Dr Osama Flashcards
What is the primary symptom associated with motor weakness?
Weakness in muscle strength
Motor weakness can manifest as difficulty in performing movements or tasks that require muscle strength.
What are the diagnostic categories for differential diagnosis of weakness?
- Genetic
- Inflammatory
- Infectious
- Neoplastic
- Toxic/drug
- Metabolic/endocrine
These categories help in identifying the underlying causes of motor weakness.
Name a condition associated with upper motor neuron lesions.
Amyotrophic lateral sclerosis
This condition is characterized by the degeneration of motor neurons.
What is a common infectious cause of motor weakness?
Guillain-Barre syndrome
This syndrome is an autoimmune condition that can lead to rapid muscle weakness.
Fill in the blank: A deficiency in _______ can lead to motor weakness.
Vitamin B12
Vitamin B12 deficiency can cause neurological issues, including weakness.
Which site of lesion is associated with spinal muscular atrophy?
Anterior horn cell
Spinal muscular atrophy is characterized by the degeneration of motor neurons in the anterior horn.
What is the grading scale for muscle strength where 0 denotes no contraction?
0: No contraction
The muscle strength grading scale ranges from 0 to 5, with 5 indicating normal strength.
What type of onset is associated with acute vascular events like ischemic stroke?
Abrupt onset
Symptoms may develop suddenly in cases of acute vascular events.
Which condition is characterized by fluctuating or relapsing motor weakness?
Myasthenia gravis
Myasthenia gravis is a neuromuscular disorder that leads to varying degrees of weakness.
True or False: Polymyositis is a type of muscular dystrophy.
False
Polymyositis is an inflammatory condition affecting the muscles, distinct from muscular dystrophies.
List two metabolic conditions that can cause motor weakness.
- Hypothyroid
- Hypoglycemia
These metabolic disorders can impact muscle function and strength.
What is the primary effect of lead poisoning on muscle function?
Motor weakness
Lead poisoning can cause neurological damage leading to weakness.
Fill in the blank: The approach to diagnosing muscle weakness includes determining if it is true muscle weakness or _______.
fatigue
Distinguishing between actual weakness and fatigue is crucial for diagnosis.
What is the significance of ‘fatigability’ in motor weakness assessment?
Worsening motor weakness with repeated muscle contraction
Fatigability is a key indicator of neuromuscular junction diseases.
Name one neoplastic condition that can cause motor weakness.
Brain tumor
Neoplastic conditions can affect muscle strength through direct compression or other mechanisms.
What is the muscle strength grading score for active movement against gravity?
3
This indicates a moderate level of strength where movement is possible but not against resistance.
What type of drug exposure can lead to motor weakness?
Organophosphate poisoning
Organophosphates are toxic chemicals that can disrupt neuromuscular function.
Fill in the blank: A slowly progressive onset of weakness may suggest _______.
Peripheral neuropathies and myopathies
These conditions typically lead to gradual muscle weakness over time.
What is the pattern of loss associated with proximal muscle weakness?
Symmetrical
Proximal muscle weakness can indicate conditions such as myopathy and myositis.
What are the two types of muscle weakness mentioned?
- Myopathy and myositis
- Peripheral neuropathy
These terms refer to different underlying conditions affecting muscle function.
What does UMNL stand for?
Upper Motor Neuron Lesion
This type of lesion affects motor pathways in the brain and spinal cord.
What does LMNL stand for?
Lower Motor Neuron Lesion
This type of lesion affects motor neurons in the peripheral nervous system.
Name the types of paralysis associated with UMNL.
- Monoplegia
- Hemiplegia
- Paraplegia
- Quadriplegia
These classifications indicate the extent and location of paralysis.
What are some features of UMNL?
- Hypertonia (spasticity or rigidity)
- Hyperreflexia
- Positive pathological reflexes (e.g., Babinski sign)
- Absent cortical sensation
These features help differentiate UMNL from LMNL.
What are some features of LMNL?
- Hypotonia
- Hyporeflexia
- Negative pathological reflexes
- Present flexor response
These characteristics are indicative of lower motor neuron involvement.
What are the types of quadriplegia?
- Quadriplegia
- Hemiplegia
- Diplegia
- Triplegia
These terms describe different patterns of paralysis affecting limbs.
What is the significance of the plantar reflex?
It is a pathological reflex used to assess the integrity of the corticospinal tract.
A positive Babinski sign indicates potential UMNL.
What structures are affected in UMNL?
- Cerebrum
- Cerebellum
- Brain stem
- Spinal cord
These areas are involved in motor control and reflex activity.
What types of muscle weakness can be distinguished based on location?
- Proximal (myopathy)
- Distal (neuropathy)
This distinction helps in diagnosing the underlying condition affecting muscle strength.
Fill in the blank: A positive Babinski sign indicates _______.
[Upper Motor Neuron Lesion]
This is a key indicator used in neurological examinations.
True or False: Hyperreflexia is a characteristic of LMNL.
