, lose weight, reduce alcohol intake, eat healthier
Treatment – drug actions and side effects: thrombolytic therapy (< 4.5 hours), warfarin (teratogenic, bruising, epistaxis), statins (GI & CNS effects), ACEi (cough)
Differential diagnosis: hypoglycaemia, epilepsy, migraines

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Describe the following for chronic lung disease (asthma):

Pathophysiology
Triggers
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

Pathophysiology: reversible airway obstruction, bronchoconstriction, mucosal oedema, airway hypersensitivity
Triggers: cold air, emotional distress, exercise, pollutants, pollen
Clinical presentation: wheeze, chest tightness, dyspnoea, cough, diurnal variation
Diagnostic results: obstructive defect on spirometry
Treatment – lifestyle factors: good inhaler technique, avoid triggers
Treatment – drug actions and side effects: β₂ agonists (tachycardia, palpitations), inhaled corticosteroids, LTRA (dry mouth, fever)
Differential diagnosis: lung fibrosis, pneumonia, acute/chronic bronchitis

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Describe the following for chronic lung disease (COPD):

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

Pathophysiology: loss of elastin, loss of surface area for gas exchange, enlargement of air spaces
Aetiology: smoking, alpha-1 antitrypsin deficiency, radon, asbestos
Clinical presentation: pursed lip breathing, barrel chest, productive cough, chronic breathlesness (worse on exertion)
Diagnostic results: hyperresonance on percusion, hyperinflation of lungs on CXR, irreversible obstructive deficit on spirometry
Treatment – lifestyle factors: stop smoking
Treatment – drug actions and side effects: external O₂ therapy, lung transplant, β₂ agonists (tachycardia, palpitations),
Differential diagnosis: emphysema, chronic bronchitis, lung cancer, bronchiectasis

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Describe the following for lung cancer:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
DIfferential diagnosis

Pathophysiology: uncontrolled cell division in lung (NSCLC / SCLC)
Aetiology: smoking, asbestos/radon exposure, metastases
Clinical presentation: cough, breathlessness, haemoptysis, weight loss, fever, fatigue
Diagnostic results: mass/space occupying lesion on CXR, tumour markers, positive lung biopsy
Treatment – lifestyle factors: stop smoking
Treatment – drug actions and side effects: surgery, chemotherapy & radiotherapy (nausea, vomiting, alopecia)
Differential diagnosis: COPD, bronchiectasis

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Describe the following for diabetes type I:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

Pathophysiology: auto-immune destruction of pancreatic β cells
Aetiology: absolute/relative insulin deficiency
Clinical presentation: polyuria, polydypsia, nocturia, weakness, fatigue, weight loss, visual disturbances
Diagnostic results: hyperglycaemia, ketonuria, ketoacidosis
Treatment – lifestyle factors: monitor sugar intake
Treatment – drug actions and side effects: insulin (hypoglycaemia, GI effects)
Differential diagnosis: chronic pancreatitis, endocrine disorders, Type II diabetes

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Describe the following for diabetes type II:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

Pathophysiology: obesity and excess food intake leads to resistance of somatic cells to insulin
Aetiology: peripheral insulin resistance
Clinical presentation: polyuria, polydypsia, nocturia, weakness, fatigue, weight loss, visual disturbances
Diagnostic results: hyperglycaemia
Treatment – lifestyle factors: lose weight, exercise, reduce alcohol intake, stop smoking, eat healthier (more fibre)
Treatment – drug actions and side effects: metformin (GI effects), sulphonylureas (hypoglycaemia, GI effects)
Differential diagnosis: chronic pancreatitis, endocrine disorders, thiazide diuretics

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Describe the following for epilepsy:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects

Pathophysiology: abnormal firing of action potentials in regions of brain
Aetiology: genetic, head injury, auto-immune, drugs
Clinical presentation: convulsions, daydreaming, loss of consciousness
Diagnostic results: abnormal EEG
Treatment – lifestyle factors: avoid triggers
Treatment – drug actions and side effects: carbamazepine, sodium valproate (teratogenic, DDIs with warfarin & COCP) , lamotrigine
Differential diagnosis: stroke, TIA

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Describe the following for anxiety:

