Data all 2 Flashcards
What is thrombocytosis?
High platlet count >400
What are 3 causes of thrombocytosis in in primary haematological disease?
- Essential thrombocytopaenia and other mylkoproliferative disorders
- Chronic myeloid leukaemia
- myelodisplasia
name 3 causes of reactive thrombocytosis?
- infection
- inflammation
- Malignancy
- Bleeding
- Pregnancy
- Post slenectomy
Name 3 causes of thrombocytopaenia due to reduced platlet production as a result of bone marrow failure?
- Infections
- Drug induced - Penicillamine
- Leukamia
- Aplastic anaemia
- Myelofibrosis
- Bone marrow replacement
- Myelodisplasia
- megaloblastic anaemia
What is hesselbachs triangle?
Also called the inguinal triangle, it is a depression that sits medially to the ,superficial inguinal ring through which direct inguinal hernias protrude through the abdominal wall
What are the borders of the inguinal/hesselbachs triangle?
- Medially - rectus abdominus
- Laterally - the inderior epigastric artery and vein
- inferiorly - The inguinal ligament
What type of hernia comes through the inguinal canal?
an indirect hernia
name 6 types of hearnia?
- Inguinal hernia .
- Femoral hernia.
- Umbilical hernia.
- Incisional hernia.
- Epigastric hernia.
- Hiatal hernia
Name 3 causes of increased intra-abdominal pressure?
- Obesity
- Pregnancy
- Other organomegaly
- COPD/chronic cough
- Prostatism
- Constipation
- heavy lifting
If the hearnia is in the scrotum, what type of hearnia is it?
Indirect is commonly found. Rarely though, it may be a direct hearnia.
What does the following Hepatitis screen indicate?
HbsAG - Negative
Anti-HBc -Negative
Anti-HBs - Negative
It means that the individual is suceptable and needs to be vaccinated
What does the following Hepatitis screen indicate?
HbsAG - Negative
Anti-HBc -Positive
Anti-HBs - Positive
It means that they have a resolved hepatitis B infection
What does the following Hepatitis screen indicate?
HbsAG - Negative
Anti-HBc -Negative
Anti-HBs - Positive
It means that they have been vaccinated.
What does the following Hepatitis screen indicate?
HbsAG - positive
Anti-HBc -Positive
Anti-HBs - Negative
It means that they have an active chronic hepatitis B infection
What antibody is raised in primary biliary cirrohsis?
Anti-mitochondrial antibody
What are the 3 umbrella causes of acute kidney failure?
- Prerenal - sudden drop in blood pressure or interupption to blood flow to kidneys
- intrarenal - direct damage to the kidneys eg. toxins, medication, inflammation, infection
- postrenal - sudden obstruction to urineflow eg. enlarged prostate, bladder stones, bladder cancer
What is a common electrolyte imbalance associated with sarcoidosis?
Hypercalcaemia
What does trismus mean?
Difficulty opening mouth due to irritation of the muscles of mastication
Where do you insert a canula for pneumothorax aspiration?
Between the 2nd and 3rd rib, mid clavicular line.
what part of the prostate gives rise to 70-80% of prostate cancer?
Peripheral zone
Name 6 complications of diabetes mellitus?
- peripheral neuropathy
- cerebro vascular disease
- Retinopathy and blindness
- Heart attack
- permanent kidney damage
- diabetic foot infections
What are ulcers in the mouth called?
aphthous ulcer
What are the features of an arterial ulcer?
- Located on the lower legs and tops of the feet or toes
- A tendency to be painful, particularly at night
- A symmetrical shape with well-defined borders, often described as having a ‘punched-out appearance’
- Minimal bleeding when touched or knocked
- Cool, pale or bluish surrounding skin that appears shiny
- Loss of leg hair
- Faint or absent ankle pulses.
What are the features of a venous ulcer?
- Being located on the lower legs, commonly the inner ankle or ‘gaiter’ region
- Causing minimal pain
- A tendency to be shallow, with lots of exudate.
What are cullens and grey-turners signs?
Abdominal haemorrhage associated with acute pancreatitis. Cullens-central, Grey-turners-lateral
What is paresis?
Partial parlysis
What is plegia?
Complete paralysis
What is hemiplegia?
Paralysis of half the body
What is tetraplegia?
Paralysis of all 4 limbs
What is the name given to the test where a patient puts a finger on their nose and then touches the clinicinans finger held at arms length?
Dysmetria
What is the name given to the test where a patient puts the theri hand upside down on their palm and then quickly flicks it back and forth between plam and dirsal aspect?
dysdiadochokinesia
Name 3 features of cerebellar pathology?
DANISH
- Dysdiadochokinesia/dysmetria
- ataxia
- nystagmus
- Intention tremor
- slurred speach
- hypertonia
What is the gait Where one foot is ‘swung’ out and around in an arc?
