. Flashcards
motion to exacerbate lateral epiconylitis
wrist extension against resistance with the elbow extended or supination of the forearm with the elbow extended
Diagnostic test for meniscal tears
MRI
what are the centor criteria
- presence of tonsilar exudate
- tender anterior cervical lymphadenopathy or lymphadenitis
- history of fever
- absence of cough
Management of gastroschisis
vaginal delivery may be attempted
newborns should go to theatre ASAP
Management of exomphalos
> caesarean section - reduce risk of sac rupture
>staged repair
bilobed nucleus and prominent eosinophilic inclusion-like nuclei
reed stenberg cells
classical feature of hodgkins lymphoma
who gets CMV negative packed red cells
pregnant patients
neonatal transfusions
why do patients with HL get irradiated red cells
prevent the risk of developing transfusion-related GVHD
modifiable risk factor for thyroid eye disease
smoking
cause of exopthalmos
autoimmune response against an autoantigen, possibly the TSH receptor -> retro-orbital inflammation
inflammation results in glycosaminoglycan and collagen deposition in the muscles
normalising clotting prior to decannulation after cardiac bypass
protamine sulphate
when should bisphosphonate treatment be reassessed
after 5 year period, reassessed for ongoing treatment with updated FRAX and DEXA
diagnostic criteria for rheumatic fever
Evidence of recent streptococcal infection.
2 major or 1 major + 2 minor Major; - erythema marginatum - sydenham's chorea - polyarthritis - carditis and valvulitis - subcutaneous nodules
Minor;
- raised ESR or CRP
- pyrexia
- arthralgia
- prolonged PR interval
management of rheumatic fever
antibiotics: oral penicillin V
NSAIDs
Most common organism found in central line infections
staph epidermidis
features of normal pressure hydrocephalus
urinary incontinence
gait abnormality
dementia
what causes normal pressure hydrocephalus
reduced CSF absorption in arachnoid villi
- SAH, head injury, meningitis
associated with perthes disease
hyperactivity and short stature
delivery in IHCP
IOL at 37-38 weeks
most common cause of osteomyelitis
staph aureus
indication for corticosteroid treatment in sarcoidosis
parenchymal lung disease uveitis hypercalcaemia neurological signs cardiac signs
management of patients with raised ICP
head elevation to 30
IV mannitol
controlled hyperventilation
removal of CSF
Cancer patient with VTE
6 months of DOAC
Management of DVT/PE in pregnancy
S/C LMWH
Dabigatran MOA
direct thrombin inhibitor
rivaroxaban MOA
direct factor Xa inhibitor
heparin MOA
activates antithrombin III
warfarin MOA
inhibits factors II, VII, IX, and X
presentation of acute chest syndrome
dyspnoea chest pain cough hypoxia new pulmonary infiltrates
treatment of acute chest syndorme
broad-spectrum AB to cover common infections such as strep pneumonia and mycoplasma, pain control and blood transfusion
management of gonorrhoea
IM ceftriaxone
most common inherited clotting disorder
von willebrand’s
types of transfusion reaction
- non-haemolytic febrile reaction
- minor allergic reaction
- anaphylaxis
- acute haemolytic reaction
- transfusion associated circulatory overload
- transfusion associated lung injury
features of non-haemolytic febrile transfusion reaction
Fever, chills
management of non-haemolytic febrile transfusion reaction
slow or stop the transfusion
paracetamol
monitor
features of minor allergic transfusion reaction
pruritis
urticaria
management of minor allergic transfusion reaction
temporarily stop the transfusion
antihistamine
monitor
management of anaphylactic transfusion reaction
stop the transfusion
IM adrenaline
ABC support
- oxygen
- fluids
features of acute haemolytic transfusion reaction
Fever, abdominal pain, hypotension
features and management of TACO
pulmonary oedema, hypertension
slow or stop transfusion
consider loop diuretic
signs of TRALI
Hypoxia, pulmonary infiltrates on chest x-ray, fever, hypotension
causes of TRALI
secondary to increased vascular permeability caused by host neutrophils that become activated by substances in donated blood
cause of TACO
Excessive rate of transfusion, pre-existing heart failure
cause of acute haemolytic transfusion reaction
ABO-incompatible blood e.g. secondary to human error
cause of anaphylaxis in transfusion
Can be caused by patients with IgA deficiency who have anti-IgA antibodies
antibiotic causing sun sensitivity
doxycycline
rose spots on abdomen
salmonella typhi- typhoid
psittacosis
presentation of waldenstrom’s macroglobulinaemia
bone marrow infiltration, splenomegaly and lymphadenopathy
difference between waldenstrom’s and myeloma
it does not cause lytic bone lesions or hypercalcaemia
what can paraproteinaemias cause
ischaemic strokes
high IgM
waldenstrom’s
If investigating a suspected DVT, and either the D-dimer or scan cannot be done within _ hours, then start a ____
4
DOAC
signs of post-thrombotic syndrome
painful, heavy calves pruritis swelling varicose veins venous ulceration
who gets necrobiosis lipoidica
diabetics
conditions that contraindicate platelets
TTP
treatment of TTP
corticosteroids
pathophysiology of ITP
precipitated by recent URTI
reduction in platelet count
antibodies directed against glycoprotein IIb/IIIa or Ib-VI-IX complex
presentation of ITP
petichiae
pupura
bleeding
management of ITP
oral pred
pooled IVIG
splenectomy
what is evan’s syndrome
ITP in association with AIHA
most common cause of viral meningitis in adults
coxsackie B
common presentation of sickle-cell
hand-foot syndrome
cause of hand-foot syndrome
sickling of RBCs interfering with circulation to hands and feet
amoebic dysentry
profuse, bloody diarrhoea
long incubation period
stool microscopy= trophozoites
treatment of dysentry
mentronidazole
treatment for invasive amoebiasis
luminal amoebicide to eradicate the cystic stage which is resistant to metronidazole and tinidazole
raised ESR + osteoporosis
multiple myeloma
primary CNS lymphoma
single brain lesion with homogenous enhancement
primary CNS lymphoma treatment
steroids
chemo
surgical intervention
2-level DVT Wells score is ≥ 2 points
proximal leg vein ultrasound scan within 4 hours
if -ve D dimer
