1. Young girl – suspect Anorexia Nervosa – linugo hair, finctional hypogonadotrophic hypogonadism -> amennorhea. LH and FSH both low. All other hormones are usually normal. Ferritin low.
2. Reiters Syndrome – arthritis, uveitis, urethritis – Chlymidia, campylobacter, Yersinia, SALMONELLA , Shigella. Balanisits.
3. PKD – aut dom Chr 16/4 assoc berry aneurysm, mitral/aortic regurg
4. Porphyria – photosensitivity, blisters, scars with millia, hypertrichosis
5. heart sounds: Aortic Stenosis s2 paradoxical split, length proportional to severity
6. Vitiligo – commonest assoctions pernicious anaemia >>> type 1 DM , autoimmune addisons, autoimmune thyoid dx
7. Gout – blood urate high/low/normal, joint aspirate pos birif, ppt thiazides, NO allopurinol/aspirin in acute phase
8. Peripheral neuropathy – a) B12 – rapid, dorsal columns (joint pos, vibration), sensory ataxia, pseudoathetosis of upperlimbs b) diabetic – slow, spinothalamic (pain, temp?) c)alcohol – slow progressive, spinothalamic d) Pb – motor upper limbs
9. CNS abnormalities in HIV: toxoplaasmosis (ring enhancing), lymphoma (solitary lesion). HIV encephalopathy, progressive multifocal leucoencephalopathy (PML – demylination in advanced HIV, low attenuation lesions)
10. Travellers diarrohea: chronic (>2 WEEKS) giardia (incidious onset rx. Metronidazole), SALMONELLA (serious systemic illness), E.coli (rx. Ciprofloxacin) , Shigella
11. Renal syndrome – minimal change disease, membanous, IgA nephropathy, post-streptococcal.
12. If you see blood on urinalysis forget about RAS
13. Thyroid Malignancy – tend to be non-functional, anaplastic has worse prognosis, local infiltration -> dysphagia, vocal cord paralysis
ALMOST Pathognomic for the exam
fatiguability -> myasthenia gravis
fasciculations -> Motor neurone diease
silvery white scale -> PSORIASIS
hypopigmented -> vitiligo/pityriasis versicolor
pretibial myxoedema --> Graves (NOT lid lag, NOT exopthalmus)
Note: originally posted at http://www.rxpgonline.com/postt36587.html
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