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

    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 :dontknow:

    (Original post by HFerguson)
    x
    You still have my top in your locker :ninja:

    No rush on this but we ought to figure out how to do the exchange at some point I guess (thanks for that btw!)
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    (Original post by Wangers)
    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.
    Would hypercalcaemia sufficient to cause polyuria produce other signs that aren't mentioned?
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    (Original post by Penguinsaysquack)
    Now realising that I really should have learnt to cook before coming here.. failed at pasta :sigh:

    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 :dontknow:



    You still have my top in your locker :ninja:

    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?
    Spoiler:
    Show
    protip: "no" is not the correct answer

    could give it you then (Y)
    oh and it'll probably be a free for all :awesome: get in early bro, but i wouldn't worry about there not being enough food
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    (Original post by HFerguson)
    I'm givin it a wash bud you at carb loading tonight?
    Spoiler:
    Show
    protip: "no" is not the correct answer

    could give it you then (Y)
    Are you really? :lol:

    Thank you very much mate

    I'm not sure about it tbh.. free food is good and all but not feeling it atm.. (still hungover)

    Probably will be there tbh

    Do you happen to know how much food there will be?
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    (Original post by Tech)
    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 :holmes:
    Yup! Congrats on getting the project you wanted. When do you start your BSc? It's my first day tomorrow. 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.
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    (Original post by FFCrusader)
    I have no idea

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

    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
    :yy: Got it. See you tomorrow then...
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    (Original post by Kinkerz)
    Would hypercalcaemia sufficient to cause polyuria produce other signs that aren't mentioned?
    I don't know what level polyuria could kick in, I just know that it is a cause, I suspect though that you may see some ECG changes with/out delerium (delerium starts around 3mmol) NR corrected calcium being 2.2-2.6ish.

    With calcium always take the albumin level to correct 40-actual albumin x 0.25 (so correction is 0.25mmol per unit above below 40 because calcium binds to albumin and the bit we need to account for that. I'd also think about PTH to differentiate causes, malignancy should supress it to undetectable levels. Pth with high ca might be hyperparathyroid (commonest cause of high calcium). One other very relavent cause would be ?chronic renal failure, evidenced from history, u&e, creatinine out of proportion to fluid status and potentially an anaemia due to lack of epo. (?microcytic, hypochromic, I think). The other 2 big causes of genuinely high ca would be sarcoidosis and multiple myeloma. Then there are clever things like tumours producing pthrp, milk alkali, hypocalsuric hypercalcaemia...you can tell I spent 3rd year in tertiary centres! They're heading towards the rare/grand round end of the spectrum. Back to bog standard would be beware pseudogout. The other reason for the urine dip is if it is high calcium, it can give nephrocalcinosis, calcium essentially silts up kidneys - this can result in renal tubular acidosis - unable to clear acid in urine hence urine ph greater than 5.3 with a metabolic acidosis.

    That dosn't really answer your question, but it was good revision for me!
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    (Original post by i'm no superman)
    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.
    There used to be a very handy staff/student shuttle bus between King's and Guy's, but for some reason they've now stopped running it - very annoying.
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    (Original post by Wangers)
    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.
    would 4-5L/day of polyuria due to hypercalcaemia be of a normal yellow colour?
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    Had my first lecture today... Yeeeehhhh boiii
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    Can we keep fresher chat to the fresher thread? Ta
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    i'm going to say cushings, can present in weird ways and the symptoms kind of fit for a subclinical-ish presentation
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    (Original post by Becca-Sarah)
    :yy: Got it. See you tomorrow then...
    Indeed. Although I might be tied up in labs just before
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    Can anyone please get me this article? http://www.ncbi.nlm.nih.gov/pubmed/10705044
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    (Original post by Supermassive_muse_fan)
    Can anyone please get me this article? http://www.ncbi.nlm.nih.gov/pubmed/10705044
    Managed to get it. PM me your e-mail address and I can send it on.
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    (Original post by Wangers)
    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
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    Skiving lectuers to be in library :ahee:

    /nerdrebel :rock:
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    (Original post by Captain Crash)
    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?
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    (Original post by Wangers)
    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
 
 
 
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