2012 Flashcards
commonest cause of mitral sten
rheumatic fever
how does mitral stenosis cause AF
volume and pressure of blood in LA increases
atrium larges
causes AF
starling forces in heart failure
increased hydrostatic pressure in vessels (pressure build up)
low oncotic pressure in veseels due to low albumin
4 main risk factors for pancreatitis
GET S gallstones ethanol trauma - incl ERCP SMOKING!!
what is the Allen’s test checking
adequate collaterals!
(hyperaemia of WHOLE hand on release of one artery)
checks both are patent and providing collateral blood supply
4 main risk factors for pancreatitis
GET S gallstones ethanol trauma - incl ERCP SMOKING!!
what is the Allen’s test checking
adequate collaterals!
(hyperaemia of WHOLE hand on release of one artery)
checks both are patent and providing collateral blood supply
drug used to treat hypercalcaemia?
drug MOA? inhibitis osteoclastic boen resorption
(NB IV 0..9% saline 4-6 L in 24 hr)
IV zolindronate
investigation to dx addison’s
short synacthen (synthetic ACTH) test --> plasma cortisol is measured before and 30 minutes after giving IM Synacthen 250ug
Failure for cortisol to rise of >420nmol/L at 30 minutes post Synacthen indicates Addison’s disease
define hospital acquired infection
-infections acquired in hospital or healthcare service unit
-1st appears >=48h after admission OR
within 30 days of discharge
-unrelated to original illness that brings pt to hospital
-not present at time of admission
how to prevent spread of infection
isolation
gown and gloves
hand washing
appropriate and prompt use of Abx
define hospital acquired infection
-infections acquired in hospital or healthcare service unit
-1st appears >=48h after admission OR
within 30 days of discharge
-unrelated to original illness that brings pt to hospital
-not present at time of admission
how to prevent spread of infection
isolation
gown and gloves
hand washing
appropriate and prompt use of Abx
3 mark question why chosen SSRI
i think the ans could be
1st line drug, lower side effect profile than others, relatively safe in overdose
labile mood and weight loss
hyperthyroidism
frontal lobe brain tumour
causes of thrombocytopenia
aplastic anaemia MDS leukaemia ITP things with splenomegaly (porthal hypertesnsion, cirrhosis, myelofibrosis, viral infections e.g. CMV, EBV
complications of infectious mononucleosis
encephalitis, meningoencephalitis, seizures, optic
neuritis, sudden sensorineural hearing loss, idiopathic
facial palsy, and Guillain-Barré syndrome
haemolytic anaemia (3%) and thrombocytopenia (25-50%),
myocarditis, pericarditits
pancreatitis,
interstitial pneumonia, rhabdomyolysis,
pathophysiology of splenomegaly
- Congestive, by pooled blood (e.g., portal hypertension)
- Infiltrative, by invasion by cells foreign to the splenic environment (e.g., metastases, myeloid neoplasms, lipid storage diseases)
- Immune, by an increase in immunologic activity and subsequent hyperplasia (e.g., endocarditis, sarcoidosis, rheumatoid arthritis)
- Neoplastic, when resident immune cells originate a neoplasm (e.g., lymphoma)
signs of EBV on mouth eaxm
exudate
petechiae on roof of mouth (sometimes)
pathophysiology of splenomegaly
Congestive, by pooled blood (e.g., portal hypertension)
Infiltrative, by invasion by cells foreign to the splenic environment (e.g., metastases, myeloid neoplasms, lipid storage diseases)
Immune, by an increase in immunologic activity and subsequent hyperplasia (e.g., endocarditis, sarcoidosis, rheumatoid arthritis)
Neoplastic, when resident immune cells originate a neoplasm (e.g., lymphoma
look at the levels of burns
-
treatment of thrombocytopenia EBV
IV steroids if severe
fhx chronic leukaemia
CLL - 2-4x more likely
CML - FHx not relevant
