data all Flashcards
What is a depression in the centre of the nail and what is associated with?
- Koilonychia or spoon nails. It can be as a result of issueswith the CVS, CRS, GI
- It is caused by Iron deficient - anaemia
What are white marks on the nail called and what are they associated with?
• Leukonychia – whitened nail bed – hypoalbuminemia – liver failure / enteropathy
What are 4 GI pathologies associated with clubbing?
- Malabsorption - Crohn’s disease and ulcerative colitis
- Cirrhosis, especially in primary biliary cirrhosis
- Cancer
What are 4 CVS pathologies associated with clubbing?
Any disease featuring chronic hypoxiaCongenital →
- cyanotic heart disease (most common cardiac cause)-
- Subacute bacterial endocarditis
- Atrial myxoma (benign tumor)
- Tetralogy of Fallot
What are 4 Lung pathologies associated with clubbing?
- Lung cancer, mainly non-small-cell (54% of all cases), not seen frequently in small-cell lung cancer
- BCFM → Bronchiectasis, cystic fibrosis, fibrosing alveolitis, mesothelioma
What is an autoimunne disease of the thyroid associated with clubbing and exopthalmos?
Graves disease.
- it is the most common cause of hyperthyroidism :
- irritability, muscle weakness, sleeping problems, a fast heartbeat, poor tolerance of heat, diarrhea, and weight loss.
what is exopthalmos?
Bulging eyes.
what is enopthalmos and name 2 conditions it is associated with?
- Sunken eyes. It may be a congenital anomaly, or be acquired as a result of trauma (such as in a blowout fracture of the orbit),
- Horner’s syndrome (apparent enophthalmos due to ptosis),
- Marfan Syndrome, silent sinus syndrome, or phthisis bulbi.
What is Anisocoria?
different sized pupils.
What is mydriasis?
Dilated pupils.
What is myosis?
constriction of the pupils.
What are the red line-like marks of the nail called, and what are they associated with?
Splinter haemorrhages -infective endocarditis is the main one but also:
- scleroderma
- trichinosis
- systemic lupus erythematosus (SLE)
- rheumatoid arthritis
- psoriatic nails
- haematological malignancy
- trauma.
What and where are hederden’s nodes and what are they associated with?
Osteoarthritis – nodes on the distal interphalangeal joints
What and where are bouchard’s nodes and what are they associated with?
Osteoarthritis – nodes on the proximal interphalangeal joints
What is palmar erythema?
Palmar erythema is reddening of the palms at the thenar and hypothenar eminences.
It is associated with the CVS, CRS, GI
- Peripheral vasodilation–Sepsis
- Chronic liver disease
- Portal hypertension
What are Janeway’s lesions?
Small red non-raised, non-painful lesions on the palms and fingers. Associated with cardio vascular system.
- Infective endocarditis
- Can come from previous Rheumatic fever
What are Orslers Nodes?
Small red nodes on the fingers. they are raised (nodular) and painful.
Associated with CVS.
• Infective endocarditis
What does a single transverse palmar crease signify in child development?
Downs syndrome.
In which fluid compartment is the majority of water in the body and what is its primary composition?
- Intracellular
- majority of our total body water is locked within our cells in the intracellular compartment.
- Composed of high potassium and low sodium. The gradient is maintained by Na-K ATPase.
Which is the second largest fluid compartment in the body and what is its primary composition?
- Interstitial
- bathes the cells and occupies spaces such as pleural cavity and joint spaces. It absorbs and loses fluid to intracellular and intravascular compartments.
- Composed of high sodium (135 – 145 mmol/L and low potassium (3.5 – 5 mmol/L) identical to blood, but with a lower protein content.
What are the basic requirements for sodium, potassium and fluid per day?
Basic requirements:
Sodium → 2mmols/kg/day
Potassium → 1mmol/kg/day
Fluid→ 1-1.5 mls/Kg/hour (for adults approx. 1.5-2.5 L/day)
Where can the body lose fluid?
- GI - vomiting and diarrhoea. can also loose ↑↑Na + K
- Insensible - can be as much as 500mls/day but can double in sepsis, burns, skin loss or pyrexia.
- Urine- 1ml/kg/hr
- Trauma - haemorrhage, drain, dialysis
What is a crystaloid?
Crystalloid solutions contain low molecular weight salts or sugars which dissolve completely in water and pass freely between the intravascular and interstitial compartments.
- Normal
- Saline
- Dextrose 5%
what is a colloid?
- Colloids contain larger molecular weight substances that do not dissolve completely and depending on their molecular size, structure and capillary permeability of he patient, remain for a longer period in the intravascular compartment than crystalloid solutions.
- You may need 2 – 3 times the volume of crystalloid to colloid to achieve the same vascular filling. they act as “a plasma expander in place of blood”.
- Albumin
- Hetastarch
- Dextran