Which one of the following serum proteins is most likely to increase in a patient with severe pneumococcal pneumonia?
Correct Answer C:
Acute phase proteins:
During the acute phase response the liver decreases the production of other proteins (sometimes referred to as negative acute phase proteins). Examples include:
*plays a more significant role in other mammals such as mice.
A 79-year-old man is admitted with congestive cardiac failure. Bloods on admission show:
Which one of the following would result from elevated BNP levels?
BNP - actions:
B-type natriuretic peptide: B-type natriuretic peptide (BNP) is a hormone produced mainly by the left ventricular myocardium in response to strain. Whilst heart failure is the most obvious cause of raised BNP levels any cause of left ventricular dysfunction such as myocardial ischaemia or valvular disease may raise levels. Raised levels may also be seen due to reduced excretion in patients with chronic kidney disease. Factors which reduce.
BNP levels include treatment with ACE inhibitors, angiotensin-2 receptor blockers and diuretics.
Effects of BNP:
Clinical uses of BNP:
1- Diagnosing patients with acute dyspnoea:
2- Prognosis in patients with chronic heart failure:
3- Guiding treatment in patients with chronic heart failure:
4- Screening for cardiac dysfunction:
Which one of the following causes of primary immunodeficiency is due to a defect in both B-cell and T-cell function?
Correct Answer C: Combined B- and T-cell disorders: SCID WAS ataxic (SCID, Wiskott-Aldrich syndrome, ataxic telangiectasia).
Wiskott-Aldrich syndrome causes primary immunodeficiency due to a combined B- and T-cell dysfunction. It is inherited in a X-linked recessive fashion and is thought to be caused by mutation in the WASP gene.
Features include recurrent bacterial infections (e.g. chest), eczema and thrombocytopenia.
Primary immunodeficiency: Primary immunodeficiency disorders may be classified according to which component of the immune system they affect.
Neutrophil disorders:
B-cell disorders:
T-cell disorders:
Combined B- and T-cell disorders:
A 65-year-old man presents with bilateral leg pain that is brought on by walking. His past medical history includes peptic ulcer disease and osteoarthritis. He can typically walk for around 5 minutes before it develops. The pain subsides when he sits down. He has also noticed that leaning forwards or crouching improves the pain. Musculoskeletal and vascular examination of his lower limbs is unremarkable.
What is the most likely diagnosis?
Correct Answer D: This is a classic presentation of spinal stenosis. Whilst peripheral arterial disease is an obvious differential the characteristic relieving factors of the pain and normal vascular examination point away from this diagnosis.
Lower back pain: Lower back pain (LBP) is one of the most common presentations seen in practice. Whilst the majority of presentations will be of a non-specific muscular nature it is worth keeping in mind possible causes which may need specific treatment.
Red flags for lower back pain:
The table below indicates some specific causes of LBP:
You have been asked to investigate the potential benefit of setting up a service to help patients with multiple sclerosis in the local area.
What is the most important factor when determining how many resources will be required?
Incidence and prevalence: These two terms are used to describe the frequency of a condition in a population.
Relationship:
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