1st years stuffs Flashcards by Aisha Mujahid

acute sinus bradycardia

atropine

if haemodynamically compromised - pace

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acute SVT

vagal manœuvres, carotid massage, IV adenosine (small half life), IV verapamil

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Which is the worst ventricular tachycardia or ventricular fibrillation

fibrillation

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treatment for HF

ACEI and BB (alaprenolol)
thiazide diuretic if mild
chronic HF - loop diuretic

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Chronic HF in africans

isosorbide mononitrate/hydralazine

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when should digoxin be given in HF

still symptomatic despite optimal treatment with diuretics

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Fever, pleurisy, herpes, lobar consolidation, rusty sputum

pneumococcal pneumonia

amox (doxyc)

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IVDU, bilateral cavitating bronchopneumonia

staphylococcus

fluc (MRSA - vanc)

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elderly/DM/alcoholic
aspiration pneumonia
cavitating in upper lobes
red jelly sputum

klebsiella

cefotaxime

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common pathogen in bronchiectasis, CF

pseudomonas

ceftrizidime/ciprofloxacin and aminoglycide

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pharyngitis, hoarseness, otitis

chlamydia pneumonia

doxy/clarithro/tetra

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birds
mucous sputum
patch consolidation

chlamydia pistacchi

doxy/clarithro/tetra

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epidemics

dry cough

mycoplasma

clarithro/tetra/cipro

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treatment for legionella

clarithro/leflo/cipro 2-3 weeks

rifampicin PO

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how to dx and rx viral pneumonia

viral culture and PCR

cipro and co amoxiclav

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HIV, immunosuppressed, bilateral peripheral interstitial shadowing

PCP - pneumocytic

co-tramoxazole

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the difference between LFTs - AST, ALP, ALT, GGT

and tru liver function tests - prothrombin, bilirubin, albumin

high damage to the liver

liver function

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AST
ALT
ALP

AST found in muscles as well as liver
ALT found only in liver
ALP slight raise normal in children, pregnancy, bone pathologies

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lone rise in GGT is what

alcohol abuse

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AST + ALT > ALP + GGT
ALP + GGT > AST + ALT
AST:ALT

acute alcohol hep, cirrhosis
PBC, gallstones
NAFLD

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increased conjugated bilirubin means what

liver its doing its job but too much - obstruction?

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increased unconjugated bilirubin means what

too much conjugate being produced
liver cannot conjugate due to damage
gilberts

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draw out ECG
what is P how long does it last 
what is PR how long does it last 
what is QRS how long does it last 
ST
T
TP

draw
atrial depolarisation 0.08-0.1s
AV nodal delay 0.12-0.2s
ventricular depolarisation less than 0.1s
ST maintains ventricular depolariation systole (contract)
T ventricular repolarisation
TP diastole (relax)

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calibration of ECG

How to work out the HR

25mm/sec
300/number of large squares between R-R
number of QRS complexes in 30 x10

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what is the normal axis of an ECG

-30 +90

what are the stages of hypertension

1- 140/90 monitor 130/80 2 - 160/100 monitor 150/95 3 - 180/100 malignant is DBP >130

in stage 1 why would drugs be started

if target end organ damage present of 10 year risk of CVD disease over 20%

treatment for hypertension

55/black - CCB/thiazide diuretic A+C/A+D A+C+D BB or AB

target for hypertension

under 80 140/90 over 80 150/90 | DM/renal/CV - 130/85

angina treatment

GTN + aspirin/ACEi/statin | bisoprolol or verapamil

unstable angina and NSTEMI treatment for low risk and high risk

low risk - aspiring, clopidegrol, nitrates | high risk - PCI, thrombolysis, CABG

treatment for a STEMI

MONAC - sublingual nitrate PCI within 90 minutes thrombolyse if PCI unavailable - streptokinase and aspirin

1st degree HB 2nd degree HB 3rd degree HB

prolongation of PR interval >0.22s mobitz 1 prolongation of PR then dropped QRS mobitz 2 dropped QRS no correlation between the two

BBB | treatment

WiLLiam MaRRow IV atropine, pacing

pan systolic to axilla | displaced apex

mid diastolic rumble | tapping apex malar rash

ejection systolic -> carotids slow rising pulse heaving apex

early diastolic | displaced apex

CURB65

confusion urea >19 RR>30 SBP60

CAP mild/mod severe HAP non severe severe

amox PO (doxy) and clarithro for 7 days IV amox (levoflox) and clarithro for 10 days amox and metro for 7 days amox, metro and gen for 7-10days

treatment of COPD

salbutamol - formerarol/salmetarol

acute COPD

``` iSOAP ipratroprium and neb salbutamol oxygen AB is purulent sputum oral pred ```

asthma treatment stages

