Deck 2 Flashcards
What are ESBLs?
Extended-spectrum beta lactamases - bacteria that are resistance to penicillins and cephalosporins
Why do loop diuretics cause hypocalcaemia?
The triple transporter in the ascending limb of the loop of Henle will absorb Na+ /K+/2Cl-. Na+ and 2CL- will be reabsorbed whilst K+ diffuses back into the tubule. This creates an electrochemical gradient (more positive in lumen, more negative in interstitium). Ca2+ will then flow down this gradient.
Blocking the triple transporter with loop diuretics will stop this effect and more calcium will be excreted in the urine.
What effect do thiazide diuretics have on calcium?
Thiazide promote calcium reabsorption (thereby causing hypercalcaemia).
NOTE: loop diuretics cause hypocalcaemia
What is atelectasis and what causes it?
Incomplete expansion of the lungs
It can be caused by anything that can reduce ventilation of airspaces (e.g. obesity, anaesthesia during surgery, mucus plug)
NOTE: it can cause hypoxia and increased risk of infection
Which bits of the brain are particularly affected by alcohol excess?
Cerebellum
Frontal lobe
Limbic System
What is bigeminy?
Repeated heart beat pattern (one long then one short) that is most often due to ectopic beats occurring so frequently that it happens after each sinus beat.
It does not require treatment unless it is symptomatic (then use beta-blockers)
What is trigeminy?
Ventricular ectopic occurs every third beat
What is a Premature Ventricular Contraction?
Heartbeat is initiated by the Purkinje fibres in the ventricles by the sinoatrial node
What does bifascicular block look like?
RBBB + left or right axis deviation
What does trifascicular block look like?
RBBB + left or right axis deviation + PR prolongation
List and give examples for the classes of antiarrhythmics.
Class 1 (Sodium Channel Blocker) - 1a: Quinidine, Procainamide, Disopyramide, Ajmaline - 1b: Lidocaine, Mexiletine, Phenytoin - 1c: Flecainide, Propafenone Class 2 (Beta-Blocker): bisoprolol Class 3 (Potassium Channel Blocker): amiodarone Class 4 (Calcium Channel Blockers): verapamil
What are the AEIOU indications for haemofiltration?
Acidosis Electrolyte Abnormalities (hyperkalaemia) Ingestion of Toxins Overload (Fluid) Uraemic Symptoms
What effect does multiple units of packed red cells have on coagulation?
It leads to an anticoagulant effect (as the packed red cell samples contain anticoagulant (calcium citrate))
This means that patients should also receive FFP if they have any more than 4 units of packed red cells
How does mycobacterium avium complex present in patients who are immunocompromised?
Similar to lymphoma Enlarged lymph nodes Fever Night sweats Weight loss
What is an advantage of RIG over PEG?
RIG does not require sedation and hence is better in patients with respiratory compromise (e.g. MND).
What is the main consequence of heparin-induced thrombocytopaenia?
Thrombosis
The binding of heparin to platelet factor 4 stimulates the generation of antibodies. These antibodies then bind to the heparin-platelet factor 4 complex and causes platelet activation resulting in thrombosis formation and depletion of platelets.
What does right ventricular strain look like on an ECG?
ST depression and T wave inversion in V1-3, I, II and aVF
How do you convert oral codeine to oral morphine?
10 mg codeine = 1 mg morphine
NOTE: breakthrough pain should be 1/6 of the total daily dose of morphine
Which organism is associated with causing infective endocarditis in patients with colorectal cancer?
Streptococcus bovis
What is the first-line treatment option for pericarditis?
NSAIDs and colchicine
