23/3/22 Flashcards
In what condition are Heinz bodies found?
What are they?
G6PD Deficency
Nucleated RBC - precursors of normal RBC - occur due to body needing to produce RBC quickly normally in response to haemolytic crisis
What is meant by the term hemosiderosis?
Iron overload in organs or tissues
How do you manage small and large bleeds in haemophilia A?
Small
- desmopressin - increases vWF - transports VIII
- tranexmic acid - increases clot size
A = VIII
Large
- IV infusion of VIII
Describe the fibrinogen, fibrin and D-dimer levels in DIC?
What situations do you commonly get DIC?
Fibrinogen decreases
Fibrin - increases (making lots of clots)
D-dimer levels increase (also breaking down lots of clots)
DIC
Delivery - obstertic emergencies
Infections/immunological
Cancer and other malignancies
What should be done with men with an unexplained iron deficent anaemia?
Refer to gastroenterology urgently
What is the first line drug used in essential thrombocytosis?
Hydroxyurea
A patient with the following blood abnormalities having had recent bleeding in unusual places has presented with no history of any infection and no infection on testing. What are they likely to have?
High granulocytes +/- high rbc +/- high platelet +/- eosinophilia/basinophilia
Chronic myeloproliferative neoplasms/disorders
In terms of chronic myeloproflierative neoplasms what is the name of the one that causes:
- proliferation of RBC
- proliferation of platelets
- fibrosis of bone marrow
RBC - polycythaemia vera
Platelets - essential thrombocythaemia
Bone marrow - primary myelofibrosis
Blast cells = what condition?
Acute leukaemia
What is thrombophillia?
A mutation in what is the most common cause?
How does it present in clinic?
Thrombophillia is a deficency of the body’s own AC - so leads to an increase in fibrin rich clots
(remember fibrin rich clots = venous clots)
Unprovoked DVT and PE and will have a family history
Factor V - most commonly (Protein C + S can’t shut it off)
To be categorised as B stage in lymphoma you need to have the presence of B symptoms. What are they?
- Fever
- Night sweats
- Weight loss
EMDR (eye movement desensitisation and reprocessing) is the most appropriate treatment for PTSD except for in which circumstance?
Combat based
Then CBT first line
PTSD symptoms that last less than a month are referred to as?
Acute stress disorder
What is the side effect that is most commonly attributable to paitents stopping clozapine?
How is it managed?
Hypersalvation
Hyoscine
What is the name of the disorder where patients suffer from repetitive, involvuntary and purposeless movements e.g. lip smacking, pursing of lips and excessive blinking?
What type of drug can it happen as a side effect of?
Tardive dyskinesia
Typical anti-psychotics e.g. haloperidol
How do you assess if someone with an ED needs to admitted?
ECG - assess HR
Biochemical side effect of SSRIs?
Hyponatremia
What are the 5 criteria for detention under the mental health act?
- Has a mental disorder
- Incapacity to make decision about healthcare treatment
- Needs to be in hospital for docs to make decision
- At risk to health of themselves and others
- Granting short-term detention is necessary
What is the first line pharma treatment of GAD?
Sertaline
What is the first line pharma treatment of OCD?
Sertaline
Name the 4 SSRIs avaliable at Tayside
Which one is suitable for <18
- Fluoxetine - <18
- Sertaline
- Citalopram
- Escitalopram
What is the difference between emergency and short term detention certificates?
Both require you to meet mental health act 5 criteria
Emergency = any practitioner + up to 72hrs
Short term = senior psych and mental health officer + up to 28 days
Is CBT and pyschotherapy doesn’t work to treat PTSD - what is the drug treatment?
SSRIs