False
Hyperreflexia is associated with UMNL.
What is the typical presentation of peripheral sensation in LMNL?
Decreased
This reflects the impairment of sensory nerves in lower motor neuron conditions.
What are the types of LMNL?
Distribution, Fasciculation, Reflexes, Sensory signs and symptoms, Neuropathy, Myopathy
LMNL stands for Lower Motor Neuron Lesions.
In neuropathy, how does the distribution of symptoms manifest?
Distal > proximal > May be present
This indicates that symptoms are more pronounced in the distal regions of the limbs.
In myopathy, how does the distribution of symptoms manifest?
Proximal > distal
This indicates that symptoms are more pronounced in the proximal regions of the limbs.
What reflexes are typically present in neuropathy?
Diminished
Reflexes may be decreased due to nerve damage.
What reflexes are typically present in myopathy?
Absent
Reflexes are usually not present in myopathy.
What sensory signs and symptoms are associated with neuropathy?
May be present
Sensory abnormalities can occur, but are not always evident.
What sensory signs and symptoms are associated with myopathy?
Absent
Myopathy typically does not exhibit sensory disturbances.
What are some associated findings with absent reflexes?
Peripheral neuropathy, e.g., Guillain-Barré syndrome
This condition is characterized by rapid onset muscle weakness and may affect reflexes.
What are the implications of bladder dysfunction and loss of motor power?
Spinal cord lesion
These symptoms suggest an issue in the spinal cord affecting motor control.
What symptoms indicate a brain stem lesion?
Bulbar symptoms (diplopia, dysarthria, dysphagia)
These symptoms suggest involvement of cranial nerves originating from the brain stem.
What laboratory investigations are commonly performed?
- Serum electrolytes, calcium, magnesium, phosphate
- Creatine kinase, Aldolase, lactate dehydrogenase, serum aminotransferases
- Thyroid stimulating hormone
- Muscle biopsy in unexplained myopathy
- Antinuclear antibodies (ANA)
These tests help identify metabolic and autoimmune conditions affecting muscles.
What are myositis specific antibodies used for?
To diagnose specific types of myositis
These antibodies can help differentiate between various inflammatory myopathies.
What diagnostic tests are used to assess nerve function?
Nerve conduction velocity (NCV) and EMG
These tests evaluate the electrical activity of muscles and the conduction speed of nerves.
What tests assess respiratory function?
Respiratory function test
This test evaluates the effectiveness of breathing and lung function.
What imaging studies can be utilized for brain evaluation?
- CT brain
- MRI brain
These imaging techniques help visualize structural abnormalities in the brain.
What condition is associated with hydrostatic pressure in the context of heart failure?
Cardiac edema
Cardiac edema is a result of increased hydrostatic pressure due to heart failure, leading to fluid accumulation.
What causes renal failure and glomerulonephritis (GN) related edema?
Retention of water and salts
Renal failure and GN lead to the body’s inability to excrete water and salts, resulting in edema.
What is the effect of liver cirrhosis on fluid retention?
Salt & water retention
Liver cirrhosis causes fluid retention due to disrupted normal liver function.
What is the threshold level of albumin that indicates oncotic pressure issues?
Albumin < 2.5 gm/dl
Low albumin levels can lead to various forms of edema due to decreased oncotic pressure.
What is nutritional edema caused by?
Malnutrition
Insufficient protein intake can result in nutritional edema due to low oncotic pressure.
What can lead to GIT edema?
Malabsorption
Conditions that impair nutrient absorption in the gastrointestinal tract can result in edema.
What results from liver cell failure in terms of edema?
Hepatic edema
Liver dysfunction can lead to inadequate albumin synthesis, causing fluid retention.
What is nephrotic syndrome associated with?
Loss of protein in kidney
Nephrotic syndrome leads to significant protein loss through urine, resulting in edema.
What causes protein losing enteropathy?
Loss of protein in GIT
This condition involves excessive protein loss through the gastrointestinal tract, leading to edema.
What type of edema is associated with allergic reactions?
Allergic edema
Allergic reactions can cause an increase in capillary permeability, leading to fluid accumulation.
What are the triggers for inflammatory edema?
Trauma, thermal burn, infection
Inflammatory processes increase capillary permeability, contributing to edema.
What are the effects of histamine, bradykinin, and cytokines on capillaries?
Vasodilation
These substances cause vasodilation, increasing capillary permeability and potentially leading to edema.
What causes lymphedema?
Lymphatic obstruction
Conditions such as tumors or filarial infections can block lymphatic drainage, leading to lymphedema.
What is the characteristic feature of myxedema?
Puffiness of eyelids
Myxedema is associated with hypothyroidism and results in non-pitting edema, particularly around the eyes.
What are some causes of localized edema?
DVT, vascular insufficiency, tumor, lymphedema, trauma, infection, thermal injury, allergy
Localized edema can arise from various conditions affecting blood and lymphatic flow.
What is the definition of edema?
