can only be diagnosed if psoriasis is present (F) also if fhx of psoriasis ref K&C

Prolongued early morning stiffness

Pericarditis ( uncommon)-10% having pericardial friction rub.

Subcutaneous nodules on extensor surfaces/over bony prominces/in juxta-articular regions.

Scleritis – pain especially on eye movement

Pleural Effusion – may cause the right sided stony dullness.

81TTFFF

Sjogrens syndrome

Autoimmune disorder causing decreased saliva production-Dry mouth

Mucous production and therefore physical resistance to inhaled pathogens and therefore RTI

Tests for RA are positive in 50%

Keratoconjunctivitis results from atrophy and fibrosis of lacrimal glands not ducts.
82TTTT

Non-thrombocytopenic purpura and bruising may is bleeding for a reason other than platelets.

Kala-azar = Visceral leishmaniasis(protozoa) which causes epitaxis. Since this epitaxis is due to capillary damage I’m assuming Kala- azar can cause non-thrombocytopenic purpura and bruising.

Platelet storage pool disorder causes bleeding due to platelet aggregation and recruitment, normal no of platelets.

Scurvy, capillary defect.
83TT(?) FFT

Diabetes

DM1 concordance 36% v’s DM2 concordance 60-100%

Commonest cause of death in DM is Cardiovarcular disease- DM1=44%,DM2=52%

DM need to insulin in times of infection to risk of DMKA.

Lipohypertrophy is due to impure insulin causing a localized immune rxn, I don’t class this as an allergy, is this right?

Cause of loss of warning of impending hypoglycaemia is autonomic neuropathy, warning with hypoglycaemic events.
84TFFTF

Hypoglycemia

Alcohol causes glucose consumption required to degrade and excrete alcohol.

Thiazide diuretics can cause hyperglycaemia

Influenza can cause hyperglycaemia.

Unaccustomed exercise will cause an increase in energy/glucose consumption.

IM has a slower rate of absorption and therefore will lower insulin availability and will cause hyperglycaemia??
85FFFTT

Farmers lung

Asthma Prevelence 10-15% general pop

Farmers lung Prevelence rare general pop and farmers

Shows non-caseating collection of histocytes ie. Non caseating granuloma

Perihilar lympadenopathy is rare.

Acute: Symptoms occur 4-6hrs post exposure although antibodies are present before and after symptoms.

Responds well to steroids acutely and responds poorly in late stages.

86TFTT

Asthma

PEFR- classically morning dipping

FRC- air in lungs at the end of tidal breath. From search think FRC is unaffected in Asthma ??

FEV-1 decreases in obstructive airway disease therefore I expect with bronchodilator.

Transfer factor is vol of gas transferred between alveolar gas and pulmonary capillary blood-

87FFFF

Case history

In CRF need to match fluid intake with output therefore can’t say fluid requirement until know output.

CRF rarely require protein restriction. I don’t think protein restriction would be “meddlesome” but not 100% ??

Requirement for renal replacement depends on progressive creatine over time so I can’t say when patient will require renal replacement therefore F.

₈₈. TTTFF

Reiters Syndrome

Conjunctivitis, Arthritis, urethritis, can be uveitis associated

Usually large joints – lower limb mono or oligoarthritis or enthesis (jxn of tendon+bone) doesn’t affect muscles!

Chronic or relapsing

Spondyloarthritides ie. Reiters syndrome – 83% HLA-b27 positive

Can get sacroilitis and spondilits which cause constant pain and stiffness- can be worse in morning.
89. TTFTF

Throtoxicosis

Thyroid eye disease is caused by autoimmunity and most common cause of thyrotox is Graves-75%. Since Graves is autoimmume-its most likely cause of thyroid eye disease.

Eye signs may worsen with radio-iodine rx.

Afib in thyrotoxicosis is usually treated by controlling rate and treating thyrotox.

Use digoxin with caution in thyroid disease- BNF

Absence of goitre makes graves unlikely but doesn’t exclude it.
90.TTTFF

Hyperparathroidism phosphate reabsorption from kidney-hypophatemia

Malignant Hyperthermia Hyponatremia
With mononeuritis complex you must rule out Goodpastures.

Progressive membranoproliferative GN  Malignant hypertension since didn’t find a connection on the web.

91. 
    The following are associated with inflammatory bowel disease
    

aCarcinoma of biliary tract T

bPyoderma gangrenosum T

cRenal calculi T

dSeropositive arthritis F

eSeronegative arthritis T
Cholangiocarcinoma in UC

In Crohn’s and UC

Oxalate calculi

e)Anklylosing spondtlitis, Monoarthritis and Sacroileitis