Med

investigations inc:

- FBE

- UECs

- ABG/VBG

- ECG (MI, arrhythmia)

- Chest x-ray

- Echocardiogram

- ductal ectasia

- intraductal papilloma

- breast ca (rarely)

(incr prolactin --> inc breastfeeding, pituitary adenoma, dopamine antagonists)

caused by multiple ducts releasing green/yellow discharge, generally only on manipulation of the nipple.

more commonly incidental finding (routine screening in asymptomatic women)

occasional presents with lump/blood nipple discharge

DCIS always needs be excluded (even tho intraductal papilloma more common)

isolated bloody nipple discharge

presents as a change to nipple appearance (rather than discharge), such as ulceration, crusting or inversion

acute idiopathic peripheral facial nerve palsy

usually self-resolves starting at 3weeks, can take up to 2months (if no signs of recovery by 6weeks = start Ix)

type IV hypersensitivity reaction

often triggered by medx within days of commencing it (eg NSAIDs/sulpha drugs/penicillins)

ssx - fever

- maculopapular rash

- flank pain

- arthralgia

can be asymptomatic

most common cause of AKI in hospital

involves acute tubular necrosis includes renal tubular cell damage and death precipitated by an acute ischaemia/toxicity/sepsis

--> intrarenal vasoconstriction or a direct effect of drug toxicity is caused by an ischemic event, nephrotoxic mechanism, or a mixture of both

4 clinical stages

- initiation (acute decr GFR + sudden incr creatinine)

- extension (ongoing hypoxia following ischaemic event + inflammatory response)

- maintenance (cell repair + blood flow returns to normal

- recovery (maintenance continues with ongoing cellular differentiation + improving GFR)