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.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.Contraindications lung surgery → FEV 90% ischaemic neuropathy, 10% retinal art occlusion.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).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.Bullae on hands and fragule skin torn by minor trauma → porphyria cutanea tarda.Foreign travel, macpap rash/flu like illness → HIV acute.Chest discomfort and dysphagia → achalasia.Drug induced pneumonitis → methotrexate or amiodarone.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).Cushings – Diagnosis: 24hr urinary free cortisol.Acromegaly – Diagnosis: Oral Glucose Tolerance Test (OGTT) followed by Growth Hormone (GH) conc.
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