What causes it?
- Hemiplegic gait
* stroke
What is a parkinsonian gait called?
a festinating gait
What is an unsteady ‘alcoholic’ gait called?
ataxic gait
What kind of gait is foot drop called?
a neuropathatic gait
What causes a neuropathic gait?
- Loss of dorsiflexion
* Common peroneal nerve palsy
What is the gait called where feet are heavily planted ‘stomped’ called?
sensory ataxia
What causes sensory ataxia?
- Diabetes
- Subacute degeneration of spinal cord
- Vitamin B12 deficiency
- Alcohol
- Drugs
Were is a chest drain inserted in a tension pneumothorax?
Mid axillary line in a trinagle formed by the border of pectoralis major, latisimus dorsi, 5th intercostal space
What kind of scar runs down the front of the chest?
What kind of surgery does it indicate?
- A median sternotomy scar.
* CABG, valve replacment
A long scar down the indside of the calf, what vein has been harvested and what surgery has it been used in?
- Great saphenoous vein
* CABG
Name 3 causes of Type 1 respiratory failure (hypoxic)?
- pneumonia
- ARDS
- Asthma
- pulmonary fibrosis
- COPD
- Pneumothorax
- PE
- Obesity
Name 3 causes of Type 2 respiratory failure (hypercapnic)?
- COPD/Asthma
- Drug overdose - Benzo’s/opiates
- CNS injury - cerebrovascular event/spinal cord injury
- Primary muscle disorders - duchens
- Neuromuscular junction disorders- MSG
What hormone changes take place during the perimenopause?
• Decreased production of oestrogen and progesterone
What test is used to assess the viability of arteries to the hands during an ABG?
Allens test
What murmur is associated with the collapsing pulse test?
Aortic regurgitation
Which artery is associated with acute cranial nerve 3 palsy?
Posterior communicating artery
What are 3 signs of base of skull fracture?
- Raccon eyes
- Battles sign - bruise behind the ear
- Haemotympanum - blood behing the tympanic membrane
Name the 3 ear bones?
• Malleus, incus, stapes
What causses dendritic corneal ulcers?
• Herpes simplex
What are holes in the urethra called?
Hypospadias
What is it called when the foreskin cant be retracted?
Phimosis
What is the emergency where a foreskin cant be retracted and it swells blocking the urethra?
Para phimosis
What are the symptoms of heartblock?
- Fainting.
- Dizziness or light-headedness.
- Fatigue (tiredness)
- Shortness of breath.
- Chest pain.
What is the medical managment of Heartblock bradycardias?
Atropine .5mg upto 3mg then subcutaneous pacing or adrenaline
What is the medical managment of ventircular fibrulation?
- VF is a shockable rhythm
* If unresponsive commence CPR, followed by AED and shock.
what are 2 differential diagnosis for a low MCV?
- Iron deficient Anaemia
* Beta thassalaemia
what are 2 differential diagnosis for a normal MCV?
- acute blood loss
* Anaemia of chronic disease
what are 2 differential diagnosis for a high MCV?
• B12 or folate
What are 2 drug causes of hyperkalaemia?
- Spironalactone
* Digoxin
What are 2 causes of hyperkalaemia related to excretion of potassium?
- Acute/chronic renal failure
* Adrenocortical insufficiency - addisons
What are 2 causes of hyperkalaemia related to compartmental shifts?
- Burns
- Trauma
- Acidosis
what is the treatment of hyperkalaemia?
- Treat underlying cause
- protect the cardiac membrane - calcium gluconate
- Shift potassium into the cells - insulin/glucose infusion
- Nebulised salbutamol
- dialysis
name 3 key ECG changes associated with Hyperkalaemia?
- Peaked T waves
- Prolonged PR interval
- Widened QRS
- Loss of P wave
- Loss of R wave amplitude
- Sine wave pattern
- Asystole
What does addisons disease do to your electrolytes?
Na↓ K↑ Ca↑
What does conns syndrome do to your electrolytes?
Na ↑ ↔ K↓
What does Cushings syndrome do to your electrolytes?
Na↑ K↓ Ca↓
What is Conns syndrome?
Hyperaldosteronism - high lvls of aldosterone and low renin- high blood pressure
What is the treatment of diabetic ketoacidosis
- give fluids
- insulin therapy
- ketone normalisation
- stablise glucose
Which structure controls heart rate?
Sino atrial node
What drug can be used on a supraventricular tachycardia?
Adenosine
What happens to the leg in a neck of fermur fracture?
Shortened, Abducted and externally rotated
What arteries supply blood to the head of the humerus?
Anterior and posterior humeral circumflex arteries
What arteries supply blood to the head of the femur?
medial and lateral femoral circumflex arteries
