Endo + Gastro
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Side effects of growth hormone therapy are?
Manily fluid retention, oedema and injection site reactions.
also, Gynaecomastia, benign intracranial hypertension, arthralgias.
Xray appearence of Crohn's?
- Strictures that should be discontinuous (in keeping with skip lesions)
- Fistula formation
X-ray appearence of UC?
Lead pipe sign...
Loss of colonic haustra
Always continuous involvment, starting at rectum
Doc...Im sweating a lot more than i used to...
What should be going through your head?
- Hypoglycaemia (insulinoma)
Drug induced liver damage...
Mouldy cereals and grains from west africa\southern china...
- Methotrexate = Liver fibrosis
- Paracetamol = Acute Hepatitis
- Octreotide = Gall stones
- Chlorpromazine = Acute Cholestasis
- Mouldy cereals = Neoplasia (Aflatoxins and Mycotoxins cause p53 mutations)
Drugs that cause gynaecomastia...
- LHRH analogues
B12 deficiency causes...?
- Megaloblastic anaemia
- Optic neuritis
- Psych symptoms\ reversible dementia
- Sensory ataxia and spastic paraparesis (SADSC)
- Glove + Stocking anaesthesia
- Methylmalonyl in urine (used for monitoring)
Hepatitis E...Whaddya know?
- Single stranded RNA (Hep B is the only DNA)
- Causes acute hepatitis, Faecoral transmission
- Causes epidemic waterborne infections
- Never develops into chronic
- Mortality in pregnant women = 20%!!!
A 78-year-old male is brought to the Emergency Department and has a witnessed seizure in the resuscitation room.His blood glucose is recorded as 1.0 mmol/l. He does not have diabetes, and has no other significant past medical history.He is given 50 ml of 50% dextrose and he slowly recovers over the next one hour. A serum cortisol concentration later returns as 800 nmol/l (120-600). What has this pt prestented with, what can cause this presentation, how would you investigate this patient?
- This is a case of spontaneous hypoglycaemia, which could be caused by:
- Insulin\sulfonylurea overdose
In this case most likely to be an insulinoma, investigate with 72 hour fast and should another episode occur take bloods within 30mins to look for insulin+c-peptide.
The elevated cortisol is normal considering hes having a hypo and under 'stress' conditions.
3 drugs that cause Hyperglycaemia? Apart from steroids.
Name 7 different types of insulin and whther they are long or short acting?
- Humilin M3 - Mixture
- Humalog - Fast acting
- Actrapid - Fast
- Novorapid - Fast
- Inulitard - isophane - intermediate acting
- Levemir - long acting
- Lantis - Glargine - Long acting
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