met rogue Flashcards by mish m

Ascites

SAAG gradient >11g/L
high
Liver cirrhosis - portal hypertension

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raises anti-mitochondrial antibodies

raised ALP, GGT

Primary biliary cholangitis

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T2DM and abnormal LFTSs?

usually non-alcoholic fatty liver disease

check ferritin for haemochromatosis

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drugs causing long QTc

cardiac
amiodarone
sotalol
1a antiarrythmic

TCAs
SSRIs - citalopram 
methadone
chloroquine 
erythromycin

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hypothyroid in pregnancy

increase levothyroxine up to 50%

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Low dose dex - NOT supp

High dose - SUPP

Cushing’s disease

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Graves

and which antibodies pls

autoimmune attack on thyroid
overactive
TSH receptor stimulating ABs
anti-thyroid peroxidase ABs

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ABC in IBS?

abdominal pain
bloating
change in bowel habits (diarrhoea/constipation)

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pharyngeal pouch

dysphagia 
regurgitation 
halitosis - bad breath 
aspiration 
--> surgical repair

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ADH action

anti-diuretic hormone
increases aquaporins
increases pure water absorbed back to blood 
decreases plasma osmolality 
increases urine osmolality

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SIADH

inappropriate ADH secretion
–> hyponatraemia
result of dilution / excessive water retention

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SIADH treatment?

fluid restriction

…

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Effects of hyponatraemia

cerebral oedema
lethargy
nausea and vomiting
headache/confusion
decreased GCS

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broad spectrum antibiotics & PPIs can cause?

C difficile infection

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C difficile

diarrhoea
abdominal pain
raised WCC
severe toxic megacolon

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C difficile treatment?

oral metronidazole 10-14 days
2nd line - vancomycin
life threatening?
-> mix oral vanc and IV met

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anaemia diagnosis

& infection?

normally ferritin
ferritin = unreliable indicator of iron levels in infection
use transferrin saturation & TIBC instead

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differentiate between IBS and IBD in primary care

fecal calprotectin

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SIADH causes

small cell lung cancer
pancreas, prostate malignancy 
stroke
neuro haemmorhages
TB, pneumonia 
drugs

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alcoholic ketoacidosis findings

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metabolic acidosis 
raised ketones
normal glucose
(raised anion gap)

alcoholic ketoacidosis treatment

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saline & thiamine infusion

C difficile investigation results

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C dif toxin = current infection

C dif antigen = past exposure/colonies

hyperkalaemia causes?

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AKI
metabolic acidosis
Addisons disease 
rhabdomyolysis 
massive blood transfusion 
drugs: 
- ACE inhibitors, ARBs
- potassium sparing diuretics 
- spironolactone 
- heparin
- ciclosporin
- beta blockers maybe?

painless obstructive jaundice

palpable gall bladder

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think malignancy

cholangiocarcinoma
pancreatic cancer

Hepatocellular carcinoma causes

``` liver cirrhosis chronic hep B/C alcohol haemochromatosis PBC ... ```

HCC features

``` late presentation cirrhosis/liver failure jaundice ascites RUQ rain hepatomegaly/spleno pruritus raised AFP - alphafetoprotein ```

hyponatraemia causes? urinary sodium >20mmol/l

``` diuretics - loop, thiazide Addisons disease renal failure SIADH hypothyroid ```

hyponatraemia causes? urinary sodium <20 mmol/l

``` diarrhoea, vomiting, sweating burns, rectal adenoma water excess - secondary hyperaldosteronism from heart failure, liver cirrhosis - nephrotic syndrome - IV dextrose ... ```

isolated bilirubin rise

Gilberts syndrome (goes away by self)

p-ANCA

primary sclerosing cholangitis | ulcerative colitis/IBD?

hyperkalaemia ECG changes

``` Tall-tented T waves flat/lost of P waves wide QRS complex increased PR interval sine wave pattern --> VF ```

severe hyperkalaemia limits

>= 6.5 mmol/L

causes of AKI

``` = STOP Sepsis, shock Toxicity Obstruction Parenchymal disease ```

some symptoms of hyperkalaemia

chest pain palpitations weakness

hyperkalaemia stabilise cardiac membrane

IV calcium gluconate | does NOT lower serum K

hyperkalaemia - short term ECF--> ICF shift

insulin/dextrose infusion | nebuliser salbutamol

remove K from body

calcium resonium (oral or enema) loop diuretics dialysis

diarrhoea acid-base disturbance?

normal anion gap metabolic acidosis

vomiting acid-base disturbance?

normal anion gap metabolic alkalosis

membranous glomerulonephritis findings

- nephrotic/proteinuria - thick base membrane - sub-epithelial spikes

cause of membranous glomerulonephritis

APA2 antibodies infection malignancy SLE, thyroid, rheumatoid

membranous glomerulonephritis treatment

ACEi/ARB - reduce proteinuria immunosuppression anticoagulation if high risk

anti-GBM disease

autoimmune, against collagen in lungs/glomeruli - nephritic - haemoptysis - linear IgG in basement membrane

IgA nephropathy findings

- macroscopic haematuria in young person, post URTI | - renal biopsy = mesangial proliferation, matrix accumulation

what is IgA nephropathy

IgA builds up in kidneys - leads to inflammation...?

what does aldosterone do?

regulates BP | resorption of Na --> water

post ERCP - epigastric pain radiating to the back, nausea, jaundice, vomiting, fever?

acute pancreatitis - common complication of ERCP

Sildenafil

Phosphodiesterase type V inhibitors erectile dysfunction, pulmonary hypertension vasodilation by increasing cGMP --> relaxes smooth muscle/vessels (corpus cavernosum)

met rogue Flashcards

(48 cards)