Your Daily Meds - 21 November, 2022
Good morning and welcome to your Monday dose of Your Daily Meds.
Case:
Which of the following patterns of serological test results indicates chronic hepatitis B virus infection?
HBsAg negative; Anti-HBc IgG positive; Anti-HBs positive
HBsAg negative; Anti-HBc negative; Anti-HBs negative
HBsAg positive; Anti-HBc IgG positive; Anti-HBs positive
HBsAg positive; Anti-HBc IgG positive; Anti-HBs negative
HBsAg positive; Anti-HBc IgM positive; Anti-HBs negative
Where: HBsAg = hepatitis B surface antigen; Anti-HBc = antibodies to hepatitis B core antigen; Anti-HBs = antibodies to hepatitis B surface antigen; IgG = Immunoglobulin G; IgM = Immunoglobulin M
Have a think.
Scroll for the chat.
Case:
With regard to functional adrenocortical adenomas, which of the following clinical scenarios is least likely to occur?
Conn’s syndrome
Cushing’s syndrome
Addison’s disease
Virilisation
Feminisation
Have a think.
Scroll for the chat.
Core Surfaces:
Hepatitis B virus (HBV) is transmitted via infected body fluids, such as blood and semen. Chronic hepatitis B is defined by the persistence of detectable hepatitis B surface antigen (HBsAg) for more than 6 months. In Australia, most cases of chronic hepatitis B are in migrants from regions of the world with high prevalence of HBV infection, such as Asia, Africa, Mediterranean countries and Pacific Island Nations. In these cases, infection with HBV is often acquired in the perinatal period or in the first few years of life.
A chronic infection with hepatitis B virus is characterised by the patient testing positive for hepatitis B surface antigen (HBsAg), IgG positivity for antibodies to hepatitis B core antigen (anti-HBc) and negative for antibodies to hepatitis B surface antigen (anti-HBs).
The Deeper You Go….:
Adrenocortical adenomas are a common benign tumour of the adrenal cortex. They are often asymptomatic and are usually found as an incidental finding on CT or Ultrasound imaging. Approximately 85% of adrenocortical adenomas are non-function, leaving 15% with potential to cause clinical conditions based on their zone of derivation from the adrenal cortex.
Here it is important to recall the anatomy of the adrenal gland:
Functional tumours of the Zona Glomerulosa result in excessive aldosterone secretion and Conn’s syndrome. Those of the Zona Fasciculata result in increased cortisol secretion, Cushing’s syndrome. And those of the Zona Reticularis can cause virilisation or feminisation. Thus, Addison’s disease, or adrenal insufficiency, is the least likely outcome of a functional adrenocortical tumour.
…the sweeter it gets.
Bonus:
What is the normal osmolality of the Extracellular Fluid (ECF)?
Answer in tomorrow’s dose.
News: I made a little Ward Call Course for you all. It maps out an Evening Ward Call shift and covers a bunch of common tasks that you may need to do, like:
Deteriorating Patients
Heparin Infusions
Fluid Orders
Electrolyte Replacement
Difficult patients - Discharge Against Medical Advice, Ryan’s Rule
End of Life etc
You can find the course page here:
It’s free and always will be. Let me know what you think.
Remember, you are free to rip these questions and answers and use them for your own flashcards, study and question banks.
As always, please contact me with any questions, concerns, tips or suggestions. Have a great day!
Luke.