TSR Med Students' Society Part III

Now realising that I really should have learnt to cook before coming here.. failed at pasta

Got a hangover so not sure if I can be bothered to go to carb loading.. wish I knew how much free food there would be



You still have my top in your locker

No rush on this but we ought to figure out how to do the exchange at some point I guess (thanks for that btw!)

I'm givin it a wash bud you at carb loading tonight?

could give it you then (Y)

Very exciting stuff - that's what the evidence is pointing towards at the minute, right?

I've got an interview this afternoon for the ibsc project I want, not really sure what to expect

I have no idea

I'm just going to go to the things mentioned in the email I think...

No entirely sure about when the Project Supervisors stuff is, but the email I got said to go in on Weds for a tour 12-2.30 G20 Engineering Building, Thurs 10-11 SEMS Seminar Room 3rd Floor Engineering Building and 1-2 Library Group Study Room 1.

On top of that the safety talk Friday 10-11.

I didn't go in for anything today since I have not been told to

Would hypercalcaemia sufficient to cause polyuria produce other signs that aren't mentioned?

I have a meeting with my supervisors tomorrow afternoon at King's College Hospital, which is a bit of a trek from Guy's campus.

Also, why are people jumping onto the ?DI bandwagon, when a) thats really rare, and b) - we have no examination findings???!

Now we have some history, if possible, examination findings please. We don't even have a basic set of obs.

No BHCG. I would be tempted by ?hypercalcaemia which could explain the polyuria, the polydipsia compensates, and of course, malignancy is a leading cause which would explain the tiredness, could also account for headaches, or they could just be part of the constitutional picture.

Plan, repeat urine dip + miscoscopy
CXR
FBC, U+E, LFT.
D/W senior, hold off any action on ?DI pending examinations, especially ?Fluid status. If in hospital, start fluid chart, free fluids for now, send MSU.

Got it. See you tomorrow then...

Can anyone please get me this article? http://www.ncbi.nlm.nih.gov/pubmed/10705044

Also, why are people jumping onto the ?DI bandwagon, when a) thats really rare, and b) - we have no examination findings???!

Now we have some history, if possible, examination findings please. We don't even have a basic set of obs.

No BHCG. I would be tempted by ?hypercalcaemia which could explain the polyuria, the polydipsia compensates, and of course, malignancy is a leading cause which would explain the tiredness, could also account for headaches, or they could just be part of the constitutional picture.

Plan, repeat urine dip + miscoscopy
CXR
FBC, U+E, LFT.
D/W senior, hold off any action on ?DI pending examinations, especially ?Fluid status. If in hospital, start fluid chart, free fluids for now, send MSU.

I agree that DI is rare, but malignancy in a 23 year old causing hypercalcaemia bad enough to cause polyuria but without any of the main features of hypercalcaemia would be more rare than DI! Under the William Hill school of medicine, the answer is most likely to be DM.

Therefore a simple random BM would be my first port of call

Fair call, I just realised the irony here!

&+ogtt regardless of bm?

If the random BM is >11.1 then the patient has diabetes as they're symptomatic - no further diagnostic tests required. OGTT is only needed if the BM is >7.0 but <11.1

Sorry, 2 monthes off and I've forgotten how to diagnose diabetes!

Yes so you test for frank diabetes and igt, and if they can't come in for ogtt, hba1c? Suppose it comes back non diabetic or with igt then do you admit, start looking for clever causes? Or if the random bm <7, forget dm or is it worth checking anyway? I know the stress response would push sugar up...