ANKI - all systems Flashcards
What is complex Regional Pain Syndrome characterised by?
PORT
P ain
O edema + sudomotor
R educed ROM
T emperature + colour changes
- disproportionate to the inciting event
- aggravated by activity
Uses of Acyclovir?
- Extrememly acive against HSV and VZV
- IV form used to treat severe cases (Herpes encephalitis, VZV pneumonitis)
- Oral form can be used to treat cold sores caused by HSV reactivation
What is non-union when referring to fracture healing?
no further progress towards union (“established nonunion”)
What % of dupuytren’s cases are sporadic?
30%
Describe atrophic non-union?
gap at # site due to either bone loss, soft tissue interposition or pathological bone (infection, tumour, AVN, etc.)
When is valproic acid often used in the place of Lithium?
- rapid cycling patients (females>males)
- comorbid substance issues
- mixed patients
- Patients with comorbid anxiety disorders
- Better tolerated than Lithium
inflammatory diarrhoea aetiology?
bacterial infection, amoebic infection
Investigations for Tuberculous osteomyelitis? name 4 things
- FBC, ESR
- Mantoux test
- Sputum/urine culture
- Xray -soft tissue swelling
periarticular osteopenia
articular space narrowing
5.Joint aspiration and biopsy
AAFB identified in 10-20%
culture +ve in 50% of cases
What causes symptoms in cubital tunnel syndrome?
1.Fibro-osseous tunnel posterior to medial epicondyle tightness develops that compresses nerve
More with elbow bent
management of delirium tremens
- diazepam
- chlordiazepoxide
this should be done AFTER
- admit the patient and correct the electrolyte imbalances/dehydration
- treat comorbidities
- give parenteral thiamine slowly and carbamazepine or phenytoin if there is a previous history of withdrawal fits
Clinical features of multiple myeloma? - say 6 things
- Bone pain and lytic lesions
- Anaemia
- recurrent infections
- renal failure
- amyloidosis
- bleeding tendency
- hyperviscosity syndrome
Treatment of rickettsiosis?
tetracycline
Uses of terbinafine?
- Active primarily against dermatophytes
- Clinical use restricted to dermatophyte infections of the skin and nails
- Mild infections treated topically, while more serious infections are treated orally
examinations performed for women with bladder/pelvic floor problems?
- General
- Abdominal
- Neurological
- Gynaecological
- Pelvic floor assessment (Oxford Scale)
what is labour?
- normal physiological process by which fetus membranes, placenta and umbilical cord are expelled from the uterus
women who have never had a baby before, what is the normal delivery time?
12-18 hours
what is normal delivery time of labour in women who have had babies before?
6-8 hour
what physiological processes can resemble labour?
- prelabour ruptured membranes
- Braxton Hicks - contractions but not contractions strong enough to be labour
- Show - mucus plug that protects baby will be expelled before labour
what brings about contractions intracellularly?
increase in intracellular free calcium
this is caused by
- oxytocin
- prostaglandins
- how many stages of labour are there?
2. describe them
- 3
- first stage: from start of regular contractions till the cervix is fully dilated
second part is from full dilation of cervix to delivery of fetus
third stage is from delivery of fetus to the delivery of the placenta and then umbilical cord
how many contractions are needed to labour effectively
in order to labour effectively - 4 strong contractions lasting at least 40 seconds in 40 seconds.
what are some indications for inducing labour?
if safer for baby and mother PET post dates (7 days over term) diabetes (increased baby size and high risk of still-birth), cardiovascular problems changes to medications fetal reasons (growth concerns)
how do you induce labour
give prostaglandins for ripening of cervix
amniotomy to rupture membrane
oxytocin will induce contractions and strengthen them
when might it not be advised to induce labour?
- obstruction
- malpresentation (oblique)
- cardiac conditions (but will probably be discussed prior with GP)
- history of uterine rupture (may not be able to support baby)
how long should the third stage of delivery last (safely)
an hour
what is PPH (postpartum haemorrhage)
blood loss following delivery of 500ml up to 24 hours after birth
secondary is same but 6 weeks
causes of postpartum haemorrhage
- coagulopathy
- traumatic tears - episiotomy etc
- uterine atony
- retained tissue or placenta - placenta praevia
- endometritis
