Pulmonary hypertension with unclear or multifactorial etiologies

Group 5 of WHO classification

 Hematologic disorders 

• myeloproliferative disorders

• chronic haemolytic anaemia

• Splenectomy 

 Systemic disorders 

• vasculitis

• sarcoidosis

• pulmonary Langerhans cell histiocytosis

• lymphangioleiomyomatosis

• neurofibromatosis

 Metabolic disorders 

• glycogen storage disease

• Gaucher disease

• thyroid disorders

miscellaneous conditions

• tumor obstruction

• Segmental pulmonary hypertension

• mediastinal fibrosis

• chronic renal failure on dialysis

Sources

1. Clinical features and diagnosis of pulmonary hypertension of unclear etiology in adults https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-pulmonary-hypertension-of-unclear-etiology-in-adults?search=%20pulmonary%20hypertension&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

2. Pulmonary Arterial Hypertension    https://emedicine.medscape.com/article/303098-overview

Causes of Hypouricaemia

The following causes Hypouricaemia

1. Xanthine Oxidase usage (Allupurinol)
2. Urate Oxidase Usage(rasburicase)
3. Vegetarian lifestyle
4. Syndrome of Inappropriate ADH secretion(SIADH)
5. Total Parental Nutrition
6. Hyperthyrodism
7. Farconi Syndrome
8. Nephritis

Causes of Acanthosis Nigrican

Causes of Acanthosis Nigrican

• Drug-Niacin
• Diabetes Mellitus
• Rabson-Mendenhall Syndrome
• Obesity
• Polycystic Ovarian Syndrome

Mnemonic- 2DROP


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Common Features of Leprechaunism

Leprechaunism is a genetic cause of defect in insulin action

• Hirsutism
• Absent subcutaneous fat
• Thick skin
• Elfin facies

Mnemonic- HATE

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Dermatologic Manifestations of Endocrinology Disorders

DERMATOLOGIC MANIFESTATIONS	ENDOCRINOLOGY DISORDERS
Acanthosis nigrican	·         Diabetes Mellitus ·         Polycystic Kidney Disease
Skin thickening	·         Acromegaly ·         Polycystic Kidney Disease
Skin thinning	·         Cushing Syndrome ·         Hypogonadism
Hirsutism	·         Polycystic Kidney Disease ·         Obesity ·         Androgen excess ·         Excess Virilization
Hyperpigmentation	·         Addison’s Disease ·         Nelson’s Disease
Strait & easy bruisability	·         Cushing’s Disease
Vitiligo	·         Autoimmune endocrinopathies e.g. Type 1 Diabetes Mellitus, Grave’s Disease,  primary hypoparathyroidism

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Drugs that can cause weight gain

Drugs that can cause weight gain(fat related)

Mnemonics- 3AS

1. Aniti-epileptics Drugs -Carbamazepine, Gabapentin ,Valporate(valproic acid)
2. Antipschotic Drugs- Monoamine Oxidase Inhibitors,Lithium, Tricyclic Antidepressants(TCA) eg Amytriptyline, Paroxetine
3. Antiglycaemic Agents- Insulin, Thazolidieones, Sulfonylurea eg Chlopropamide
4. Steriod Hormones
5. Others-a) Female Contraceptive e.g Progestin based,b)Atenolol

Substances that Lipoprotein transport

1. Vitamins (Fat soluble ones only)
2. Triglycerides
3. Cholesterol

Classification of Lipoproteins

Classification of Lipoproteins(5 in number)

1. Chylymicron
2. Very Low Density Lipoprotein(VLDL)
3. Low Density Lipoprotein(LDL)
4. Intermediate Density Lipoprotein(IDL)
5. High Density Lipoprotein

Factors that affect HBAIC results

1. Haemoglobinopathies
2. Anemia
3. Method used for assay
4. Uraemia
5. Blood transfusion
6. Recticulocytosis