22 December #2 Flashcards
What medications can be given if adenosine does not work in SVT?
Beta blockers e.g. metoprolol or CCB e.g. Verapamil
What is Prehns sign?
Elevation of the scrotal sac relieves pain
If true epididymo-orchitis
If untrue then torsion
What are features of bullous pemiphigoid?
Autoimmune condition with antibodies against BP 180 and 230
Itchy tense blisters around flexures, heal with no scarring
No mucosal involvement (rarely can be)
Immunofluorescence shows IgG and C3 at dermoepidermal junction
Treat with oral steroids as mainstay
What are features of Legionnaires disease?
Caused by Legionella pneumophilia
Flu like symptoms
Dry cough
bradycardia
Confusion
Hyponatraemia
Lymphopaenia
Deranged LFTs
Diagnose with urinary antigen
Treat with erythromycin/clarithromycin/ ciprofloxacin (?rifampicin?)
What are features of Pneumocystis carinii pneumonia?
Affects immunocompromised (HIV)
Present with dry cough, fever, exertional dyspnoea
CXR- bilateral perihilar interstitial shadowing
Diagnose- bronchoalveolar lavage/sputum
Treat with Co-trimoxazole
What is the management of staph pnuemonia in CF patients?
Flucloxacillin
What tumour marker is present for bowel cancer?
CEA
What tumour marker can be used for breast cancer?
Ca27.29
Ca153
AFP
Ca 199
What questionnaire is used for alcohol dependence?
CAGE
What questionnaire is used for anxiety/depression?
HADS
What score is used for pressure sores?
Waterlow
What are features of anterior uveitis?
Acute painful red eye
Ciliary flush
Fixed small irregular shaped pupil
Hypopyon
Photophobia- intense
Lacrimation
Impaired vision
How can you differentiate between teratoma and epidymal cyst?
Teratoma does not trans illuminate
What are features of Klinefelters syndrome?
XXY
Small firm testes
Gynaecomastia
Low testosterone- elevated gondaotrophin levels
Taller than average
Delayed puberty
Primary gonadal failure- most common type
What is diagnostic criteria for diabetes?
HbA1c >48
Fasting glucose >7
Random glucose ?11/1
OGTT 2 hour glucose >11.1
If asymptomatic then need two results
What is DVT advice for long haul flight in low risk?
Stay hydrated
Avoid alcohol/sedatives
Walk around regularly
What is Brucellosis?
Mediterranean fever
Infects farm animals but can spread to humans in close contact or drinking unpasteurised milk
-Headache
-Fever
-Sweating
-Muscle cramps
- Splenomegaly
What are features of Cholera?
GI infection from food/water
Watery diarrhoea
Fever
Vomiting
Colicky abdominal pain
What are symptoms of Lyme Disease?
Early
- erythema migrans- bulls eye rash
- headache
- fever
-arthralgia
Later
- Heart block
- peri/myocarditis
- facial nerve palsay
- meningitits
What are investigations/management of Lyme Disease?
Can be clinical if erythema migrans present
Antibodies to Borrelia burgforferi are first line test on immunosorbent assay
Doxycycline if Lyme disease
Ceftriaxone if disseminated disease
What are features of constrictive pericarditis?
Abdominal pain
Ascites
Dyspnoea
Ankle swelling
Tachycardia
Raised JVP
Impalpable apex beat
Pericardial calcification on CXR
How to convert from oral morphine to fentanyl patch?
Fentanyl is just under twice as potentH
How to convert from oral morphine to SC diamorphine?
Diamorphine 60mg= 180mg oral morphine
How is prediabetes diagnosed?
HbA1c42-48
Impaired fasting glucose 6.1-6.9
Impaired glucose tolerance
- fasting <7
- OGTT value 7.8-11.0
What Criteria is used to validate IBS?
Rome
