which drug cause hot flashes
A clomiphene
B niacin
C lithium
D carbamazepine
Which of the following does not have a role in the management of chronic cancer
pain?
- Carbamazepine
- Clodrinate
- Dexamethasone
- Nifedipine
- Pinavarium
A urine specimen is sent from a local general practitioner. The clinical information on the request form is ‘urine is repeatedly tinged green or blue’. It also tells you he has multiple underlying pathologies.
Which of the following is a recognised cause of green/blue urine?
Amitriptyline
Levodopa
Phenothiazines
Rifampicin
Senna
A 59-year-old male presented with a three-week history of cough and progressive breathlessness and three episodes of haemoptysis in 24 hours. At the onset of the initial symptoms he visited his GP, who diagnosed a respiratory tract infection and prescribed a course of broad-spectrum antibiotics. The cough persisted and the patient remained breathless. His effort tolerance had become significantly reduced from walking two miles daily to being breathlessat rest. He had felt increasingly lethargic and nauseous for a week before being seen in the Accident and Emergency Department. Twenty-four hours previously he had coughed an egg-cup-full of fresh clots of blood on three separate occasions. There was no history of sore throat or night sweats. Prior to a week previously, his appetite was good. There was no history of weight loss. He had a past history of haemorrhoids which were surgically ligated two years ago.The patient was married with one son and worked as a mechanic. He smoked 10 cigarettes per day and consumed 2–3 units of alcohol per week. There was no history of travel abroad. There was no family history ofnote, with the exception that his mother had beentreated for pulmonary TB 16 years ago.
On examination, he appeared pale and centrally cyanosed. There was no evidence of clubbing or lymphadenopathy. There was bilateral pitting ankle oedema. The heart rate was 110 beats/min, and regular, and blood pressure was 176/105 mmHg. The JVP was raised 4 cm above the sternal angle. On examination of the respiratory system chest expansion was symmetrically reduced.
The trachea was central. Percussion note was dull at both bases, and on auscultation there was widespread bronchial breathing at both mid-zones and bases. Precordial and abdominal examination was normal.
Investigations are shown.
Hb 7.2 g/dl, WCC 12× 10^9/l, Platelets 500× 10^9/l,
Sodium 137 mmol/l, Potassium 5.2 mmol/l,
Urea 19 mmol/l, Creatinine 400 μmol/l, Calcium 2.1 mmol/l, Phosphate 2 mmol/l, Albumin 40 g/l
ECG Sinus tachycardia. Partial RBBB
Chest X-ray Alveolar shadowing affecting both lower zones
Urinalysis Blood +++, Protein ++, Numerous blood cells and red cell casts
Lung function: FEV1 65% predicted, FVC 60% predicted, TLC 68% predicted
RV 66% predicted, TLCO 110% predicted.
AntiMPO & antiproteinase-3 both are negative.
Renal biopsy was planned.
What is the most likely diagnosis?
A. Anti-GBM disease
B. Wegner’s granulomatosis
C. Microscopic polyangiitis
D. Polyarteritis nodosa
E. Pneumonia
which causes flatulence diarrhea
A acarbose
B metformin
C pioglitazone
D glipizide