06/03 Flashcards
What are key features of post MI ventricular septal defect?
Acute heart failure- chest pain, orthopnoea, dyspnoea
Pan systolic murmur
What are key features of haemophilia?
Affects boys Haematomas Haemarthrosis Prolonged bleeding after trauma Easy bruising
What should be given during CPR if the underlying cause is thought to be PE?
Alteplase
What are the causes of cardiac arrest?
Thrombus
Toxins
Tamponade
Tension pneumothorax
Hypovolaemia
Hyperthermia
Hypokalaemia and other electrolyte disturbances
Hypoxia
What is nephrogenic diabetes inspidus?
Caused by lithium
Urine remains dilute <300 despite dehydration and desmopressin administration
When should synchronised DC cardioversion be given?
Patients with tachycardia and signs of shock, syncope, myocardial ischaemia or heart failure
Can be given up to 3 shocks
How can frontal lobe tumours present?
Disinhibition
Difficulty controlling emotions and behaviour
Poor language production- Broca’s aphasia
How can a brainstem tumour present?
Unsteadiness Loss of balance Diplopia Dysphagia Dysarthria
How can a cerebellar tumour present?
Difficulty walking
Difficulty speaking
Loss of dexterity
Loss of balance and coordination
How can a parietal tumour present?
Altered smell/taste/hearing
Agnosia- cannot recognise familiar things
Impaired spatial awareness
How can temporal lobe tumour present?
Wernickes aphasia
Auditory agnosia
What are causes of a 3rd nerve palsy?
Diabetes mellitus Vasculitis Uncal herniation due to raised ICP Posterior communicating artery aneurysm Cavernous sinus thrombosis MS
What is used to treat cerebral oedema due to tumours?
Dexamethasone
What hormone secretion is decreased due to stress response?
Insulin
Oestrogen
Testosterone
How is carotid artery stenosis diagnosed?
Duplex USS
What are features of a low pressure headache?
Occurs 24-48hrs post LP
Worse on standing up
Relieved by lying down
What is management of low pressure headache?
Normally self resolves within 72hrs
If not blood patch/ epidural saline/ IV caffeine
What is the management of angina?
GTN spray prn
Beta blocker e.g. atenolol
CCB e.g. nifedipine (if used with beta blocker) or verapmil if monotherapy
Use dual therapy if symptoms not controlled by monotherapy
What should be done in a patient with a CHAD score of 0?
Refer for trans thoracic ECHO to exclude valvular disease
If valvular disease present then require anti coagulation