``` salbutamol beclometasone LABA increase dose of beclo montelukast/theophylline oral steroids ```

acute asthma

``` OSHITMAN oxygen neb salbutamol IV hydrocortisone neb ipratroprium oral theophylline Mg sulphate anaesthetic ```

TB treatment

2 months RIPE | 4 months RI

TB drugs side effects

R - orange piss I - neuropathy, agranulocytis P - hep, gout E - colour blind

Sarcoid - h/s, increase in what, treatment

4 Ca and ACE oral pred

CXR showing ground glass to honey comb

IPF

a pneumothorax treatment

needle aspirate 2nd ICS mid clavicular

Pleural effusion drain where

5th mid axillary | drain if empyema

pleural effusion transudate under 30 | exudate over 30

pericarditis, HF, nephrotic syndrome | pneumonia, TB, MI, cancer, pancreatitis

difference between type 1 rest failure and type 2

type 1 decrease in O2 and normal or low co2 | type 2 low o2 and increase co2

treatment of a small and a large PE

small herparin/warfarin | large - thrombolyse

central. rapid mets. increase cortisol decreased sodium

SCLC

non smoker | mucous secreting glandular cells

adenocarcinoma

cavities | central necrosis, increased calcium and increase PTH

squamous

poorly differentiated. mets early

large cell

non nauseating granulomas | nauseating granulomas

sarcoid | TB

symptoms and treatment for GORD

heartburn aggravated by lying down, regurg, nocturnal cough, water brash gaviscon, ranitidine, omeprazole

what is gastroperesis and the treatment

delayed gastric emptying not due to an obstruction | liquid diet, gastric pacemaker

treatment of gastric adenocarcinoma

if proximal do total resection | if distal do partial resection

55-65 yr olds | defect of pacemaker cells

gastrointestinal stromal tumours

dx of H pylori

stool antigen breath test serology IgG

treatment of h pylori

omeprazole, amoxicillin (metro) and clarithro for 2 weeks

coeliac HLA blood test histology

HLA DQ2 and DQ8 tTGA IGA villous atrophy, crypt hyperplasia and increase lymphocytes

what is meckels diverticulum and the symptoms

tubular structure 60cm from ileocaecal value remenant of omphalomesenteric duct painless melanoma

commonest cause of food poisoning

campylobacter

what food poisoning is outbreaks

E Coli 0157 and salmonella

commonest cause of viral diahrroae in under 3s

rotavirus

explosive vom

noravirus

which 2 organisms have the longest incubation periods for food poisoning

camp and EColi

toxin producing organisms

SA, perfringes, bacillus cereus, EColi

causes of bloody diahroha

camp, shigella, EColi

``` ix for typhoid salmonella, camp, shigella giardia, amoeba, parasites Cliff, Coli norovirus ```

``` blood culture stool culture stool micro soon toxin stool PCR ```

non severe CDiff | severe CDIff

oral metro | oral vanc

treatment of IBD

5ASA mesalazine, steroids, immunosuppreiosn, anti TNF

crohns v UC

mouth to anus, fissures, non nauseating granulomas involving rectum and up, crypts, cx is toxic megacolon, PSC

Hep A

rna, gay sex, IVDU | Hep A IgM

Hep B

DNA, blood-blood, sex

Hep C

RNA, blood-blood, sex chronic liver disease fatigue Hep C AB and DNA

Hep D

relies on Hep B

Hep E

face-oral, zoo

AI hep

young women on the pill fatigue discomfort, myalgia, loss of appetite ANA, SMA, anti LKM, increase IgG

what is PBC

chronic inflam and destruction of intra and extra hepatic ducts middle aged women AMA and ANA increase IgM

non cirrhotic, well demarcated echogenic spot on US

hemangioma

central scar, bile ducts, kuppfer cell, young/middle aged women

focal nodular hyplasia

women, glycogen storage disease, pill

hepatic adenoma

farmer, sheep parasites

hydatid cysts

haemachromatosis

bronzed diabetic | increased iron - mutation in HFE

willsons

lots of copper | kesser Fleischer rings

PSC

UC ANA pANCA men pred, metho

below and lateral to inguinal ligament | above and medial

femoral | inguinal

hyperkalaemia in VT

CaCl

``` native valve prosthetic valve SA MRSA strep viridian's enterococcus staph epidermis ```

``` amox, gent vanc, gent, rifampicin fluc vanc, gent benzylpenicillin, gent amox/vanc, gent vanc, gent, rifampicin ```

tetralogy of fallot

VSD, overriding aorta, RV outflow obstruction, RV hypertrophy

on an antibody where is the Fab and where is the Fc

FAB top | FC bottom

``` ventricular diastole (relaxation) ventricular systole (contraction) ```

0. 5s | 0. 3s

IgA

dimeric in milk 2nd most abundant

IgD

low levels

IgE

type 1 hs

IgM

pentameric | first Ig produced

IgG

crosses placenta | most abundant

Type 1 hs

IgE and mast cell degeneration

Type 2 hs

AB mediated IgG/IgM

Type 3

immune complex

Type 4

T cell mediated