Flashcards in DPD2: Meeran- Histopathology, Addisons, TB Deck (19)
What is the commonest brain tumour?
from Lung in men
from breast in women
What is the most common primary benign and malignant brain tumour?
In decreasing order, list 4 metabolic states most likely to cause a seizure?
Hypokalaemia (more likely arrhythmia)
What measurements of 9am serum cortisol determine adrenal failure?
< 100 nmol/L is diagnostic
> 550 nmol/L: adrenal insufficiency unlikely
What measurement in a Short Synacthen Test suggests adrenal failure?
IM 250 mg tetrocosactrin (synthetic ACTH)
Serum cortisol < 550 nmol/L at 30 mins indicates adrenal failure
If a biopsy of the adrenals shows multinucleated giant cells and caveating granulomata, what is the diagnosis?
Tuberculosis Addisons disease
What are the most common causes of Addisons disease?
Name the 4 antibiotics used in treatment of tuberculosis
Explain the regimen of antibiotic use in TB
4 drugs for 2 months as it takes 2 months to get the culture + sensitivity back
If sensitive to all 4, stop P+E as these have the most SEs (unless sensitivity shows resistance to RI, in which case, may choose 2 others)
What drugs are required for treating tuberculosis Addisons?
Prednisolone 5mg OD
Fludrocortisone 100mcg OD
Rifampicin is an enzyme inducer, so high dose pred is necessary
Describe pulmonary oedema
Abnormal leakage of fluids into lung interstitium + alveoli
Causes: LV failure, ARDS, fluid overload, neurogenic
What is a pleural effusion?
Fluid in the pleural space
Transudates: increased venous pressure
Exudates: increased leakiness of pulmonary capillaries
What causes a transudate pleural effusion?
Hypoproteinaemia (Cirrhosis, nephrotic syndrome)
What causes a exudate pleural effusion?
Infection: Pneumonia, TB
Inflammation: RA, SLE
Malignancy: Mesothelioma, Lymphoma
What protein concentration defines transudates and exudates?
Transudate: < 25g/L
Exudate: > 35g/L
What are the most likely causative organisms of a community acquired pneumonia?
Describe the appearance of Streptococcus pneumoniae on gram stain
Gram +ve diplococcus
Like "rugby balls" in pairs
Describe the appearance of Haemophilus influenza on gram stain
Gram -ve bacilli
Poor uptake of gram stain due to thin peptidoglycan wall