Deck 3 Flashcards
How does TRALI present?
Hypoxia
Bilateral pulmonary infiltrates
Fever
Hypotension
NOTE: it is caused by the activation of host neutrophils by substances in the blood products. This triggers an inflammatory reaction within the lungs.
Which drugs increase the risk of gout?
Alcohol Diuretics Cytotoxics Ciclosporin Pyrazinamide
List some triggers for psoriasis.
Beta-blockers
Antimalarials
Stress
Streptococcal infection (guttate)
What is an indium labelled white cell study used for?
It labels white cell and watches where they accumulate (a bit like a PET scan for infection)
It is good for identifying occult abscesses
What pleural fluid results would you expect in a patient with empyema?
pH < 7.2
Glucose < 3.3 mmol/L
LDH > 1000
How do aminophyllines work?
Non-selective phosphodiesterase inhibitor (raises cAMP –> activate PKA –> inhibits TNF-alpha and leukotriene synthesis)
Non-selective adenosine receptor antagonist
NOTE: end result is bronchodilator
What are the presenting features of cerebral venous sinus thrombosis?
Headache
Papilloedema
Tonic Clonic Seizures
NOTE: MR or CT angiography/venography is required for diagnosis, and it is treated with anticoagulation
How does Whipple’s disease manifest?
Diarrhoea and arthropathy
Can also cause lymphadenopathy, skin hyperpigmentation, pleurisy and pericarditis
Duodenal biopsy shows subtotal villous atrophy which is PAS stain positive (caused by Tropheryma whipplei)
It is treated with oral co-trimoxazole
What is the first-line treatment option for gout?
NSAIDs
Colchicine 500 mg QDS can be used if NSAIDs are contraindicated (NOTE: reduced dose of 500 mg BD can be used in patients with renal impairment)
What is juvenile myoclonic epilepsy?
Condition characterised by generalised tonic clonic seizures usually provoked by sleep deprivation and excessive alcohol intake
Which common class of medications reduce excretion of lithium?
Diuretics (in particular, thiazide diuretics)
What is the cardiac index?
A haemodynamic parameter measured in intensive care which divides cardiac output from the left ventricle in one minute by the total body surface area
Low cardiac index is suggestive of cardiogenic shock
What are the typical presenting features of inclusion body myositis?
Weakness of quadriceps and long muscles of fingers
CK may be normal
What is Waldenstrom’s macroglobulinaemia?
A lymphoproliferative disorder characterised by IgM paraproteinaemia
It can result in hyperviscosity and splenomegaly
Which nerve root is responsible for the biceps reflex?
C56
Therefore, damage to this root will result in Erb’s palsy (loss of abduction and loss of biceps-mediated supination)
What is Liddle syndrome?
A secondary cause of hypertension resulting from a mutated epithelial sodium channel
Results in hypertension, alkalosis and hypokalaemia with suppressed renin and aldosterone.
What are the main features of dengue fever?
Fever, muscle aches, headache, rash
Lymphopaenia, Thrombocytopaenia and deranged LFTs
Which mutation is most often responsible for MODY?
Hepatic Nuclear Factor 1A (HNF1A)
NOTE: MODY presents in early adulthood with insulin-dependent diabetes mellitus (autosomal dominant) - they are very sensitive to sulphonylureas
When should phenytoin levels be checked after oral loading?
In roughly 2 weeks as phenytoin has a long half-life and therefore takes time to reach steady state concentrations
Aim 10-20 mg/L
What are the main functions of the proximal convoluted tubule?
Reabsorb sodium, amino acids and glucose
Exchange H+ ions for bicarbonate (reabsorb bicarbonate)
