revision at Royal part deux

I saw Hypertrophic pulmonary osteoarthropathy today! HPOA is sometimes seen in patients with lung cancer and pleural mesothioloma.

Reduced chest expansion on one side--> think focal pathology like consolidation, collapse, pleural effusion, pneumothorax.

Bilateral reduction in chest wall movement--> think diffuse fibrosis and COPD.

Crackles can be graded according to causes.

Fine crackles --> pulmonary fibrosis

Medium crackles --> left ventricular failure
Coarse crackles --> bronchiectasis

3 types of metabolites which accumulate in DKA. Beta-hydroxybutyrate, aceta-aldehyde, acetate.

Signs to watch out for in DKA: tender abdomen, kussmaul respiration, acetone fruity breath
confusion/depressed consciousness, dehydration (tachycardia and low BP and slow CRT)