13/10/21 Flashcards
Definition of Oppositional Defiant Disorder. General ballpark characteristics.
Recurrent negative, defiant, disobedient and hostile behaviour toward authority figures:
- losing temper + being angry and resentful
- being spiteful or vindictive
- arguing with adults
- actively defying or refusing to comply with adults’ requests or rules
- deliberately annoying people
- blaming others for his or her mistakes
- being touchy or easily annoyed by others
Definition of Conduct Disorder. When is this diagnosed? General characteristics.
- disorder of childhood or adolescence
When there is behaviour that violates the rights of others or societal norms
- aggression towards people, animals or property, often with a callous manner and lack of empathy
- deceitfulness or theft
- serious violations of rules
Characteristics of Antisocial Personality Disorder.
Characteristed by:
- routinely disregards the rights of others → deceitfulness, impulsivity, lack of remorse as well as repeated criminal acts, disregards for others safety, aggressive behaviour
- developmental history → longstanding pattern with conduct disorder prior to age of 15
- sociopathy is a lay term that is essentially synonymous with ASPD. Psychopathy indicates a particularly malignant form of ASPD → severe end of the antisocial behaviour spectrum.
What is seberrhoeic dermatitis? Which part of the kin does it usually affect?
Chronic relapsing skin eruption characterised by erythema and scaling
Most commonly affects the scalp.
- Facial seberrhoeic dermatitis affects the medial part of the cheeks, nasolabial folds, and nose. Common cause of a “butterfly rash” that is also in SLE but in SLE the nasolabial folds are spared.
What is the non-pharm and first line management for seberrhoeic dermatitis?
- low irritant skin cleanser
- Facial → shampoo hair often
- Combination products of antifungal cream + topical corticosteroid:
- hydrocortisone + clotrimazole 1% + 1% cream topically, daily or BD until skin clears up for 2 weeks
Which leads correspond to the lateral myocardium? Which leads correspond to inferior myocardium? Which leads correspond to septal myocardium?
Which leads correspond to anterior myocardium?
Which leads correspond to posterior myocardium?
V1-2 -> Septal V3-4 -> Anterior II + III + aVF -> Inferior i + aVL + V5 + V6 -> Lateral (V5-6 - apical) V7-9 -> Posterior
Which coronary vessel does an anterior infarct correspond with?
Left Anterior Descending Artery
Describe 2 main changes in the ECG in an anterior STEMI + 2 bonus.
- ST Elevation in V1-6 plus 1 and aVL
- Minimal reciprocal ST depression in III and aVF
- Q waves in V1-2, reduced R wave height (a Q-wave equivalent) in V3-4
- Premature Ventricular Complex (PVC) with R on T phenomenon
What is the clinical significance of a posterior STEMI?
- Posterior Infarction → 15-20% of STEMIs, usually occuring as extension of interior or lateral infarction
- if posterior extension of lateral or inferior infarction → much larger area of myocardial damage → increased risk of LV dysfunction and death
- If isolated posterior STEMI → indication for emergent coronary reperfusion but the lack of obvious ST elevation means that diagnosis can be missed.
2 main changes on ECG for a posterior STEMI and 3 other changes.
ST Elevation in V7-9
in V1-3
- Horizontal ST depression
- Tall, Broad R waves (>30ms)
- Upright T waves
- Dominant R Wave (R/S Ratio > 1) in V2
What is coeliac disease? How many people in Australia have coeliac disease? If first degree relative has coeliac -> what is the patient’s risk?
Disorder of the small bowel caused by an immune response to ingested wheat gliadins and related proteins in oats, rye and barley → resulting in inflammation and tissue damage
1 in 100 people in Australia have coeliac disease
The risk of a 1st degree relative developing coeliac disease is about 1 in 10
Symptoms of coeliac disease? (5 points)
- Lethargy
- Diarrhoea
- Abdominal Pain
- Bloating
- Indigestion
Other ways in which patients with coeliac disease can present? (4 points)
- complication of coeliac disease → anaemia or osteoporosis
- associated disease → dematitis herpetiformis
- Primary Infertility or Recurrent Miscarriages
- Micronutrient deficiencies → Fe Deficiency, B12 or Folate Deficiency
How do you diagnose coeliac disease?
- *The diagnosis of Coeliac Disease → Duodenal Biopsy**
- Characteristic histology → intraepithelial lymphcytosis with blunting of villi
What other two tests are relevant in coeliac disease? Explain their role in diagnosis.
- *IgA Anti-Tissue Transglutaminase + Anti-Deamidated Gliadin Antibody tests**
- Positive coeliac serology is INSUFFICIENT to diagnose coeliac disease however the higher the serology the higher the predictive value for coeliac disease - Human Leukocyte Antigen DQ2/DQ8 (HLA DQ2/8) Genotyping
- can exclude coeliac diagnosis if genotypes are absent- If absent genotype → patients will not have the disease or ever develop it