Excess interstitial fluid
Edema occurs when there is an accumulation of fluid in the interstitial spaces of tissues.
What are the main factors affecting fluid movement in capillaries?
• Hydrostatic pressure
• Oncotic pressure
• Capillary permeability
• Lymphatic obstruction
These factors influence how fluids are filtered and reabsorbed in the capillary system.
What is the total body weight percentage of fluids in males?
60%
This percentage indicates the proportion of body weight that is made up of fluids.
What percentage of total body fluids is intracellular fluid (ICF)?
2/3
Intracellular fluid makes up the majority of the body’s fluid volume.
What percentage of total body fluids is extracellular fluid (ECF)?
1/3
Extracellular fluid includes interstitial fluid and plasma.
What is the net filtration pressure at the arterial end of a capillary?
+10 mm Hg
This positive value indicates that fluid exits the capillary into the interstitial space.
What is the net filtration pressure at the venous end of a capillary?
-7 mm Hg
This negative value indicates that fluid re-enters the capillary from the interstitial space.
At the mid-capillary, what is the condition of fluid movement?
No net movement of fluid
This occurs when hydrostatic pressure equals osmotic pressure.
Fill in the blank: The percentage of plasma in extracellular fluid is _______.
25%
Plasma is a component of extracellular fluid.
True or False: Lymphatic obstruction can lead to edema.
True
Lymphatic obstruction prevents the drainage of excess interstitial fluid, contributing to edema.
What defines a hypertensive emergency?
BP > 180/120
Immediate reduction of BP is necessary except in cases of ischemic stroke and acute renal failure.
List the symptoms associated with a hypertensive emergency.
- Stroke Symptoms
- Agitation/Delirium
- Head Injury
- Hyperadrenergic
- Visual Disturbance
- Papilloedema
- Flame Haemorrhages
- Eclampsia
- Chest Pain
- Myocardial Ischaemia
- Acute Kidney Injury
- Dyspnoea
- Pulmonary Oedema
- Back Pain
- Aortic Dissection
What is resistant hypertension?
Uncontrolled BP despite use of three or more antihypertensive drugs.
What should be ruled out when diagnosing resistant hypertension?
Pseudoresistance.
What factors may indicate secondary hypertension?
- Age less than 30
- Age more than 50
- Resistant HTN with failure of ≥ 3 drugs
True or False: It is safe to immediately reduce blood pressure in all cases of hypertensive emergency.
False
Exceptions include ischemic stroke and acute renal failure.
Fill in the blank: Resistant hypertension is defined as uncontrolled BP despite the use of _______ antihypertensive drugs.
[three or more]
What lifestyle change is recommended to manage stress?
Reduce stress
Stress management techniques may include mindfulness, exercise, and relaxation strategies.
What should be done regarding smoking for blood pressure management?
Stop smoking
Smoking cessation can significantly improve cardiovascular health.
What is the recommendation for alcohol consumption?
Limit alcohol
Excessive alcohol intake can contribute to high blood pressure.
How often should one exercise to manage blood pressure?
Regular exercises
Physical activity helps maintain a healthy weight and reduces hypertension.
What type of diet is recommended to combat a high salt intake?
Low salt diet
A healthy diet should focus on reducing sodium to lower blood pressure.
What dietary change is suggested for hypercholesterolemia?
Low fat diet
Reducing saturated fats can help manage cholesterol levels.
What should be maintained to address obesity?
Maintain healthy weight
Weight management is crucial for overall health and blood pressure control.
What is an example of an ACE inhibitor?
Captopril (Capoten)
ACE inhibitors help relax blood vessels and lower blood pressure.
What is an example of an ARB?
Losartan
ARBs are used to manage hypertension by blocking the effects of angiotensin II.
What is a common calcium channel blocker (CCB)?
Verapamil
CCBs help to lower blood pressure by relaxing the heart and blood vessels.
What type of medication is propranolol?
Beta blocker
Beta blockers reduce heart rate and lower blood pressure.
What type of diuretics are commonly used?
Thiazides + Loop diuretics
Diuretics help the body eliminate excess salt and water to lower blood pressure.
What are direct vasodilators used for?
Hydralazine + Nitroprusside
These medications help to relax blood vessels directly, lowering blood pressure.
Fill in the blank: _______ is a lifestyle change that involves reducing sodium intake.
Low salt diet
True or False: Regular exercise can help manage blood pressure.
True
What is the initial investigation for all hypertensive patients?
Urinalysis, serum creatinine, and urea or estimated GFR
Additional tests include electrolytes, blood glucose, lipid profile, and ECG.
What laboratory tests are recommended for assessing renal health in hypertensive patients?
Serum creatinine and urea, estimated GFR, and renal ultrasound
These tests help evaluate renal parenchymal disease.
Which imaging technique is used for suspected renal vascular disease?
Renal duplex or CT angiography
This is important for diagnosing renal vascular disease.
What tests are indicated for hyperparathyroidism?
