FRACP 2019 Flashcards
(28 cards)
How to monitor secondary hypothyroidism
T4
T3 is only required if the diagnosis is unclear
What is Whipple’s triad?
(1) symptoms of hypoglycemia
(2) hypoglycemia (blood glucose level <50 mg/dL)
(3) relief of symptoms following ingestion of glucose
Presentation of female carriers of X-linked adrenoleukodystrophy
Peripheral neuropathy and myelopathy
How to diagnose adrenoleukodystrophy
VLCFA levels
What is the worse allele in alpha-1 antitrypsin deficiency?
Z
(M is the allele associated with normal alpha-1 antitrypsin production and there is also the null allele that results in no alpha-1 antitrypsin production)
What is the most common genetic mutation in hereditary motor neuron disease?
C9ORF72
What is the MOA of riluzole?
modulates sodium channels and inhibits glutamate release, providing a survival benefit of about 3e6 months, potentially greater for patients with bulbar-onset disease
What is the purpose of ATG in haematogenous stem cell transplant?
To prevent graft versus host disease
What is delayed anaphylaxis to meat mostly caused by?
galactose-alpha-1,3-galactose (alpha-gal) due to sensitisation to ticks
Who needs tetanus IG?
Immunosuppressed people or people with uncertain/no tetanus vaccination histroy with a wound that is more than a clean, minor wound
Who needs tetanus vaccinations in wounds?
Anyone who has had less than 3 tetanus doses
Any wound in people who haven’t had tetanus for >10 years
Any wound more than a clean minor wound in people who haven’t had tetanus for >5 years
Precautions for meningococcal
Droplet
What is the most common opportunistic pathogen following solid organ transplantation?
CMV
What chemotherapy class is most commonly associated with enterotoxicity?
fluoropyrimidines (particularly fluorouracil [FU] and capecitabine) and irinotecan
Management of acute chemotherapy related colitis
- Admit to hosptial is complicating features of 7 or more stools over baseline a day
- Loperamide
- Increase loperamide
- S/c octreotide
- Investigate for other causes
- Stop chemotherapy
ECOG scale
0 -> 5
0 = fully independent
5 = dead
What is a feature of cancer cachexia?
Hypertriglyceridaemia and increased VLDL production
What is the pathogenesis of dialysis disequilibrium?
Cerebral oedema
Skin necrosis in dialysis patients diagnosis and treatment
Calciphylaxis
Non-calcium phosphate binders, sodium thiosulphate and cinacalcet if PTH high
what is the difference in presentation between ulnar neuropathy at the elbow vs wrist?
Clawing of 4th and 5th digits worse at the wrist because there is sparing of the FLEXOR DIGITORUM PROFUNDUS (flexes DIP in 4th and 5th digits) with a lesion at the wirst
What does Fanconi syndrome affect the reabsorbtion of?
Glucose, amino acids, uric acid, phosphate, and bicarbonate
What’s the most likely interstitial lung disease pattern seen in RA?
UIP
What rheumatological condition is associated with apical pulmonary fibrosis?
Ankylosing spondylitis
What lung volumes require whole body plethysmography and not spirometry
Reserve volume
Functional residual capacity
Total lung volumes
