3 January Flashcards
What are features of pharyngeal pouch?
AKA Zenker Diverticulum
Dysphagia
- first mouthful swallowed easily but as pouch feels then obstruction occurs
Palpable neck swelling
- may gurgle
Cough
Pulmonary infection
Bad breath
Diagnosed on barium swallow
Treat with surgery
What are features of resp distress in neonates?
RR >60
Chest recession
Grunting
Nasal flaring
Increased oxygen requirement
What are features of malignant otitis externa?
Caused by Pseudomonas Aeruginosa
Affects diabetics/AIDS
Persistent earache
Foul smelling otorrhoea
Red mass lesion
Biopsy= granulation tissue
Causes osteomyelitis of the temporal bone
What is the management of STEMI?
Aspirin 300mg
If PCI within 120 mins
- Praugrel
- Transfer to PCI
If no PCI within 120mins
- Fibrinolysis
- give antithrombin at the same time
- give ticagrelor post procedure
- if no ECG resolution consider PCI
If on oral anticoagulants swap praugrel for clopidogrel
What is the management of NSTEMI?
Aspirin 300mg
Fondaparinux if no immediate PCI planned
Estimate 6 month mortality- GRACE
Low risk
- conservative management, give ticagrelor
High risk
- Offer PCI immediately if unstable or within 72 hours
- Give prasugrel or ticagrelor
- give unfractionated heparin
What are causes of sterile pyruia?
Treated UTI within 2 weeks treatment
Renal stones
Prostatitis
Chlamydia urethritis
Renal Papillary necrosis
GU TB
Polycystic kidney
Appendicitis
What are features of Silicosis?
Occupational fibrosing lung disease
- mining/ slate works/ foundries/ potteries
Upper zone fibrosing lung disease
Egg shell calcification
What LP findings are present in bacterial meningitis?
Polymorphonuclear cells ?300mm
Protein raised
Low glucose <50% of serum
Appears cloudy
What are features of MEN 1?
Parathyroid- hyperparathyroidism
Pituitary
Pancreas- insulinoma, gastrinoma
What are features of MEN 2a?
Phaeochromocytoma
Medullary thyroid cancer
Parathyroid
What are features of Men 2b?
Medullary thyroid cancer
Marfinoid body habitus
phaeochromocytoma
What are features of red degeneration of fibroid?
Localised abdominal pain
Vomiting
Loew grade fever
Tenderness over a mass in uterus
US- degenerating myoma with mixed echodense or echolucent appearance
What is the management of listeria in pregnancy?
Amoxicillin and Gentamicin
What is the management of toxoplasmosis in pregnancy?
Spiramycin
What are features of sinus arrythmia?
Normal physiological phenomenon seen in young healthy people
Heart rate varies due to changes in vagal tone
Inspiration increases HR and expiration decreases HR
