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DPD > Haematology + Endocrinology > Flashcards

Haematology + Endocrinology Flashcards

(43 cards)

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1
Q
  • Cough
  • Breathlessness
  • Recent travel
  • Coarse crepitations and bronchial breathing
  • Hyponatraemia
  • Deranged LFTs

Prescribe amoxicillin and …?
Why?

A

Clarithromycin

• Typical pneumonia

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2
Q

What are 3 organisms in atypical pneumonia?

A
  • Mycoplasma pneumoniae
  • Chlamydia pneumoniae
  • Legionella pneumpphilia
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3
Q
  • Dyspepsia
  • Weight loss
  • Microcytic anaemia

Next appropriate investigation?

A

OGD (gastroscopy)

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4
Q

What tests should you do in microcytic anaemia?

A
  • Haematinics

* Coeliac screen (TTG Ab) - can also cause B12 deficiency

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5
Q

How do you confirm coeliac disease?

A

Duodenal biopsy - villous atrophy

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6
Q

70 year old man
• Bloody diarrhoea
• Negative culture and C. diff toxin

Most likely diagnosis?

A

Ischaemic colitis

• Bloody diarrhoea in elderly patients

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7
Q

40 year old man
• Palpitations for 4 hours
• ECG: AF

Treatment and why?

A

DC cardioversion

  • Less than 48 hours
  • Converts AF to sinus rhythm
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8
Q

How is an SVT converted back to sinus rhythm?

A

Adenosine (rate control)

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9
Q

What is used to control rate in AF?

A
  • Beta-blocker or verapamil

* Digoxin or amiodarone if contraindication

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10
Q

When is amiodarone used?

A

Pulseless VT / VF

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11
Q

Complications of portal hypertension?

A
  • Encephalopathy
  • Ascites
  • Spontaneous bacterial peritonitis
  • Variceal bleed
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12
Q 
20 year old boy
• Diarrhoea
• Malaise
• Low Hb
• High creatinine
• Schistocytes

What skin sign would you expect to see and what is the diagnosis?

A

Jaundice

Schistocytes = haemolysis

Haemolytic Uraemic syndrome

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13
Q

Which 3 conditions have microangiopathic haemolytic anaemia?

A
  • DIC
  • HUS
  • TTP
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14
Q

Bloods tests in DIC and HUS?

A

DIC
• low platelets
• high PT/APTT
• high D-dimer

HUS
• Low Hb
• High bilirubin
• High creatinine (uraemia)
• Low platelets
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15
Q

Hereditary (3) and acquired (4) causes of haemolytic anaemia?

A

Hereditary
• Red cell membrane (hereditary spherocytosis)
• Enzyme deficiency (G6PD)
• Haemoglobinopathy (sickle cell disease, thalassaemia)

Acquired
• Autoimmune
• Drugs
• Infection
• MAHA
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16
Q

What are small bowel folds called and what size would you expect the small bowel to be in obstruction?

A

Valvulae conniventes

> 3cm

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17
Q

What are large bowel folds called and what size would you expect the large bowel to be in obstruction?

A

Haustra

> 6cm, > 9cm at caecum

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18
Q

3 causes of hyponatramia with hypovolaemia?

Study These Flashcards
A
  • Diarrhoea
  • Vomiting
  • Diuretics
19
Q

3 causes of hyponatraemia with euvolaemia and their tests?

Study These Flashcards
A
  • Hypothyroidism - TFTs
  • Adrenal insufficiency - short synacthen test
  • SIADH - plasma + urine osmolality
20
Q

3 causes of hyponatraemia with hypervolaemia?

Study These Flashcards
A
  • Cardiac failure
  • Cirrhosis
  • Nephrotic syndrome
21
Q 
60 year old man
• Confused
• Cough
• Low sodium
• Low plasma osmolality (low sodium)
• High urine osmolality (high sodium)

Next most appropriate investigation and why?

Study These Flashcards
A

CXR

• Lung cancer producing excess ADH

22
Q

What are almost all cases of hyponatraemia due to?

Study These Flashcards
A

Rise in ADH - but this isn’t always ‘inappropriate’ as in SIADH

23
Q

Top 2 investigations for SIADH (and other cause)?

Study These Flashcards
A
  • CXR - lung cancer
  • Brain CT - brain tumour

Drugs e.g. SSRI, TCA

24
Q

35 year old man with sweating, weight loss, nail separating from nail bed. What is the nail sign called and what is the cause? What are other causes of this sign?

Study These Flashcards
A

Onycholysis caused by thyrotoxicosis

  • Trauma
  • Fungal infections
  • Psoriasis
25
``` 20 year old woman • Abdominal pain • Vomiting • T1DM • High BM ``` Most appropriate next investigation?
Capillary ketone
26
``` 26 year old man • Chest pain • Smoker • Scratching sound on auscultation • Global ST elevation ``` Diagnosis?
Pericarditis
27
``` 60 year old • Collapse • T1DM • Normal BP • Ejection systolic murmur • ECG: S from V1/V2 and R from V5/V6 add up to ≥7 ``` What does the ECG suggest?
Left ventricular hypertrophy
28
* Loin pain * Normal CRP * Urinalysis: +++ blood Next appropriate investigation?
CT KUB Stones: pain, haematuria
29
* Hypercalcaemia * Low PTH * Backache * Normal ALP Most likely diagnosis?
Multiple myeloma
30
2 main causes of hypercalcaemia?
* Primary hyperparathyroidism | * Malignancy
31
When is ALP high?
* Obstructive liver disease | * Bone disease - malignancy, fracture, Paget's disease
32
Why is ALP normal in multiple myeloma?
* Osteoblasts make ALP * Plasma cells from MM suppress osteoblasts * So ALP is normal
33
Mnemonic for multiple myeloma?
``` CRAB • Calcium - high • Renal impairment • Anaemia • Bone - pain, osteoporosis ```
34
60 year old man • Cough • Haemoptysis • Air-fluid level on CXR What does this CXR finding suggest?
Cavitating lesion
35
Causes of cavitating lung lesions?
* TB, Staph, Klebsiella * Rheumatoid arthritis * Pulmonary embolism
36
35 year old woman • Ankle oedema • Normal echo • Low albumin Next most appropriate investigation? Expected diagnosis?
Urinalysis - proteinuria • Nephrotic syndrome
37
30 year old man • Recurrent GI and nosebleeds • Red dots over mouth and tongue Diagnosis?
Hereditary haemorrhagic telangiectasia Autosomal dominant
38
* Low sodium * Short synacthen test shows small increase in cortisol (100 to 200) Diagnosis?
Adrenal insufficiency Normal patient short synacthen increase to > 600
39
* Very high prolactin * Low testosterone * Low LH * Low FSH Diagnosis?
Prolactinoma | pituitary adenoma
40
* High prolactin * High IGF-1 * OGTT: failure of GH suppression Diagnosis?
Acromegaly | pituitary adenoma
41
* Low oestradiol * High FSH * High LH Diagnosis?
If older - menopause | If younger - premature ovarian insufficiency
42
* Low free T4 * High TSH Diagnosis?
Primary hypothyroidism
43
Endocrine function tests in multinodular goitre?
Normal

DPD (6 decks)

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