Clinical presentation
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

Clinical presentation: worry, stress, nervousness, irritability, insomnia (6 months)
Treatment – lifestyle factors: cognitive behavioural therapy, social support, activities & sport
Treatment – drug actions and side effects: pregabalin, SSRIs (nausea, vomiting, insomnia)
Differential diagnosis: PTSD, OCD, panic disorders, hyperthyroidism

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Describe the following for depression:

Aetiology
Clinical presentation
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

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Aetiology: predisposing factors (genetics, female, childhood), perpetuating factors (financial strain, substance misuse, stressful job), precipitating factors (loss, poor health, break up)
Clinical presentation: low mood, anhedonia, weight loss, insomnia, suicidal thoughts
Treatment – lifestyle factors: cognitive behavioural therapy, exercise & social activities, community, eat more
Treatment – drug actions and side effects: SSRIs (nausea, vomiting, insomnia), TCAs, SRNI
Differential diagnosis: hypercalcaemia, hypothyroidism

Describe the following for pneumonia:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

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Pathophysiology: accumulation of inflammatory exudate in the alveoli of lung
Aetiology: bacterial/viral infection (Strep pneumonia / others)
Clinical presentation: cough, green sputum, breathlessness, fatigue, coarse crackles, chest pain
Diagnostic results: high neutrophils, consolidation on CXR, positive sputum culture
Treatment – lifestyle factors: no smoking
Treatment – drug actions and side effects: amoxicillin, clarithromycin, doxycline (allergy, DDIs, toxicities)
Differential diagnosis: pleurisy, TB

Describe the following for meningitis:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – drug actions and side effects
Differential diagnosis

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Pathophysiology: inflammation of the meninges
Aetiology: bacterial/viral infection (Neisseria meningitides)
Clinical presentation: purpuric rash, neck stiffness, photosensitivity
Diagnostic results: positive bacterial culture, positive lumbar puncture gram stain
Treatment – drug actions and side effects: ceftriaxone (GI effects), meningoccocal vaccine
Differential diagnosis: encephalitis, intracranial mass

Describe the following for pyelonephritis:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

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Pathophysiology: upper urinary tract infection
Aetiology: E.Coli, antibiotic use, unprotected sex, immunocompromised, diabetic (risk factors)
Clinical presentation: loin pain, dysuria, polyuria, urinary incontinence
Diagnostic results: positive bacterial culture, nitrites and leucocytes on urinalysis
Treatment – lifestyle factors: safe sex
Treatment – drug actions and side effects: co-amoxiclav for 14 days (toxicities, DDIs, allergy), antibiotic prophylaxis
Differential diagnosis: UTI, urinary tract obstruction,

Describe the following for UTI:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

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Pathophysiology: bacteria invades and forms biofilm in GU tract, forming a natural surface infection
Aetiology: E.coli, antibiotic use, unprotected sex, immunocompromised, diabetic (risk factors)
Clinical presentation: polyuria, dysuria, haematuria, suprapubic pain
Diagnostic results: positive bacterial culture, nitrites, blood and leucocytes on urinalysis
Treatment – lifestyle factors: safe sex, bodily hygiene
Treatment – drug actions and side effects: trimethoprim (rash, GI effects), nitrofuratoin , antibiotic prophylaxis
DIfferential diagnosis: BPH, prostatitis, urinary tract obstruction, bladder hypertrophy

Describe the following for hypertension:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

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Pathophysiology: persistent elevation of blood pressure
Aetiology: idiopathic, genetic, male, secondary to disease
Clinical presentation: 90% asymptomatic, chest pain, dyspnoea
Diagnostic results: BP > 139/89
Treatment – lifestyle factors: reduce salt intake, exercise, eat healthier, lose weight
Treatment – drug actions and side effects: ARBs (↑K+), ACEi (cough, ↑K+), CCBs, thiazide diuretics
Differential diagnosis: AMI, heart failure

Describe the following for heart failure:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

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Pathophysiology: one/both sides of heart unable to pump sufficient blood to meet demands of body despite adequate filling pressure
Aetiology: congenital defect, PE, pulmonary hypertension, diabetes, atherosclerosis, smoking, hypercholesterolaemia
Clinical presentation: cyanosis, dyspnoea, orthopnea, PND, oedema, chest pain
Diagnostic results: hypoxia, increased deoxyhaemoglobin, cardiomegaly, high cholesterol, atherosclerotic plaques, hypertrophy, hypertension
Treatment – lifestyle factors: exercise, lose weight, eat healthier (more fibre), stop smoking, less alcohol
Treatment – drug actions and side effects: ACEi (cough), loop diuretics, aspirin (GI effects), β₂ antagonists (bronchoconstriction) , GTN spray
Differential diagnosis: AMI, angina, pericarditis, lung fibrosis