PTH and calcium levels
This helps diagnose primary hyperparathyroidism.
What is the purpose of the dexamethasone suppression test?
To assess cortisol levels for Cushing’s syndrome
It helps in diagnosing hypercortisolism.
Fill in the blank: The investigation for acromegaly involves measuring _______.
GH and IGF-1
These hormones are elevated in acromegaly.
What is the significance of urinary catecholamine metabolites?
They are used to diagnose pheochromocytoma
Pheochromocytoma is a tumor of the adrenal glands that secretes catecholamines.
True or False: A lipid profile is part of the routine investigations for hypertensives.
True
Lipid profiles help assess cardiovascular risk.
What tests are used to diagnose hypo/hyperthyroidism?
TSH, T3, and T4 levels
These hormone levels help evaluate thyroid function.
What condition is assessed with polysomnography?
Obstructive sleep apnea
Polysomnography is a sleep study used to diagnose sleep disorders.
Which drugs are screened for in urine toxicology screening related to hypertension?
Steroids and oral contraceptives
These medications can contribute to secondary hypertension.
What is the role of ECG in hypertensive patients?
To assess for left ventricular hypertrophy (LVH) and coronary artery disease (CAD)
ECG changes can indicate cardiovascular complications related to hypertension.
List the endocrine tests for secondary hypertension.
- Growth hormone (GH) and IGF-1 for acromegaly
- PTH and calcium for hyperparathyroidism
- Aldosterone for hyperaldosteronism
- Cortisol levels and dexamethasone suppression for Cushing’s syndrome
- Urinary catecholamines for pheochromocytoma
- TSH, T3, and T4 for thyroid disorders
These tests help identify specific causes of secondary hypertension.
What are the typical symptoms of the condition described?
Usually no symptoms (accidentally discovered)
Often referred to as the silent killer.
What are the occasional symptoms that may occur?
Headache, shortness of breath, epistaxis
Occurs occasionally.
What are the key factors for accurate blood pressure measurement?
- Patient seated quietly
- For at least 5 minutes in a chair
- With feet on the floor
- Arm supported at heart level
- Cuff size (80% of the arm)
- At least 2 measurements
What is a major complication related to disrupted blood supply to the brain?
Stroke
Can lead to serious neurological deficits.
What complications can arise that affect vision?
- Vision loss
- Blurred vision
- Complete loss of vision
What are some complications related to hearing?
- Hearing loss
- Tinnitus or ringing in the ears
What heart-related complications can result from this condition?
- Coronary artery disease
- Enlarged heart
- Heart failure
What kidney complications can arise?
- Kidney scarring
- Kidney failure
What reproductive system complication is mentioned?
Sexual dysfunction
What is the prevalence of hypertension among Egyptian adults?
26.3%
This statistic highlights the significant public health concern regarding hypertension in Egypt.
Define hypertension.
Blood pressure ≥ to 140/90 mmHg
Hypertension is often referred to as high blood pressure.
What is considered optimal blood pressure?
Less than 120/80 mmHg
Optimal blood pressure is ideal for cardiovascular health.
What are the categories of blood pressure readings?
Optimal, Normal, High normal, Grade 1, Grade 2, Grade 3
These categories help in diagnosing and managing hypertension.
What is Grade 1 hypertension?
Mild hypertension (140-159 systolic or 90-99 diastolic)
It is the least severe form of hypertension.
What systolic blood pressure range defines Grade 2 hypertension?
160-179 mm Hg
This indicates moderate hypertension.
What diastolic blood pressure range defines Grade 3 hypertension?
110 and over mm Hg
This represents severe hypertension.
What are the primary (essential) causes of hypertension?
- Genes
- Aging
- Stress
- Smoking
- Alcohol
- Lack of exercise
- High salt diet
- Hypercholesterolemia
- Obesity
- Diabetes Mellitus
These factors contribute to the majority of hypertension cases.
What is the most common cause of secondary hypertension?
Renal disease
Secondary hypertension arises from identifiable underlying conditions.
Name two types of renal conditions that can cause secondary hypertension.
- Renal artery stenosis (RAS) atherosclerosis
- Renal parenchymal disease
These conditions can lead to increased blood pressure.
List some endocrinal causes of secondary hypertension.
- Growth Hormone (acromegaly)
- Parathyroid Hormone (hyperparathyroidism)
- Aldosterone (hyperaldosteronism)
- Cortisol (Cushing’s syndrome)
- Catecholamines (pheochromocytoma)
- Thyroid Hormones (hypo/hyperthyroidism)
Hormonal imbalances can significantly affect blood pressure.
What vascular conditions can lead to secondary hypertension?
Coarctation of aorta and Vasculitis
These conditions can lead to increased resistance in the vascular system.
Can obstructive sleep apnea cause hypertension?
True
Sleep apnea is linked to increased blood pressure.
What types of drugs are known to potentially cause secondary hypertension?
- Steroids
- Oral contraceptives
Certain medications can influence blood pressure regulation.
