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Passmedicine NME 2

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domnewman1's version from 2016-01-17 23:55

Section 1

Question Answer
What causes carcinoid syndromeHepatic mets releasing serotonin into systemic circulation.
Name 3 classical features of carcinoid syndromeFlushing that resolves spontaneously, generalised abdo pain, diarrhoea
Name one DPP4 inhibitorSitagliptin
Name 2 side effects of DPP4Headaches, nausia
Can Gliclazide cause hypos, also what class is it?Yes, Sulfonylurea
First sign of Wilson's disease in adultsNeurological difficulties
What are the two diagnostic test for Wilsonsreduced serum caeruloplasmin, increased 24hr urinary copper excretion.
Treatment of Wilsonspenicillamine (chelates copper) has been the traditional first-line treatment
Treatment of acute variceal haemorrhageTerlipressin
Prophylaxis of variceal haemorrhagePropanolol
3 features of Primary sclerosing cholangitisjaundice and pruritus, right upper quadrant, pain, fatigue
Main association of Primary sclerosing cholangitisUlcerative colitis
When do you not treat sub-clinical hypothyroidismRaised ESR
Treatment of hep C pegylated interferon-alpha, ribavirin and a a protease inhibitor
Lack of haustra on barium enima Ulcerative colitis
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Section 2

Question Answer
Features of Viral hepatitis ommon symptoms include: nausea and vomiting, anorexia myalgia lethargy right upper quadrant (RUQ) pain
Features of Biliary colic RUQ pain, intermittent, usually begins abruptly and subsides gradually. Attacks often occur after eating. Nausea is common
Features of Acute cholecystitis RUQ pain, intermittent, usually begins abruptly and subsides gradually. Attacks often occur after eating. Nausea is common, plus pyrexia and murphy's sign.
Features of Ascending cholangitis fever (rigors are common) RUQ pain jaundice
Features of Gallstone ileus Abdominal pain, distension and vomiting.
Features of Cholangiocarcinoma Billary colic plus anorexia, jaundice and weight loss.
Features of Acute pancreatitis Severe epigastric pain Vomiting is common Examination may reveal tenderness, ileus and low-grade fever Periumbilical discolouration (Cullen's sign) and flank discolouration (Grey-Turner's sign) is described but rare
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