Describe the following for gallstones:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects

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Pathophysiology: formation of gallstones obstructing the cystic duct
Aetiology: diabetes, genetics, COCP, IBS, age, female, obesity, Crohn’s disease
Clinical presentation: 70% asymptomatic, biliary colic (acute abdominal pain, right sided and hypogastric), worse with eating, jaundice, nausea, flatulence, constipation, steatorrhea, abdominal distension
Diagnostic results: positive on ultrasound
Treatment – lifestyle factors: healthy diet
Treatment – drug actions and side effects: monitoring, keyhole surgery to remove gallbladder
Differential diagnosis: peptic ulcer disease, pancreatitis, small bowel/stomach cancer

Describe the following for hypercholesterolaemia:

Pathophysiology
Aetiology
Clinical presentation
Diagnostic results
Treatment – lifestyle factors
Treatment – drug actions and side effects
Differential diagnosis

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Pathophysiology: abnormally high levels of cholesterol deposit around the body
Aetiology: genetic, diet
Clinical presentation: xanthelasma, xanthoma, corneal arcus, obesity
Diagnostic results: high cholesterol levels (high LDL)
Treatment – lifestyle factors: eat healthier (less fats), exercise, drink less alcohol, less smoking, lose weight
Treatment – drug actions and side effects: statins (CNS effects, GI effects), bile salt sequestrants
Differential diagnosis: hyperlipidaemia, diabetes

Describe the following for inflammatory bowel disease: - Pathophysiology - Aetiology - Clinical presentation - Diagnostic results - Treatment – lifestyle factors - Treatment – drug actions and side effects - Differential diagnosis

- **Pathophysiology**: inflammation leads to cryptitis / fistula formation - **Aetiology**: idiopathic, genetics, smoking - **Clinical presentation:** abdominal pain, abdominal distension, haematochezia, loose stools, fever, fatigue, weight loss - **Diagnostic results:** granulomas/fistulas on gram stains, fecal calprotectin, - **Treatment – lifestyle factors:** stop smoking, less alcohol, adhere to medication, lose weight - **Treatment – drug actions and side effects:** azathioprine (infection risk, hepatitis, anaemia), methotrexate (teratogenic, infection risk, hepatitis) - **Differential diagnosis:** Crohn's disease, Ulcerative colitis, gastric/small bowel cancer, irritable bowel syndrome, Coeliac's disease

Describe the following for bowel cancer: - Pathophysiology - Aetiology - Clinical presentation - Diagnostic results - Treatment – lifestyle factors - Treatment – drug actions and side effects - Differential diagnosis

- **Pathophysiology**: uncontrolled cell division - **Aetiology**: genetic, idiopathic - **Clinical presentation:** abdominal distension, abdominal pain, weakness, weight loss, fever - **Diagnostic results:** adenocarcinoma on biopsy, tumour markers - **Treatment – lifestyle factors:** lose weight, eat healthier, stop smoking, drink less alcohol - **Treatment – drug actions and side effects:** chemotherapy (alopecia, mucositis), radiotherapy, surgery - **Differential diagnosis:** IBS, inflammatory bowel syndrome, gallstones

Describe the following for ischaemic heart disease: - Pathophysiology - Aetiology - Clinical presentation - Diagnostic results - Treatment – lifestyle factors - Treatment – drug actions and side effects - Differential diagnosis

- **Pathophysiology**: formation of atherosclerotic plaque encroaches on coronary arteries - **Aetiology**: diabetes, hypercholesterolaemia, hypertension, AMI - **Clinical presentation:** breathlessness, chest pain, sweating, pallor - **Diagnostic results:** raised cholesterol, raised BP, hypoxia, hypercapnia, hypertrophy, stenosed arteries - **Treatment – lifestyle factors:** lose weight, exercise, less alcohol, stop smoking, eat healthier, reduce stress - **Treatment – drug actions and side effects: β₂** blockers (bronchoconstriction), GTN spray, ARBs (↑K⁺), ACEi (cough, ↑K⁺) - **Differential diagnosis**: pericarditis, costochondritis, angina, acid reflux

