• Archive for July, 2013

    Diabetes Mellitus and Complications

    by  • 16/07/2013 • Endocrine

    Diabetes mellitus  Chronically elevated glucose  Fasting glucose:  Normal <6mmol/L  Impaired glucose tolerance 6-7mmol/L  Diabetes >7mmol/L  2-hours post 75g glucose challenge:  Normal <7.8mmol/L  Impaired glucose tolerance 7.8-11.1mmol/L  Diabetes >11.1mmol/L   DM T1 (insulin dependent):  Rare disease of white northern Europeans 25:100,000  p/c: <30yo (average...

    Read more →

    Fibromyalgia

    by  • 13/07/2013 • Rheumatology

    Painful, non-articular condition of unknown cause, involving muscles. Common and results in significant disability and handicap, 90% female, 40-50yo.  p/c: pain/tenderness locations o Insertion of nuchal muscles into the occiput o Upper border of trapezius midportion o Muscle attachments to upper medial border of scapula o Anterior aspects of C5, C7 intertransverse spaces...

    Read more →

    Chronic fatigue syndrome (CFS) / myalgic encephalomyelitis (ME)

    by  • 12/07/2013 • Rheumatology

       Debilitating and distressing, prevalence 0.2-2.6%, women.  Cause: unknown, follows virus (10% EBV), immunization, chemical toxins (e.g. organophosphates, CT)…  p/c: unexplained fatigue for >6/12, not due to ongoing exertion, nor alleviated by rest, reduced activity and >4 of following = impaired memory/concentration, tender cervical/axillary LNs, post-exertional malaise lasting >24h (delayed: starting...

    Read more →

    Vasculitis

    by  • 11/07/2013 • Rheumatology

    Vasculitis  Inflammation within or around blood vessels (-/+ necrosis). Severity depends on size and site of vessel involved.  Causes: idiopathic (50%), CTD (SLE/RA), infection (rheumatic fever, I.E. Lyme’s disease), drugs (NSAIDSs, antibiotics), neoplasia (lymphoma, leukaemia).  General p/c: skin (=palpable painful purpura on lower legs/buttocks), systemic (=fever, night sweats, malaise, weight loss,...

    Read more →

    Mixed Connective Tissue Diseases

    by  • 10/07/2013 • Rheumatology

    Overlapping group of disease – common pattern = they all affect many organs and are associated with fever, malaise, are chronic (relapsing/remitting), and respond to steroids. Difficult to diagnose – if unsure, refer to rheum. Systemic lupus erythematosus (SLE)  p/c: Rare (1:3000), autoimmune, female, afro-carribean/asian, 15-40yo, multisystem involvement: joints (arthritis, myalgia…), skin (photosensitivity,...

    Read more →