• Archive for August, 2013


    by  • 14/08/2013 • Cardiology

    Definition  Hypotension: <90 / <60  Normal: 90-139 / 60-89  Mild HTN: 140-159 / 90-99  Moderate HTN: 160-179 / 100-109  Severe HTN: >180 / >110  Malignant HTN (and imminent secondary organ damage): >200 / >140   Incidence  20-30% of the adult population (urban, western disease)  40-45% in...

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    Libmann Sacks Endocarditis

    by  • 13/08/2013 • Cardiology

    (sterile endocarditis): in patients with SLE, composed of many small vegetations on valves or endocardium. Precipitating an inflammatory response. N.B: I.E tends to produce large bulky vegetations. 

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    Female Hypogonadism

    by  • 09/08/2013 • Endocrine

     p/c: fatigue, amenorrhoea, infertility, male pattern baldness, acne, hirsuitism, anosmia (in Kallman’s syndrome), signs of oestrogen withdrawel (menopausal symptoms), obesity (PCOS), galactorrhoea (increased PRL), Hx of excessive exercise/stress, any drugs that may increase PRL, CTs?  In primary hypogonadism, oestrogen withdrawel symptoms occur – hot flushes, sweats, mood changes, vaginal dryness, pain on...

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    Male Hypogonadism

    by  • 08/08/2013 • Endocrine

     Hypogonadism pre-puberty: o p/c: gynecomastia, high pitched voice, testicular volume <5ml, penile length <5cm, arm span 6cm or more than height, delayed bone age, reduced muscle bulk, absent pubic hair, absent erections, absent libido.  If onset is post-puberty: o p/c: normal body proportions, facial wrinkling, gynecomastia, pigmented scrotum, osteoporosis, testicular volume >15ml,...

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    by  • 07/08/2013 • Endocrine

     Failure of ovaries or testes to produce sex steroids (oestrogen/testosterone) from either gonadal failure (-primary hypogonadism) or from hypothalamic-pituitary failure (=secondary hypogonadism).  The key difference between primary and secondary is whether LH/FSH levels are high (=intact hypothalamic-pituitary axis) or low (=damaged axis). Low se steroids are seen in both scenarios. 

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    Other pituitary hormone deficiencies (hormone – clinical feature of deficiency – diagnostic test)

    by  • 05/08/2013 • Endocrine, Miscellaneous Endocrine Disorders

     GH – weight loss – GH levels are stimulation with insulin/arginine/glucoagon, meaure IGF-1 levels  FSH/LH – no 2nd sexual hair, infertility, impotence – measure male testosterone. In pre-menopause female presence of periods, in post-menopause meaure FSH/LH  ACTH – pale, hypoadrenal – short synACTHen test, insulin tolerance test  TSH – hypothyroid...

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    Multiple Endocrine Neoplasia (MEN)

    by  • 03/08/2013 • Endocrine, Miscellaneous Endocrine Disorders

     MEN processes are very rare conditions in which a single gene defect causes multiple endocrine tumours within the patient.  MEN syndromes most commonly present with disorders of calcium metabolism  Probands and their families need to be screened regularly for new malignancies.  MEN 1: parathyroid hyperplasia 95%, pituitary adenoma 70%, pancreatic...

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    Diabetes Insipidus (DI)

    by  • 02/08/2013 • Endocrine, Miscellaneous Endocrine Disorders

     Is the passage of large volumes of inappropriately diluted urine in the presence of concentrated plasma – due to reduced secretion or reduced efficacy of ADH (released from posterior pituitary)  It is uncommon, is linke to polyuria (>2.5L/d) and polydipsia and must NOT be due to..  DM or renal failure ...

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    Pituitary Gland Disease

    by  • 01/08/2013 • Endocrine, Miscellaneous Endocrine Disorders

     Selective of panhypopituitary (total) failure  Can present as visual failure, selective excess of specific hormones (due to tumour hyper-secretion), and hyperprolcatinaemia (from mass lesions).  Diseases include: o Intrinsic neoplastic processes: as above o Inflammatory processes: TB, sarcoidosis, invasion by extrinsic tumour cells (=pit failure or hyperprolactinaemia due to disruption of tonic...

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