Describe the following for osteoarthritis: - Pathophysiology - Aetiology - Clinical presentation - Diagnostic results - Treatment – lifestyle factors - Treatment – drug actions and side effects - Differential diagnosis

- **Pathophysiology**: increased wear and tear to joints, degenerative disease - **Aetiology**: idiopathic, age-related, trauma, secondary to disease - **Clinical presentation:** joint pain, stiffness, crepitis, grinding, swelling - **Diagnostic results:** no inflammation, osteophytes, subchondral sclerosis, subchondral cyst, decreased joint space on X-ray - **Treatment – lifestyle factors:** avoid vigorous exercise, only moderate exercise, stay on feet (avoid immobility) - **Treatment – drug actions and side effects:** painkillers, treat underlying condition - **Differential diagnosis:** RA, broken bone, osteoporosis

Describe the following for rheumatoid arthritis: - Pathophysiology - Aetiology - Clinical presentation - Diagnostic results - Treatment – lifestyle factors - Treatment – drug actions and side effects - Differential diagnosis

- **Pathophysiology**: Rhematoid factor triggers autoimmune reaction at joints - **Aetiology**: auto-immune - **Clinical presentation:** joint swelling, stiffness, warmth, heat, pain - **Diagnostic results:** positive for Rheumatoid factor - **Treatment – lifestyle factors:** avoid vigorous exercise, adhere to medicine - **Treatment – drug actions and side effects:** methotrexate (teratogenic, hepatitis, infection risk), sulfasalazine (GI effects) - **Differential diagnosis:** osteoarthritis, spondylarthritis, psoriatic arthritis

Describe the following for peptic ulcer disease: - Pathophysiology - Aetiology - Clinical presentation - Diagnostic results - Treatment – lifestyle factors - Treatment – drug actions and side effects - Differential diagnosis

- **Pathophysiology**: break down of mucosal layer, increase in gastric pH, production of ammonia - **Aetiology**: H.pylori infection - **Clinical presentation:** abdominal pain, worsened with eating, abdominal distension, nausea, vomiting, diarrhoea, weight loss - **Diagnostic results:** positive C-13 urease breath test, H.pylori on stool sample, ulcer on endoscopy - **Treatment – lifestyle factors:** avoid alcohol, eat healthier, avoid spicy food and coffee, lose weight, exercise - **Treatment – drug actions and side effects:** clarithromycin, amoxicillin, omeprazole/lansoprazole - **Differential diagnosis:** GORD, gastric adenocarcinoma

Describe the following for pulmonary embolism: - Pathophysiology - Aetiology - Clinical presentation - Diagnostic results - Treatment – lifestyle factors - Treatment – drug actions and side effects - Differential diagnosis

- **Pathophysiology**: distant emboli lodges in pulmonary arteries - **Aetiology**: 90% DVT, immobilisation, surgery, hyperlipidaemia - **Clinical presentation:** cough, chest pain, SOB, haemoptysis, fever - **Diagnostic results:** hypoxia, emboli in pulmonary arteries, pulmonary hypertension - **Treatment – lifestyle factors:** weight loss, exercise, eat healthier, stop smoking, less alcohol - **Treatment – drug actions and side effects:** heparin, warfarin (bleeding, bruising, teratogenic) - **Differential diagnosis:** pericarditis, TB, pneumonia, pneumothorax

Describe the following for deep vein thrombosis: - Pathophysiology - Aetiology - Clinical presentation - Diagnostic results - Treatment – lifestyle factors - Treatment – drug actions and side effects - Differential diagnosis

- **Pathophysiology**: thrombophlebitis of deep veins in legs - **Aetiology**: immobility, age, surgery, smoking, COCP, male, heart failure, pregnancy - **Clinical presentation:** 50% asymptomatic, tenderness, swelling, warmth, pain, congestion - **Diagnostic results:** positive on USS, positive D dimer - **Treatment – lifestyle factors:** weight loss, exercise, eat healthier, stop smoking, less alcohol - **Treatment – drug actions and side effects:** heparin, warfarin (bleeding, bruising, teratogenic) - **Differential diagnosis:** vascular/neurological claudication, vasculitis, cellulitis, ruptured Baker's cyst

