• Histories
    • Cough → atypical pneumonia (dry cough, fever, muscle pain, headache, diarrhoea)
    • Dyspepsia → peptic ulcer (ask about NSAID use, relationship of pain to eating), GORD (reflux/heartburn, worse when lying down)
    • Palpitations
  • Coeliac ⇒ IgA TTG for screening. Duodenal biopsy for diagnosis.
  • Ischaemic Colitis ⇒ PR bleed (bloody diarrhoea).
  • PR Bleeding ⇒ infective colitis, UC/CD (younger patient), ischaemic colitis, malignancy, diverticulitis.
  • New AF <48hrs onset ⇒ DC cardioversion.
  • Portal Hypertension ⇒ encephalopathy (confused), ascites (abdo distension), SBP (WCC >250), variceal bleed, caput medusae.
  • Haemolytic Uraemic Syndrome ⇒ schistocytes on blood film. Haemolysis + AKI + Thrombocytopenia following bloody diarrhoea.
    • TTP = HUS + fever + neurological signs.
  • DIC ⇒ low platelets, low fibrinogen, high d-dimer/fibrin degradation products, raised PT/APTT.
  • When someone presents with hyponatraemia ⇒ do urine sodium (will tell you if someones hypovolaemic - low urine sodium means hypovolaemia or hypervolaemia)
  • Euvolaemic Hyponatraemia ⇒ SIADH, addisons, hypothyroidism.
  • Onycholysis ⇒ associated with thyrotoxicosis. Can also be due to psoriasis, fungal infection or trauma.
  • Left Ventricular Hypertrophy ⇒ deep S wave in V1/V2, tall R wave in V5/V6.
  • Hypercalcaemia ⇒ ALP raised if bone metastases. ALP normal if multiple myeloma.
  • Cavitating Lesion ⇒ air (black) at the top, white on the bottom. TB, staph aureus, klebsiella, squamous cell carcinoma.
  • Nephrotic Syndrome ⇒ proteinuria, hypoalbuminaemia, oedema. Higher risk of thrombosis. Also causes hyperlipidemia. Urinalysis to look for proteinuria.
  • Hereditary Haemorrhagic Telangiectasia ⇒ recurrent nose bleeds. Autosomal dominant condition.
  • Macrocytic Anaemia ⇒ alcohol, myelodysplasia (pancytopenia), hypothyroidism, liver disease, folate/b12 deficiency.
  • Sickle Cell Acute Crises ⇒ analgesia, oxygen, IV fluids, antibiotics. Splenectomy for repeated episodes of splenic sequestration.
  • Hypercalcaemia ⇒ polyuria and polydipsia due to nephrogenic diabetes insipidus.
  • Sliding Scale/Variable Rate IV insulin Infusion ⇒ if diabetic patient unwell or undergoing surgery (and not eating).
    • Fixed Rate ⇒ Tx of DKA.