Clinical Cases Flashcards
how do you define an aneurysm?
- bulging of artery that causes it to enlarge
- 1.5x
what causes an aneurysm? (4)
- cardiovascular disease
- atherosclerosis
- smoking
- trauma
why do AAAs normally appear at the bottom of the aorta and not higher up?
find it coincidentally
at which vertebral level would you palpate to examine the aortic pulse?
- L1-L5 but it bifurcates at L2
what is atherosclerosis?
narrowing of artery due to plaque
what are the main risk factors of atherosclerosis? (2)
- smoking
- high fat diet
what causes chest pain in atherosclerosis?
angina caused by reduced blood flow to the heart
what are healthy levels of cholesterol?
- 5mmol/L or less
- under 200mg
how might a myocardial infarction occur?
when blood can’t flow to the heart
what is the most common method of coronary artery bypass?
- coronary artery bypass graft (CABG)
- then stent
it is harder to diagnose pneumonia in elderly individuals compared to those under 65, why is this?
symptoms may differ
why is pneumonia particularly concerning in older adults?
comorbidities lead to weakened immune systems
how does covid-19 develop in a patient?
- immune system attacks an infection of the SARS-CoV-2 virus in lungs
- alveoli swell
- leaks fluids
how is pneumonia treated?
- antibiotics, oxygen
what is a pneumothorax?
- collapsed lung
- air fulls pleural space
what is the difference between a tension pneumothorax and a spontaneous pneumothorax?
- tension - caused from penetrating chest trauma, more you breathe the worse it gets, can cause mediastinal shift
- spontaneous - no real cause, blebs just ruptur
what are the common causes of a pneumothorax? (5)
- chest pain
- tachycardia
- history of trauma
- cyanosis
- low BP
which lifestyle choices lead to gastric ulceration? (5)
- smoking
- medication
- spicy food
- stress
- alcohol
which symptoms would be experienced after eating with a gastric ulcer vs duodenal ulcer?
- eating improves pain of duodenal ulcer but worsens pain of gastric ulcers
what causes blood and ‘grit’ in vomit?
- ulcer bleeding
- digested blood that looks like coffee grounds
why does a patient with gastric ulcers have to attend regular endoscopies?
to check the ulcer has healed
how is a colonoscopy performed?
- long, thin tube with a camera on the end inserted up rectum and into stomach
- allows doctors to clearly see the inside of your colon
what anatomical feature has been lost with a patient demonstrating a ‘lead pipe colon’?
Haustre
what impact might have UC have on a patient’s life? (3)
- pain
- toilet more frequently
- j-pouch can lead to fertility problems
what is a J-pouch? What else can be offered for UC?
- colon and rectum removed and small intestine attached to form passage and rectum
- medications
what might cause swelling in the abdomen and feet/ankles?
- body attempts to compensate for this pressure by diverting blood flow into other veins
why does the skin and eyes appear yellow in cirrhosis & portal hypertension?
- excess bilirubin in blood
what can portal hypertension result in?
- splenomegaly
- caput medusae
what is splenomegaly and caput medusae?
- splenomegaly- enlarged spleen
- caput medusae- distended and engorged paraumbilical veins, which are seen radiating from the umbilicus across the abdomen
what would happen if a patient continued drinking alcohol with liver cirrhosis?
- need a liver transplant
what is the difference between a rectocele, cystocele and uterine prolapse?
- all caused by weakening of the pelvic floor muscles
- rectocele - rectum protrudes into vaginal wall
- cystocele - bladder drops from normal position into vaginal wall
- uterine prolapse - uterus drops from normal position to vaginal wall
what are the risks and benefits involved with a midline episiotomy? (3)
- less bleeding
- less pain
- increased risk of perineal body damage
how does a midline episiotomy compare to a mediolateral episiotomy?
- medio-lateral is at a 45 angle
- less risk of damage to perineal body
- more painful and bleeding
how are pelvic organ prolapses prevented and treated? (5)
- lifestyle changes
- pelvic floor exercises
- hormonal treatment
- vaginal pessaries
- surgery
what is epididymitis?
- a tube (epididymis) at the back of the testicles become swollen and painful
- caused by infection
- treated with antibiotics
what is the route of infection from the tip of the penis to the epididymis? (6)
- spongy urethra
- membranous uretha
- prostatic urethane
- through hole into ejactulatory duct
- vas deferent
- epididymis
why are UTI’s less common in men compared to women?
- men have longer, thinner urethra that is further from the rectum
what is a differential diagnosis?
- when symptoms match more than one condition and additional tests are necessary before making an accurate diagnosis
how would you determine if a patient has epididymitis and not testicular torsion? (3)
- blood tests
- bacterial culture of urine
- testicular torsion is more acute onset
what is cancer?
- disease caused when cells divide uncontrollably and spread into surrounding tissues
what is the difference between radiotherapy and chemotherapy?
- radiotherapy is a treatment where radiation is used to kill cancer cells
- chemotherapy is a cancer treatment where medicine is used to kill cancer cells
explain why difficulty urinating is a symptom of prostate pathology
- you might get urinary problems if the cancer is pressing on your urethra or has spread around the prostate eg. urethra & bladder
what is locally advanced prostate cancer?
- cancer that has started to break out of the prostate, or spread to the area just outside the prostate
how does locally advanced prostate cancer differ from ‘normal’ prostate cancer and advanced prostate cancer?
- advanced cancer has spread outside the prostate to other parts eg. lymph nodes, bones, liver, lungs
- normal hasn’t spread yet
what is a prostatectomy and what are the consequences?
- surgical procedure for the partial or complete removal of the prostate
- may cause erectile dysfunction or incontinence
