Appetite

CLINGS

• Cholecystokinin
• Leptin
• Inhibit appetite

• Neuropeptide Y
• Ghrelin
• Stimulate appetite

Pellagra symptoms

Vitamin B3 (niacin) deficiency

The three D‘s:

• Dermatitis
• Diarrhoea
• Dementia

Pancreatic hormones

PIGS

• Pancreatic polypeptide
• Insulin
• Glucagon
• Somatostatin

Multi System Atrophy

Please Straighten Any Shy Cunts Out

• Parkinsonism – Striatonigral degeneration
• Autonomic failure – Shy-Drager syndrome
• Cerebellar ataxia – Olivopontocerebellar atrophy

Papp-Lantos bodies found

WHO Declarations

Declaration of:

• Geneva – Germany (Nazi); new Hippocratic oath in view of crimes committed in Nazi Germany
• Helsinki – Human experimentation; ethical principles against testing man
• Tokyo – Torture; physician ethics regarding torture and inhumane treatment
• Malta – Munchies; force-feeding people is inhumane
• Lisbon – Liberties; the rights of patients
• Ottawa – Optimal child health / Offspring (think children)

Genetic testing

Southerners Do Not Rouse White People

• Southern blot – detects DNA
• Northern blot – detects RNA
• Western blot – detects Protein

End-of-life symptoms

PANDA

• Pain – consider diamorphine 2.5 mg SC hourly PRN, adjust as required
• Agitation – consider midazolam 2.5 mg SC hourly PRN, adjust as required
• Nausea and vomiting – consider haloperidol 0.5-2 mg QDS PRN, cyclizine, levomepromazine 3.125-6.25 mg SC
• Dyspnoea – consider regular morphine, steroids, diazepam
• Airway secretions – consider hyoscine butylbromide 20 mg SC TDS PRN

Consider palliative care team review and syringe driver

Source here

Recognising end-of-life

Inert People Breath Slowly (to be used in the clinical context)

• Infections / ulcers that are recurrent or persistent
• Progressive weight loss (>10% over last six months)
• Breathlessness at rest or minimal exertion (MRC scale 4/5)
• Self-care reduced or lack of interest (in a chair >50% of the time)

More information here

Sepsis 6

O2 FLUID

• Oxygen

• Fluids IV
• Lactate measurement
• Urine output measurement (catheterisation)
• Infection screen inc. blood cultures, FBC, CRP +/- urine dip/culture, swabs
• Drugs – antibiotics as appropriate

ACE inhibitor contraindications

PARK

• Pregnancy – teratogenic
• Allergy
• Renal artery stenosis (caution in renal failure especially if creatinine >200umol/L)
• Kalaemia – hyperkalaemia, also hyponatraemia or hypotension/hypovolaemia