30/11/21 Flashcards
Clinical Features of Cystic Fibrosis?
Diagnosis of Cystic Fibrosis?
Screening for immunoreactive trypsin and trypsinogen in newborns detects 75%
Sweat test for elevated chloride and sodium levels
Risk Factors for Suicide?
Psychiatric Disorder → especially major depression, bipolar disorder, schizophrenia, schizoaffective disorder, substance use disorder, personality disorder
Current Psychosis
Family History of Suicide
Access to Means of Suicide with high potential lethality → guns, firearms, ropes, hosepipes
Definite plan of suicide attempt
History of dangerous behaviour on impulse
Low likelihood of suicide attempt being detected
Ambivalence toward survival of suicide attempt
Social isolation or absence of social supports
Chronic Medical Illness → especially if painful
Recent Major Loss → includes loss of face in some cultures
Feeling of Hopelessness
Severe Acute Asthma Management
Salbutamol (100microg/actuation) via pMDI plus spacer
- 1-5yo → 6 puffs
- 6yo → 12 puffs
Ipratropium Bromide (21microg/acutation) via pMDI plus spacer
- 1-5 yo → 4 puffs
- 6yo → 8 puffs
Repeat dose every 20-30mins as required for the first hour if needed (or sooner as needed)
Start O2 → titrate O2 >95%
- If no improvement (within minutes) → for transfer from non-acute settings to ED
Prednisolone (within 1st hour if no improvement or worsening symptoms) → 1mg/kg for 3-5 days
- in children 1-5yo → if mild/moderate wheezing responds to bronchodilator therapy → avoid systemic corticosteroids
Reaction following MMR vaccine?
MMR Vaccine - develop fever 7-10 days after vaccination → can last 2-3 days
fever can be associated with malaise and non-infectious rash
Lithium is associated with ______ diease? Explain what needs to be done.
lithium inhibit release thyroid T4 and T3
lithium can cause goitre and hypothyroidism
if thyroid function abnormal → still give lithium but thyroid dysfunction should be treated
TSH and AntiTPO antibody titres should be conducted prior to lithium treatment commencement
TFTs shold be reevaluated every 6-12 months for several years.
Investigations when on lithium?
Serum Lithium Concentration - 3-6 months
Serum Creatinine and Urea Concentrations - 3-6 months
Serum Sodium Concentration - assess hydration, assess hypernatraemia in patients with altered conscious state, review every 6-12 hours
TFTs - 6-12 months
Serum Calcium - 12 months
ECG
Signs of mild, moderate and severe dehydration in a child?
Mild: No Clinical Signs, Increased Thirst
Moderate: Delayed CRT >2 seconds, Increased RR, Decreased Tissue Turgor
Severe: Very delayed CRT >3 seconds, Increased RR, Signs of Shock, Mottled Skin, Deep Acidotic Breathing
Rabies Exposure? When do you need postexposure prophylaxis? what is it?
If nibbling of uncovered skin or minor scratches or abrations without beleding or anything more than this.
if less - no prophylaxis
if more - if non-immune for vaccine d0,3,7,14
if more if immune <3months - nothing
if more and if immune >3 monts -> d0 and d3 doses
Inferior FOot pain
Plantar Fascia
Calcaneal Fat Pad
PF FP
Posterior Foot Pain
Achilles Tendon Insertion
Superficial Calcaneal Bursa
Posterior Impingement of Soft Tissues/Os Trigonum in active people
Calcaneal Apophysitis - Severs Disease
Lateral Foot Pain
Lateral Ligaments of the Ankle
Sinus Tarsi
Medial Foot Pain
Tibialis Posterior Tendon and Sheath
Tibialis Posterior Insertion and Apophysis in Adolescents
What is a toddler fracture? Who gets it and why?
Occult fracture of the lower limb bones
9 months to 3 years
result of new stressors on bone due to recent and increasing ambulation
Clinical Features and Treatment of Toddlers Fracture?
Clinical Features
- vague symptoms
- refuse to weight bear
- irritable
No treatment and spontaneously heal
can have a backslab → fracture clinic in 2 weeks with X-ray
