Causes of SIADH : chest/cerebral/pancreas Pathology, porphyria, malignancy, Drugs (carbamazepine, chlorpropamide, clofibrate, atipsychotics, NSAIDs, rifampicin, opiates). diagnostic test for asthma -> morning dip in PEFR >20%. wheeles, URTICARIA, drug induced -> aspirin. acute red eye -> acute closed angle glaucoma > less common (ant uveitis, scleritis, episcleritis, subconjuntival haemmorrhage). Absent papilloedema–>Normal pressure hydrocephalus. demetia, gait abnormaily, urinary incontinence. Causes: pineal tumor, stroke, hydrocephalus, MS. Perinauds syndrome: dorsal midbrain syndrome, damaged midrain and superior colliculus: impaired upgaze (cf PSNP), lid retraction, convergence preserved. Occulomotor nuclei intact, supranuclear Pathology. Absent voluntary downward gaze, normal dolls eye. Progressive Supranuclear palsy: Steel Richardson. Causes: MS, SLE, Miller fisher, overdose(barb, phenytoin, TCA), Wernicke. Convergence retraction nystagmus, but convergence reflex is normal. Aide memoire (TRIES TO YANK THE ipsilateral BAD eye ACROSS THE nose ). Ipsilateral adduction palsy, contralateral nystagmus. Internuclear opthalmoplegia: medial longitudinal fasciculus connects CN nucleus 3-4. Horners – sweating lost in upper face only – lesion proximal to common carotid artery. Guillan Barre syndrome: check VITAL CAPACITY.(44). Tumor compressing Respiratory tract –> investigation: flow volume loop. Restrictive Cardiomyopathy: sclerodermma, amyloid, sarcoid, HCT, glycogen storage, Gauchers, fibrosis, hypereosinophilia Lofflers, caracinoid, malignancy, radiotherapy, toxins. Dilated Cardiomyopathy: OH, bp, thiamine/selenium deficiency, MD, cocksackie/HIV, preg, doxorubicin, infiltration (HCT, sarcoid), tachycardia. HOCM/MVP – inc by standing, dec by squating (inc all others). X linked: Beck/Duch musc dyst, alports, Fragile X, G6PD, Haemophilia A/B. Aut dom conditions: Achondroplasia, Ehler Danlos, FAP, FAMILIAL hyperchol,Gilberts, Huntington’s, Marfans’s, NFT I/II, Most porphyrias, tuberous sclerosis, vWD, PeutzJeghers. Inf MI, artery invlived -> Right coronary artert. HBSag positive, HB DNA not detectable –> chornic carier.(33). albumin normal, total protein high -> myeloma (hypercalcaemia, electrophoresis). hepatitis B with general deterioration -> hepaocellular carcinoma. diarrhoea, bronchospasm, flushing, tricuspid stenosis -> gut carcinoid c liver mets. causes of villous atrophy: coeliac (lymphocytic infiltrate), Whipples, dec Ig, lymphoma, trop sprue (rx tetracycline).
Diabetes Random >7 or if >6 OGTT (75g) ->11.1 also seen in HCT. insulinoma -> 24 hr supervised fasting hypoglycaemia. diagnosis of polyuria -> water deprivation test, then DDAVP. pemphigus – involves mouth (mucus membranes), pemphigoid – less serious NOT mucosa. severe retroorbital, daily headache, lacrimation –> cluster headache. temporal tenderness–> temporal arteritis -> steroids > 90% ischaemic neuropathy, 10% retinal art occlusion. 1.5 cm difference btwn kidneys -> Renal artery stenosis –> Magnetic resonance angiogram. A hypertensive patient having osteoporosis should be started on thiazides diuretics. (19) A hypertensive patient with prostatism should be given Alpha blocker. contraindications lung Surgery –> FEV dec bp 130/90, Ace inhibitors (if proteinuria analgesic induced headache. electrolytes disturbance causing confusion – low/high Na.
TREMOR postural,slow progression,titubation, relieved by OH->benign essential TREMOR AutDom. sarcoidosis, erythema nodosum, arthropathy –> Loffgrens syndrome benign, no Rx needed. middle aged man with KNEE arthritis –> gonococcal sepsis (older people -> Staph). (13).The best initial therapy for newly diagnosed hypertensive patient with no other comorbidity is diuretics.(14). primary hrperparathyroidism –> high Ca, normal/low PO4, normal/high PTH (in elderly). Splenectomy –> need pneumococcal vaccine AT LEAST 2 weeks pre-op and for life.
Wallenburg pica syndrome step 1 skin#
Bullae on hands and fragule SKIN torn by minor trauma –> porphyria cutanea tarda. foreign travel, macpap rash/flu like illnes –> HIV acute. chest discomfort and dysphagia –> achalasia. Drug induced pneumonitis –> methotrexate or amiodarone.(8).
Obese woman, papilloedema/headache –> Benign Intercanial Hypertention. Herpes encephalitis –> temporal lobe calicification OR temporoparietal attentuation – subacute onset i.e. Rash on buttocks – Dermatitis herpetiformis (coeliac dx).
Wallenburg pica syndrome step 1 free#
Cushings – Diagnosis: 24 hr urinary free cortisol. Acromegaly – Diagnosis: Oral Glucose Tolerance Test followed by Growth Hormon concentration.
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