13/4/22 Flashcards
What is more palpable mass in artery or vein?
What vein runs in the medial posterior of leg?
Vein as more superifcal
Great saphenous - think saphenous nerve suopplies medial leg
Posterior compartment is responsible for what movement of ankle?
- anterior
- medial
- lateral
Lateral - eversion
Posterior - plantar flexion
Anterior - dorsiflexion
Medial - inversion
In compartment syndrome pain is felt when stretching muscles of the affected area.
How is this tested?
By testing function of opposite muscles
e.g. anterior leg affected - worse by testing posterior mucsles
What do you use to lower hyperkalaemia?
Insulin + dextrose over 15 mins (reduce potassium but keep sugars up)
Use calcium gluconate to protect the heart if >6.5 or showing signs on ECG
- important to treat the underlying cause as only moving K+ intercellulary - it will come back
What meds are used to manage malignant HTN that is causing symptoms?
IV sodium nitroprusside
IV labetolol
What cells produce insulin and glucagon and where does this happen?
Insulin - beta cells
Glucagon - alpha cells
Isles of Langerhans in the pancreas
Why do you get weight loss with T1DM?
No insulin - sugar can’t get into cells - cells starved of sugar so lipolysis and break down proteins - hungry and weight loss
What mnemonic should you use when drug counselling
ATHLETICS
Action Timeline How to take Length of treatment Effects Tests Important side effects Contradictions Supplementary advice
What are common side effects of metoformin?
Nausea and vomitting
Stomach pain
There is the 2-2-2 rule that applies to weight loss/maintaince/gain in diabetic drugs. What drug is each?
Loss
- GLP-1 receptor agonist (semaglutide)
- SGLT2 i (empagliFLOZIN)
Maintain
- metoformin
- DPP4 inhibitor (AloGLIPTIN)
Gain
- SUs (GLIclazIDE)
- piogitazone
What is the typical HbA1c target in diabetic management?
<7%
Would SUs cause a high or low C-peptide and why?
High - cause more insulin to be released from the cells
What does each power movement in the neuro exams test?
Shoulder abduction - C5 Elbow flexion and wrist extension - C6 Elbow extension and wrist flexion - C7 Thumb extension (press down on thumb) - C8 Finger abduction - T1
Hip flexion - L2,3
Hip extension - L5,S1
Knee flexion - L3,4
Knee extension - L5,S1
Dorsiflexion - L4,5
Plantar flexion - S1,2
Inversion - L4,5
Eversion - L5,S1
Extension of knee and hip the same
Point to the sky and into the middle are both the same
Explain the process of prenatal screening for Down’s Syndrome and what happens afterward
At 11-14wks - serum screening = high BCG and low PAPP-A - nuchal translucency = assess fluid at the back of baby's neck = more means Down's more likely
If high risk then offer diagnostic tests
CVS
- 9-12weeks
- sample of the placenta through abdo or vagina
- higher risk of pregnancy loss
Amniocentisis
- 15-19wks
- sample of the amniotic fluid by inserting a needle into the abdo
- 1% risk of pregnancy loss
- small risk of infection
Aside from Down’s syndrome what other conditions is prenatal screening testing for?
Edward’s syndrome (trisomy 18)
Patau’s syndrome (trisomy 13)