What pregnancy-related condition is associated with hypertension?
Eclampsia
Eclampsia can occur in pregnant women and is a severe complication.
What is a common location of chest pain during angina or heart attack?
Upper chest
Chest pain can vary in location, including substernal areas and radiating pain.
Which areas can chest pain radiate to during an angina or heart attack?
- Neck
- Jaw
- Arms
- Epigastric region
- Left shoulder
Radiating pain is a significant indicator of heart-related issues.
What characterizes chest pain in angina and myocardial infarction (MI)?
- Pressure
- Tightness
- Heaviness
- Burning
These sensations are key indicators of cardiac distress.
What type of chest pain is associated with pericarditis?
Sharp
Pericarditis pain is distinct from the pressure-like sensations in angina.
What type of chest pain is typically experienced with esophageal reflux?
Burning
This can often be mistaken for cardiac pain.
What characterizes chest pain due to gallbladder disease?
- Burning
- Pressure
Gallbladder issues can mimic cardiac symptoms.
What type of chest pain is associated with esophageal spasm?
- Pressure
- Tightness
- Burning
Esophageal spasms can create sensations similar to angina.
What characterizes chest pain caused by pulmonary embolism, pneumonia, or pleurisy?
Pleuritic
Pleuritic pain is often sharp and worsens with breathing.
What type of chest pain is associated with aortic dissection?
Tearing/ripping
Aortic dissection pain is often described as severe and sudden.
What characterizes chest pain related to musculoskeletal disease?
Aching
Musculoskeletal pain is typically localized and can vary in intensity.
How does emotional and psychiatric pain present in terms of chest discomfort?
Variable
Emotional distress can manifest as chest pain but varies greatly among individuals.
What is the term for pain that is felt between the shoulder blades?
Intrascapular
Intrascapular pain can be associated with various conditions, including cardiac issues.
What is chest pain?
Chest pain is a pain in any area of your chest that may spread to other areas, including down your arms, into your neck or jaw.
What are the characteristics of chest pain?
Chest pain can be sharp or dull. You may feel tightness, achiness, or like your chest is being crushed or squeezed.
What are the cardiac causes of chest pain?
- Angina Pectoris
- Myocardial infarction
- Aortic dissection
- Pulmonary embolism
What are some non-cardiac causes of chest pain?
- Pneumothorax
- Pleurisy
- Pericarditis
- Myositis
- Herpes zoster
- GERD
- Cholecystitis
- Esophageal spasm
- Anxiety
Fill in the blank: Chest pain may spread to other areas, including down your arms, into your _______ or jaw.
neck
What imaging technique is used to visualize the chest for cardiac issues?
Chest x ray
Useful for detecting heart size and shape, as well as fluid in the lungs.
Which test records the electrical activity of the heart?
ECG
Electrocardiogram helps in diagnosing arrhythmias and heart attacks.
What are cardiac enzymes used for in cardiac assessment?
To detect heart muscle damage
Common enzymes include troponin and creatine kinase.
What imaging modality uses sound waves to assess heart function?
Echocardiography
Provides real-time images of heart structures and blood flow.
What is the purpose of cardiac catheterization?
To diagnose and treat cardiovascular conditions
Involves inserting a catheter into the heart’s chambers.
What does CT coronary angiography visualize?
Coronary arteries
Helps identify blockages or narrowing of the arteries.
Which imaging technique uses radioactive materials to assess heart function?
Radionuclide cardiography
Useful for evaluating blood flow and heart muscle viability.
What does cardiac MRI assess?
Detailed images of the heart structures
It provides information about heart muscle and function.
What is the purpose of an endomyocardial biopsy?
To obtain heart tissue for diagnosis
Helps in diagnosing myocarditis and other heart conditions.
What laboratory tests are included in the initial evaluation for cardiac issues?
CBC, Electrolytes, Renal functions, Liver enzymes, Thyroid screening, NT-proBNP
These tests help assess overall health and identify underlying causes.
What are nonpharmacological treatments for cardiac conditions?
Removal of precipitating causes, Correction of underlying cause, Surgical correction: CABG, Restriction of Physical Activity
CABG stands for Coronary Artery Bypass Grafting.
Which class of medications is used to decrease afterload?
ACEI, ARBs
Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers.
What is the role of nitrates in cardiac treatment?
To relieve angina and decrease myocardial oxygen demand
They dilate blood vessels, improving blood flow.
Which medications are used to decrease preload?
Diuretics, Dialysis
They help remove excess fluid from the body.
What are cardiac glycosides used for?
To promote contractility
Digoxin is a common example.
Which medications are used to decrease remodeling of the heart?
Beta blockers, ACEI, ARBs, Mineralocorticoid antagonists, SGLT 2 inhibitors
These help improve heart function and structure.
What is cardiac resynchronization therapy used for?
To improve heart function in heart failure
It coordinates the contractions of the heart’s ventricles.
What does ICD stand for in cardiac treatment?
