Cards Flashcards
what are the side effects of tamsulosin
dizziness and postural hypotension
how can you catergorise urinary symptoms
voiding symptoms
storage symptoms
post- micturition
what are the management options for BPH
watch and wait alpha 1 antagonists 5 alpha reductase inhibitors combination therapy TURP (transurethral resection of the prostate)
what class of drug is tamsulosin and alfuzosin
alpha one antagonist
how does tamsulosin work
decreases smooth muscle tone of the prostate and bladder
what class of drug is finasteride
5 alpha reductase inhibitor
how does finasteride work
blocks the conversion of testosterone to DHT which induces BPH
this can reduce the size of the prostate
what are the side effects of finasteride
erectile dysfunction, reduced libido, ejaculation problems
increases PSA levels
how is pre eclampsia prevented in at risk women
aspirin 75mg from 12 weeks
discribe BP changes during pregnancy
blood pressure falls in the first trimester until 20 weeks
after this BP usuallly increases to pre pregnancy levels
how is hypertension in pregnancy usually defined
140/90
or an increase from normal of over 30
what is pregnancy induced hypertension
hypertension in the latter half of pregnancy
no proteinuria or oedema
increased risk of pre eclampsia or hypertension
what is pre eclampsia
pregnancy induced hypertension with proteinuria
may also be oedema
what are the features of papilloedema
venous engorgement
blurring of the optic disc margin
elevation of the optic disc
loss of optic cup
what are the causes of papilloedema
SOL malignant hypertension intercranial hypertension hydrocephalus hypercapnia
what is the most common cause of travellers diarrhoea
e coli
what are the symptoms of giardia lamblia
watery non bloody diarrhoea bloating apyrexial dry mucous membranes lethargy malabsorption
how do you treat giardiasis
metronidazole
what are the features of MND
upper and lower motor neurone signs
- fasculations
- no sensory signs
- mixture of UMN and LMN
- wasting of small hand muscles
- no cerebellar signs
what are the features of C diff
usually occurs after prolonged antibiotic use in in patients
gram postive
treat with metronidazole or vancomycin
What organism causes pseudomembranous colitis
c diff
what are the features of c diff
diarrhoea
abdo pain
raised white cell count
toxic megacolon
what is thumb printing a sign of
bowel inflammation
what does QDS mean
four times a day
what are some features of GORD
delayed gastric emptying (40%)
impaired oesophageal clearance of refluxed acid
presence of columnar epithelium
what causes prothrombotic tendency in nephrotic syndrome
loss of antithrombin 3 in the urine
increased plasma conc of fibrinogen
increased plasma conc of factors 5, 7, 8, 10
increased risk of developing renal vein thrombosis
what is nephritic syndrome
inflammation of the kidneys (glomerulus), with blood in the urine
what are the signs and symptoms of nephritic syndrome
haematuria proteinuria hypertension blurred vision azotemia oligouria
what are some causes of nephritic syndrome
post strep glomerulonephritis haemolytic uraemic syndrome goodpastures syndrome SLE infective endocarditis
what are the signs of nephrotic syndrome
protein in the blood low albumin levels swelling anasarca (dropsy) hyponatraemia
what is anasarca aka dropsy
extreme generalised oedema
what is mass effect
a growing mass (eg cancer or haematoma) that causes symptoms by pushing on or displacing surrounding tissues
what is paraneoplastic syndrome
a syndrome caused by humoural factors released by a neoplasm or an immune response to that neoplasm
what cancers commonly have associated paraneoplastic syndromes
lung
breast
ovaries
lymphatic system
what is a lymphoma
cancer of lymphocytes
what is the defining feature of Hodgkins lymphoma
reed sternberg cell
what are lymphocytes
NK cells, T cells and B cells
main cell type found in lymph
Diabetes insipidus
not enough ADH
polyuria and polydipsia
SIAHD features
too much ADH
oligouria
causes of SIADH
too much release from posterior pituitary gland
release from an inappropriate source (eg a small cell lung cancer)
what are the symptoms of a SVC obstruction
SOB
dilated chest wall veins
facial swelling
plethora
why is albumin a good marker of liver function
only produced by hepatocytes
what LFT is raised in billiary disease
ALP
due to it being synthesised in the biliary tree
what pathology would you find unconjugated bilirubin
pre hepatic jaundice
what pathology would you find conjugated bilirubin
hepatic or post hepatic jaundice
what pathology would you find an elevated prothrombin time
vitamin K deficiency
when would you request a group and save
elective surgery
involves identifying the blood group and cross matching for antibodies
what ECG signs would you expect with hypertension
left ventricular hypertrophy shown by tall R waves in leads V5-6 and deep S waves in leads V1-2.
what is Conn’s
primary hyperaldosteronism - salt and water retention with hypokalaemia
what causes Conn’s
adrenal adenoma or bilateral adrenal hyperplasia
where are phaeochromocytomas found
adrenal medulla
- headaches
- sweating
- palpitations
- weight loss
- tremours
what are the causes of phaeochromocytomas
MEN2
Von Hippel Lindau syndrome
NF1
what is Von Hippel Lindau syndrome
autosomal dominant angiomatosis
what are the features of familial hypercholesterolaemia
autosomal dominant condition due to mutation in the LDL receptor, causing elevation of LDL
increased risk of coronary artery disease
abnormal extension (2)
decerebrate rigidity
abnormal flexion (3)
decorticate rigidity
what arteries supply blood to the lung parenchyma
bronchial arteries from descending aorta
where do bronchial veins drain to
pulmonary vein
what does the ductus arteriosis connect
pulmonary artery to the aortic arch
what is the function of the DA
allows blood from the right ventricle to bypass the fetus’ lungs
what is erythema nodusum
tender red nodules usually seen on the shins
inflammation of the fat cells
what are some causes of erythema nodusum
TB mycoplasma pneumoniae EBV IBD sarcoidosis cancer
what are some signs and symptoms of sarcoidosis
fatigue SOB weight loss erythema nodudosum hilar lymphadenopathy hypercalcaemia
