cr rogues Flashcards
familial hypercholesterolaemia?
total HDL/LDL >7.5mmol
PH/FH of premature CHD or event
tendon xanthoma
familial hypercholesteraemia management?
refer to lipid clinic high dose statins stop 3 months before conception/congenital defects family screen - autosomal dom for children 10yrs, if both parents 5yrs
Polycythaemia vera
myeloproliferative disorder
increase in red cell volume, neutrophils, platelets
Polycythaemia vera features
hyperviscosity, pruritus, splenomegaly
can progress to myelofibrosis, acute leukaemia
clot risk!
Polycythaemia vera management?
aspirin - thrombosis risk
venesection - keep Hb normal
chemo - hydroxyurea
Post-thrombotic syndrome
6 months 2 years after initial DVT
chronic venous hypertension
chronic pain, swelling, hyperpigmentation, venous ulcers
Post-thrombotic syndrome mmgt?
compressions stockings - improve blood flow/reduce symptoms.
Myelofibrosis findings ???
tear drop - poikilocytes on blood film
anaemia
high WBC and platelet count early in the disease
unobtainable bone marrow biopsy - dry tap
high urate and LDH - increased cell turnover
multiple myeloma
hypercalcaemia
immune thrombocytopenia purpura
immune-mediated reduction in platelets
ABs against glycoprotein IIb/IIIa or Ib-V-IX
immune thrombocytopenia purpura presentation
petichae, purpura
bleeding (epistaxis)
catastrophic bleeding
immune thrombocytopenia purpura mmgt?
oral prednisolone
IV Ig
Desmopressin
synthetic vasopressin /ADH
stimulates VWF release from WP bodies (endothelial)
sickle cell - fall in Hb?
Aplastic crisis
infection with parvovirus
Angina not controlled by beta-blocker
calcium channel blocker - nifedipine
Angina - on a BB, cannot tolerate a CCB?
what do you add?
a long-acting nitrate
ivabradine
nicorandil
ranolazine
Nicorandil
K channel activator
vasodilates coronary arteries
SE: headache, flushing, anal ulceration
unprovoked pulmonary embolisms mgmt?
6 months - DOAC apixaban, rivaroxaban
if not LMWH followed by dabigatran or edoxaban
LMWH followed VKA (warfarin)
DOACs
dabigatran, rivaroxaban, apixaban, edoxaban
blocks single factor
Pulseless electrical activity & asystole
non-shockable - unresponsive to defibrillation 1mg IV adrenaline 2 mins CPR rinse, repeat treat cause
suspected DVT?
ultrasound
D-dimer & interim anticoagualtion - DOAC
continue if +ve
cause of VT
monomorphic - MI
poly - hypokalaemia, long QT
