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What happens to TfTs during times of acute illness?
Sick euthyroid. So you're TSH is normal but your t3 and t4 are low.
Fragmented red cells. Uremia. Low platelets. Febrile. High wcc. Confusion. in a pregnant pregnant woman. Diagnosis?
overlaps with HuS
Autoimmune poly glandular syndrome type 1?
Rarer form of APS
- mucocutaneous candidiasis
Autoimmune poly glandular syndrome type 2?
- Autoimmune thyroid disease
What can PCV transform into?
Drugs that cause pancreatitis?
- azathioprine and mesalazine
- furo and bendro
Causes of a raised protein in CSF?
- tuberculous, bacterial and fungal meningitis
- viral encephalitis
- Spinal block
Drug causes of a long QT?
- Amiodarone, sotalol, class 1a
What causes downbeat nystagmus?
Foramen magnum lesion - Arnold chiari malformation
Cerebellum vermis lesion
Drugs for motion sickness?
Raised ALP and normal bone chemistry =?
In hypothyroidism what's the first thing you do is some ones hyperlipidemic?
Give them thyroxine and control their TSH adequately.
What happens to serum caeruloplasmin in Wilson's?
What's the most appropriate investigation in someone with a chronic venous ulcer?
ABPIs cus you're going to stocking them and you need to work out whether it's mixed or not.
What drugs precipitate lithium toxicity?
What drug improves prognosis in stable angina?
When is it best to give the pneumococcal vaccine to a pt due to have splenectomy?
1 month before op.
A normal PaCO2 during an acute asthma attack?
Life-threatening. Shud always be low.
What is PEP?
3 drugs for 1 month.
Murmur in HoCM?
Ejection systolic. Louder on Valsalva. Quieter on squatting.
What drugs precipitate AACG?
Met common side effect of progestogen only pill?
Treatment options fir aplastic anaemia?
- Supportive with blood products
- avoiding infection
Antithymocyte globulin or anti lymphocyte globulin.
stem cell transplantation - allo grafts have 80% success rate.
How does toxic multinodular goitre present?
what doe investigations show
what is the treatment of choice?
- Thyrotoxic with irregular nodular goitre.
- patchy uptake on scintigraphy
- best rx is radioiodine
Amiodarone induced thyrotoxicosis type 1?
Excess iodine uptake.
carbimazole or potassium perchlorate. + stop amiodarone (unlike AIH)
Amiodarone induced thyrotoxicosis type 2?
treat with corticosteroids + stop amiodarone (unlike AIH)
Commonest site for an atrial myxoma?
Fossa ovalis border in the Left atrium.
Dentistry in warfarin patients?
Check INR 72 hrs before. If less than 4.0 Then continue.
Feature of cholesterol embolisation?
- livedo reticularis
- Renal failure
V for vigabagrin?
V for visual field defects.
check fields every 6 months
Vitamin d resistant rickets?
X linked dominant presents as failure to thrive
problem with reabsorbing phosphate in the kidney.
low serum phosphate, normal calcium, raised ALP,
cupped metaphysis and widening epiphysis
When do you start ARV in a pregnant woman with HIV?
What drugs do you avoid in HOCM?
Nitrates, ace inhibitor, inotropes.
- Sensorineural deafness
- euthyroid or mild hypothyroid
Adding progesterone to HRT?
- Increased risk of breast cancer
- decreased risk of endometrial cancer
- Increased risk of venous thromboembolism
Discoid lupus treatment?
Topical steroids then oral hydroxychloroquine
Treatment of pulmonary hypertension?
All dependent on acute vasodilator testing.
if positive then calcium channel blockers
if negative then prostacyclin analogues, phosphodiesterase inhibitors and endothelin receptor antagonists.
Causes of a warm AIHA?
Features on investigation?
What do you treat with?
- Neoplasia eg lymphoma and CLL
- autoimmune eg SLE
- drugs eg Methyldopa
IgG, extravascular, haemolytic in the spleen.
steroids, immunosuppresion, splenectomy.
Causes of a cold AIHA? Features on investigation?
- Neoplasia eg lymphoma
- infections eg mycoplasma and EBV
IgM, intravascular, can cause Raynaud's and acrocyanosis.
Fibrosis affecting the lower zones?
- Connective tissue disorders except AS
Causes of tricuspid regurg?
- Right vent dilation
- cor pulmonale
- rheumaric heart disease
- IE assoc with IVDU
- ebsteins anomaly
Causes of predominant hypercholesterolaemia?
- nephrotic syndrome
everything else causes hypertriglyceridaemia.
Target BP in hypertension?
- Age Clinic BP ABPM / HBPM
- < 80 years. 140/90. 135/85
- > 80 years. 150/90 145/85
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