Implantable Cardioverter-Defibrillator
It is used to monitor and treat life-threatening arrhythmias.
What is the purpose of intra-aortic balloon counterpulsation?
To improve coronary blood flow and reduce workload on the heart
It involves inflating and deflating a balloon in the aorta.
What is the last resort treatment for severe heart disease?
Cardiac transplantation
It involves replacing a diseased heart with a healthy donor heart.
What is the definition of heart failure with reduced ejection fraction?
HFrEF: LVEF ≤40%
HFrEF stands for Heart Failure with Reduced Ejection Fraction.
What is the definition of heart failure with mildly reduced ejection fraction?
HFmrEF: LVEF 41-49%
HFmrEF stands for Heart Failure with mildly Reduced Ejection Fraction.
What is the definition of heart failure with preserved ejection fraction?
HFpEF: LVEF ≥50%
HFpEF stands for Heart Failure with Preserved Ejection Fraction.
What are the common symptoms of heart failure?
- Headache
- Fatigue
- Dizziness
- Blurring of vision
- Chest pain
- Claudication pain
Symptoms can vary based on the type of heart failure.
What are the signs associated with left-sided heart failure?
- Cough
- Dyspnea
- Orthopnea
- Paroxysmal nocturnal dyspnea (PND)
- Recurrent chest infection
Left-sided heart failure primarily affects lung function.
What are the symptoms of right-sided heart failure?
- Jaundice
- Right hypochondrial pain
- Abdominal distension
- Malabsorption
Right-sided heart failure often leads to systemic congestion.
What are the key signs of heart failure?
- Hypotension
- Tachycardia
- Pallor
- Cold extremities
- 3rd heart sounds (gallop)
- Enlarged tender liver
- Ascites
- Lower limb edema
- Congested pulsating neck veins
- Increased JVP
- Bilateral fine basal crepitations on back
These signs indicate various physiological changes in heart failure.
What is the NYHA classification for heart failure?
- Class I: no limitation
- Class II: slight limitation
- Class III: marked limitation
- Class IV: unable to do any effort
NYHA stands for New York Heart Association and classifies the extent of heart failure symptoms.
True or False: In NYHA Class I, patients experience dyspnea, palpitation, or fatigue at ordinary effort.
False
Class I patients do not experience limitations at ordinary effort.
Fill in the blank: The LVEF for heart failure with preserved ejection fraction is _______.
≥50%
This indicates that the heart’s pumping ability is relatively normal.
What are the key objective criteria for diagnosing heart failure?
- Evidence of cardiac structural abnormalities
- Functional abnormalities
- LV diastolic dysfunction
- Raised LV filling pressures
- Raised natriuretic peptides
These criteria help to confirm the presence of heart failure.
What is heart failure?
Inability of the heart to pump an adequate blood supply to meet the metabolic needs of the body
It is a clinical syndrome due to structural or functional cardiac disorder.
What are the primary causes of heart failure?
- Vascular
- Valvular
- Cardiomyopathy
- Congenital heart disease
- Hypertension
- Cardiac arrhythmia
- Infective
- Infiltrative disease of heart
These causes can lead to the heart’s inability to function effectively.
What are some precipitating factors of heart failure?
- Increase demand
- Anaemia
- Fever
- Infection
- Salt intake
- Thyrotoxicosis
- Pregnancy
- Arrhythmia
- Alcohol ingestion
- Thiamine deficiency
- Uncontrolled hypertension
- Drugs (e.g., beta adrenergic blockers, salt retaining drugs like steroids, NSAIDs)
These factors can exacerbate existing heart failure conditions.
What are the classifications of heart failure?
- Acute or Chronic HF
- Right or left-sided HF
- Low or high cardiac output HF
- Systolic or diastolic HF
- Preserved EF, mid-range EF or reduced HF
These classifications help in understanding the type and severity of heart failure.
True or False: Heart failure can only be classified as acute.
False
Heart failure can be classified as either acute or chronic.
Fill in the blank: Heart failure can be caused by _______ disorders.
[structural or functional]
These disorders affect the heart’s ability to pump blood effectively.
What is edema?
Swelling caused by excess fluid in body tissues
Edema can be localized or generalized.
What are common causes of localized edema?
Venous or lymphatic obstruction, local injury
Local injury can be thermal, immune, infectious, or mechanical.
What is the significance of albumin levels in edema?
Albumin levels < 2.5 g/dL may indicate hypoalbuminemia contributing to edema
Low albumin can lead to fluid retention.
What are some conditions that can cause edema?
- Drug-induced
- Hypothyroidism
- Severe malnutrition
- Cirrhosis
- Nephrotic syndrome
- Heart failure
- Renal failure
Each condition can affect fluid balance and contribute to edema.
What are some treatment options for edema?
- Treatment of underlying cause
- Stop drug causing edema
- Restrict salt and fluid intake
- Monitor input-output
- Diuretics
- Protein-rich diet (if due to malnutrition)
Treatment focuses on addressing the root cause of edema.
