26/04 Flashcards
Clarithromycin SE
dyspepsia
supraventricular tachycardia +Wolff-Parkinson-White syndrome ecg sign
Delta wave and short PR interval
The delta wave means heart conducts earlier than usual just before the QRS complex, which together with the short PR interval are characteristic of Wolff-Parkinson-White syndrome. It can sometimes establish a re-entrant circuit resulting in supraventricular tachycardia due to an accessory conducting bundle.
Radiotherapy for breast cancer increased risk for ?
lung cancer
beta blocker/ bisoprolo overdose treatment
glucagon
treatment for group A strep sore throat in patients with penicillin allergy.
Erythromycin 500mg
abdominal pain and bloating ongoing for over 6 months. This is associated with intermittent loose and smelly stools with no blood or mucus. She has a past medical history of B12 deficiency and her mum is on levothyroxine for thyroid disease.
On examination she is pale, her abdomen is generally tender but soft with no guarding. Digital Rectal Examination is normal.
coeliac disease
faecal calprotectin tested for
IBD
which drug can cause peripheral oedema?
amlodipine
P O
tension pneumothorax signs
Tracheal deviation to the left because build-up of pressure in lung, reduced chest expansion, hyperresonant percussion on the right, decreased vocal resonance on the right
tumour marker for cholangiocarcinoma
CA 19-9
mode of action of imatinib
Inhibition of tyrosine kinase
vitamin B3 (niacin) deficiency symptoms
Dementia, Dermatitis/skin irritation and Diarrhoea.
3D
Pneumocystis jirovecii is best stained by
silver stain
Bullous pemphigoid
rare skin condition that causes large, fluid-filled blisters.
electrical alternans
change in QRS
Lyme disease
infectious disease caused by the bacterium Borrelia burgdorferi
hysterectomy
removed womb
polydipsia
excessive or abnormal thirst, accompanied by intake of excessive quantities of water or fluid
dips like water
Polycythaemia rubra vera (PRV)
which means the bone marrow makes too many blood cells.
afebrile
not feverish
low O2 sats , which test ?
ABG
consolidation on R heart border for CAPn
which lobe affected
middle R
does 65 yo count as a point in CURB 65?
what does score of 2 mean
yes
hospital
CURB 65 mortality risk
0 – 0.7%
1 – 3.2%
2 - 13%
3 - 17%
4 - 41.5%
5 - 57%
Systemic inflammatory response syndrome (SIRS)/ sepsis
≥ 2 of:
> 38°C or < 36°C
Heart rate > 90
Respiratory rate > 20
WBC > 12,000/mm³ or < 4,000/mm³
target O2 levels for COPD patient
88-92%
indications for long-term oxygen therapy.
PaO2 score of between 7.3 and 8 with the presence of peripheral oedema
smoke inhalation damages the lungs to cause emphysema
Smoke inactivates alpha-1 antitrypsin in the lungs, which leads to increased action of elastases and breakdown of elastic tissue.
Smoke activates polymorphonuclear leucocytes to cause emphysema.
smoke inhalation damages the lungs to cause chronic bronchitis
Mucous gland hyperplasia, basal cell metaplasia and basement membrane thickening
mmm
pneumothorax >2cm and/or breathless management
aspirate 16-18 gauge cannula
pneumothorax >2cm
chest drain
indications for use of long term oxygen therapy in COPD
Clinically stable non-smokers with PaO2 of <7.3 (approximately equal to oxygen saturations of 88%) measured at least twice, a minimum of 3 weeks apart, despite maximum treatment
OR
A PaO2 of 7.3-8.0 with concurrent secondary complications of COPD (one of the following):
Pulmonary hypertension
Secondary polycythaemia
Peripheral oedema
Nocturnal hypoxaemia
OR
In terminally ill patients for palliation
lung volume reduction surgery in COPD
upper lobe predominant emphysema, FEV1 >20% predicted, PaCO2 below 7.3 kPa, and TlCO/ transfer capacity for CO above 20% predicted.
infection changes to sputum
Change in volume and colour of sputum
ECG changes are present which may be seen in COPD:
P pulmonale: peaked P waves in leads II, III and aVF
Right axis deviation
Absent R waves in right facing leads
Low voltage QRS in left facing leads
Sinus tachycardia (hypoxia, dyspnea, medication related e.g. salbutamol, theophylline)
Indications for surgery in COPD
lung volume reduction surgery if:
They have upper lobe predominant emphysema
FEV1 >20% predicted
PaCO2 below 7.3 kPa
TlCO above 20% predicted.
