• Abnormal Liver Function Tests

    by  • 05/05/2013 • 0 Comments

     Often abnormal LFTs accompany specific symptoms  Sometimes abnormal LFTs can be seen in well/asymptomatic patients and warrant further investigation  In these patients, the abnormal test may herald an underlying disease and it is then prudent to make a diagnosis to make prognostic and therapeutic decisions.  Causes of abnormal LFTs: o...

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    Iron Deficiency due to GI Pathology

    by  • 03/05/2013 • 0 Comments

     2 causes of iron deficiency:   1. Reduced absorption in GI tract: due to mucosal disease (=coeliac disease ), duodenal bypass (=polagastrectomy) or dietary deficiency. 2. Chronic blood loss: due to menstrual bleeding, PU disease, GI neoplasia (colonic adenomatous polyps, caecal/gastric/rectal carcinoma),...

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    Diverticular Disease

    by  • 02/05/2013 • 0 Comments

     Many elderly people have asymptomatic ‘diverticula change’ or ‘diverticulosis’  Prevalence: 50% >50yo  Pathophysiology: may be genetic predisposition, but best considered an acquired condition. Those with Marfan’s and Ehlers-Danlos syndrome tend to develop diverticula earlier in life.  P/c: – tend to present with ‘complications’ rather than symptoms of diverticular change… o...

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    Peptic Ulcer Disease

    by  • 01/05/2013 • 0 Comments

    Peptic (=’acid-related’) ulcer = DU or GU or both! Duodenal ulcer: o Incidence: improving in line with improvements in living standards, still affects 10-15% in certain populations. Helicobacter pylori carriage and NSAIDs use are the major RFs.  p/c: o Dyspepsia: abdo pain, worse at night, relived by food o Vomiting: due to oedema...

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    Reflux and Hiatal Hernia

    by  • 30/04/2013 • 0 Comments

     A hiatal hernia is a herniation of the proximal stomach into the chest caused by a congenital defect in the diaphragm (rarely acquired abnormality).  It predisposes to gastro-oesophageal reflux of gastric acid contents and inflammation of the distal third of the oesophagus (=reflux oesophagitis) or gastric metaplasia (=Barrett’s epithelium).  Incidence: v...

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    Nutritional Deficiencies

    by  • 29/04/2013 • 0 Comments

     Xerophthalmia = lack of Vit A o Major cause of blindness in the Tropics o Conjunctivae become dry and develop oval/triangular spots (=Bitot’s spots). Cornea becomes cloudy and soft. o Tx: Vit A 200,000 units stat po, repeat in 24h, then again 7/7 later. Seek special advice if pregnant (Vit A embryopathy must...

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    Renal- At a Glance

    by  • 28/04/2013 • 0 Comments

     Drugs excreted by kidney which can accumulate in renal failure: digoxin, lithium, morphine and metabolites, penicillins, gentamicin, vancomycin, erythromycin, acyclovir  Drugs which require higher doses in renal failure: frusemide  Drugs that can exacerbate metabolic effects in pre-existing renal failure: spironolactone (=hyperkalaemia), corticosteroids (=uraemia), NaCl (=water retention)  Drugs which can produce...

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    Drugs and Kidneys

    by  • 28/04/2013 • 0 Comments

     Final common route of elimination for many drugs/metabolites is the kidney, through: glomerular filtration, active tubular secretion or passive tubular reabsorption.  Water soluble drugs are excreted in the unchanged active form (gentamycin)  Lipid soluble drugs like morphine, first undergo hepatic conjugation with a highly polarised endogenous substance (e.g. glucoronic acid) to...

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    Renal Transplant

    by  • 28/04/2013 • 0 Comments

     2000 renal transplants / yr in UK  Specific criteria must be met to be suitable for renal transplant: o Age <70yo o Must be HIV negative o Free of bacterial infection/malignancy o Have no severe cardiac disease o Must not have a renal disease that will recur  Transplantation is limited by...

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