What are the causes of non-pitting edema?
- Lymphedema
- Myxedema
Non-pitting edema does not retain a dimple when pressure is applied.
True or False: Edema can result from both cardiac and renal causes.
True
Both cardiac and renal dysfunction can lead to fluid accumulation.
Fill in the blank: _______ is a condition associated with severe malnutrition that can lead to edema.
Nephrotic syndrome
Nephrotic syndrome is characterized by proteinuria and low serum albumin.
What is edema?
Swelling caused by excess fluid in body tissues
Edema can be localized or generalized.
What are common causes of localized edema?
Venous or lymphatic obstruction, local injury
Local injury can be thermal, immune, infectious, or mechanical.
What is the significance of albumin levels in edema?
Albumin levels < 2.5 g/dL may indicate hypoalbuminemia contributing to edema
Low albumin can lead to fluid retention.
What are some conditions that can cause edema?
- Drug-induced
- Hypothyroidism
- Severe malnutrition
- Cirrhosis
- Nephrotic syndrome
- Heart failure
- Renal failure
Each condition can affect fluid balance and contribute to edema.
What are some treatment options for edema?
- Treatment of underlying cause
- Stop drug causing edema
- Restrict salt and fluid intake
- Monitor input-output
- Diuretics
- Protein-rich diet (if due to malnutrition)
Treatment focuses on addressing the root cause of edema.
What are the causes of non-pitting edema?
- Lymphedema
- Myxedema
Non-pitting edema does not retain a dimple when pressure is applied.
True or False: Edema can result from both cardiac and renal causes.
True
Both cardiac and renal dysfunction can lead to fluid accumulation.
Fill in the blank: _______ is a condition associated with severe malnutrition that can lead to edema.
Nephrotic syndrome
Nephrotic syndrome is characterized by proteinuria and low serum albumin.
What are the two types of edema based on localization?
Generalized (anasarca) and localized
What are the two types of pitting in edema?
Pitting and non-pitting
What are the characteristics of cardiac edema?
Bilateral symmetrical + pitting + painless (BPP)
More in lower extremities, slow progression, dyspnea, cardiomegaly, enlarged tender liver, increased JVP
What are the characteristics of renal edema?
Bilateral symmetrical + pitting + painless (BPP)
More in eyelid and periorbital (more in morning), rapid progression, oliguria, hematuria, hypertension, proteinuria, impaired kidney function tests (KFTs)
What are the characteristics of hepatic edema?
Bilateral symmetrical + pitting + painless (BPP)
Associated with ascites, spider angioma, and jaundice
List some drugs that can cause edema.
- Nonsteroidal anti-inflammatory drugs
- Antihypertensive agents
- Direct arterial/arteriolar vasodilators
- Hydralazine
- Clonidine
- Methyldopa
- Guanethidine
- Minoxidil
- Calcium channel antagonists
- Alpha-adrenergic antagonists
- Thiazolidinediones
- Steroid hormones
- Glucocorticoids
- Anabolic steroids
- Estrogens
What investigations are conducted for nutritional causes of edema?
Nutritional investigations
Specific tests not listed
What investigation is used for gastrointestinal causes of edema?
Fecal fat estimation for malabsorption
Which liver function tests (LFTs) are performed for hepatic edema investigation?
- ALT
- AST
- ALP
- Bilirubin
What renal investigations are performed for edema?
- Serum protein
- Albumin
- Urine protein
- Urine casts
What cardiac investigations are performed for edema?
- ECG
- Echo
What hormone levels are checked in suspected hypothyroidism related to edema?
- TSH
- T3
- T4
True or False: Cardiac edema is typically painful.
False
True or False: Renal edema usually presents with rapid progression.
True
Fill in the blank: The type of edema associated with an enlarged tender liver is called _______.
Hepatic edema
What is hemoptysis?
Expectoration of blood originating from the lower respiratory tract
Hemoptysis can vary from blood streaking of sputum to coughing up large amounts of pure blood.
What are the airway causes of hemoptysis?
- Bronchitis
- Bronchiectasis
- Bronchogenic carcinoma
- Broncho-vascular fistula
These conditions are related to the respiratory system and can contribute to hemoptysis.
What vascular lung diseases can cause hemoptysis?
- Pulmonary embolism
- Pulmonary or bronchial aneurysm
- Arterio-venous malformation
These vascular issues can lead to bleeding in the lungs, resulting in hemoptysis.
What are some parenchymal lung diseases that can cause hemoptysis?
- Infection: TB, klebsiella, staph. aureus
- Alveolar hemorrhage: Goodpasture syndrome
- Congestion: CHF, mitral stenosis
These diseases affect the lung tissue directly, leading to potential bleeding.
What systemic causes can contribute to hemoptysis?
- Hemorrhagic blood disease: ITP, hemophilia
Systemic conditions affecting blood coagulation can lead to hemoptysis.
What differentiates true hemoptysis from false hemoptysis?