Describe the following for hyperthyroidism: - Pathophysiology - Aetiology - Clinical presentation - Diagnostic results - Treatment – drug actions and side effects - Differential diagnosis

- **Pathophysiology**: excessive thyroid hormone production increases negative feedback of TSH and enhances metabolism - **Aetiology**: autoimmune (TSI), thyrotoxicosis, excessive oral T₄ therapy, functional pituitary adenoma - **Clinical presentation**: intolerance to heat, weight loss, palpitations, irritability, tachycardia, tremors - **Diagnostic results:** high levels of T₄, low levels of TSH, positive on USS - **Treatment – drug actions and side effects:** carbimazole, thyroid surgery, radioactive iodine - **Differential diagnosis:** anxiety, phaeochromocytoma, Grave's disease

Describe the following for hypothyroidism: - Pathophysiology - Aetiology - Clinical presentation - Diagnostic results - Treatment – lifestyle factors - Treatment – drug actions and side effects - Differential diagnosis

- **Pathophysiology**: insufficient thyroid hormone production decreases negative feedback on TSH and decreases metabolism - **Aetiology**: autoimmune destruction (TSI), thyroid surgery, anti-thyroid drugs, iodine deficiency - **Clinical presentation:** intolerance to cold, weight gain, low mood, bradycardia - **Diagnostic results:** low levels of T₄, high levels of TSH, - **Treatment – drug actions and side effects:** oral T₄ therapy, iodine supplementation - **Differential diagnosis:** depression, hypercalcaemia, Hashimoto's disease

Describe the following for tension headache: - Aetiology - Clinical presentation - Treatment – lifestyle factors - Treatment – drug actions and side effects - Differential diagnosis

- **Aetiology**: emotional distress, eye strain, hunger, physical tension in neck&back muscles - **Clinical presentation:** felt as a band / across the forehead, lasts for several days, worsens throughout the day, tiring, does not disturb sleep, sensitive to light/noise, does not limit physical activity - **Treatment – lifestyle factors:** stress, posture, exercise, warm bath, massage - **Treatment – drug actions and side effects:** paracetamol (overdose, toxicity), NSAIDs (Gi effects), amitryptilline (confusion, headache, nausea) **- Differential diagnosis:** migraines, cluster headache

Describe the following for migraines: - Triggers: - Clinical presentation - Treatment – lifestyle factors - Treatment – drug actions and side effects - Differential diagnosis

- **Triggers**: dieting, loud noises, strong smells, smoky rooms, depression, anxiety, stress - **Clinical presentation:** one-sided and throbbing, nausea, only relieved with sleep - **Treatment – lifestyle factors:** avoid triggers - **Treatment – drug actions and side effects:** paracetamol (overdose, toxicity), NSAIDs (Gi effects) - **Differential diagnosis:** cluster headaches, tension headaches

Describe the following for cluster headache: - Triggers - Clinical presentation - Treatment – lifestyle factors - Treatment – drug actions and side effects - Differential diagnosis

- **Triggers**: alcohol, strong smells, raised temperature (hot bath, hot weather) - **Clinical presentation:** clusters, occur every day for weeks then disappear for months, severe, one-sided, adult male smokers, red watery eyes, ptosis, rhinorrhea, disturb sleep - **Treatment – lifestyle factors:** avoid triggers - **Treatment – drug actions and side effects:** triptans, corticosteroids, verapamil, lithium - **Differential diagnosis:** migraines, subarachnoid haemorrhage

Describe the following for giant cell arteritis: - Aetiology - Clinical presentation - Diagnostic results - Treatment – lifestyle factors - Treatment – drug actions and side effects - Differential diagnosis

- **Aetiology**: swelling and inflammation of the arteries in the temples and behind the eye - **Clinical presentation:** adults \> 50, frontal headache, tender forehead, pain in jaw muscles, worsens with chewing & combing hair, can lead to sudden loss of eye sight - **Diagnostic results:** raised CRP indicating inflammation - Treatment – lifestyle factors: - **Treatment – drug actions and side effects:** prednisolone (hyperglycaemia, hypertension, weight gain, osteoporosis, opportunistic infections), aspirin (Gi effects), omeprazole (reduce likelihood of stomach ulcer) - **Differential diagnosis:** migraines, cluster headache

Clinical Conditions Flashcards

(38 cards)