True hemoptysis: below VC, persists as blood-tinged sputum, history of cardiopulmonary disease
False hemoptysis: above VC, does not persist, obvious by ENT examination
VC stands for vocal cords, distinguishing the source of the bleeding.
What are the key differences between hemoptysis and hematemesis?
Hemoptysis: coughing of blood, bright red, frothy, absent GIT symptoms
Hematemesis: vomiting of blood, brownish red, contains food particles, present GIT symptoms
Recognizing these differences is crucial for proper diagnosis.
Fill in the blank: Hemoptysis is defined as ______.
expectoration of blood originating from the lower respiratory tract
True or False: Hemoptysis can be mixed with sputum.
True
This is characteristic of true hemoptysis.
What color is the blood typically associated with hemoptysis?
Bright red
This color indicates fresh blood from the lower respiratory tract.
What associated symptoms are present with hematemesis?
- Nausea
- Gastrointestinal symptoms
These symptoms help differentiate hematemesis from hemoptysis.
What type of lung disease is tuberculosis classified as in the context of hemoptysis?
Infection
TB is one of the infections that can lead to hemoptysis.
What is a cough?
A protective natural reflex that removes irritants from upper and lower airways
It results in a sudden expulsion of air from the lungs that carries excessive secretions or foreign material from the respiratory tract.
What are the types of cough?
- Acute
- Subacute
- Chronic
Acute cough lasts up to three weeks, subacute cough lasts three to eight weeks, and chronic cough lasts longer than eight weeks.
What is an acute cough?
Present for up to three weeks
It is one of the classifications of cough based on duration.
What is a subacute cough?
Present for three to eight weeks
It is one of the classifications of cough based on duration.
What is a chronic cough?
Present for longer than eight weeks
It is one of the classifications of cough based on duration.
What are the two categories of cough based on productivity?
- Dry
- Productive
Productive cough involves mucus production, while dry cough does not.
Where are the cough receptors located?
- Larynx and supralaryngeal area
- Trachea and bronchi
- Ear canals and eardrums
- Pleura, pericardium, and diaphragm
- Esophagus and stomach
These locations are involved in the cough reflex mechanism.
What is the role of the vagus nerve in coughing?
It transmits signals from cough receptors to the cough center in the medulla
The cough center coordinates the cough reflex.
What medical conditions can cause an acute cough?
- Common cold
- Acute bronchitis
- Pneumonia
- Asthma
- Exacerbation of chronic causes
These conditions are common triggers for acute coughing episodes.
What medical conditions can cause a chronic cough?
- Chronic bronchitis
- COPD
- Suppurative lung disease
- Heart failure
- Cancer
These conditions are potential underlying causes of chronic coughing.
Which medications are known to cause cough?
ACE inhibitors
These medications can lead to a cough as a side effect.
What is the role of expiratory muscles in coughing?
They facilitate the expulsion of air during the cough reflex
This includes muscles like the diaphragm and larynx.
True or False: Cough is one of the most common chest symptoms.
True
Coughing is frequently reported by patients with respiratory issues.
What is a cough?
A protective natural reflex that removes irritants from upper and lower airways
It results in a sudden expulsion of air from the lungs that carries excessive secretions or foreign material from the respiratory tract.
What are the types of cough?
- Acute
- Subacute
- Chronic
Acute cough lasts up to three weeks, subacute cough lasts three to eight weeks, and chronic cough lasts longer than eight weeks.
What is an acute cough?
Present for up to three weeks
It is one of the classifications of cough based on duration.
What is a subacute cough?
Present for three to eight weeks
It is one of the classifications of cough based on duration.
What is a chronic cough?
Present for longer than eight weeks
It is one of the classifications of cough based on duration.
What are the two categories of cough based on productivity?
- Dry
- Productive
Productive cough involves mucus production, while dry cough does not.
Where are the cough receptors located?
- Larynx and supralaryngeal area
- Trachea and bronchi
- Ear canals and eardrums
- Pleura, pericardium, and diaphragm
- Esophagus and stomach
These locations are involved in the cough reflex mechanism.
What is the role of the vagus nerve in coughing?
It transmits signals from cough receptors to the cough center in the medulla
The cough center coordinates the cough reflex.
What medical conditions can cause an acute cough?
- Common cold
- Acute bronchitis
- Pneumonia
- Asthma
- Exacerbation of chronic causes
These conditions are common triggers for acute coughing episodes.
What medical conditions can cause a chronic cough?
- Chronic bronchitis
- COPD
- Suppurative lung disease
- Heart failure
- Cancer
These conditions are potential underlying causes of chronic coughing.
Which medications are known to cause cough?
ACE inhibitors
These medications can lead to a cough as a side effect.
What is the role of expiratory muscles in coughing?
They facilitate the expulsion of air during the cough reflex
This includes muscles like the diaphragm and larynx.
True or False: Cough is one of the most common chest symptoms.
True
Coughing is frequently reported by patients with respiratory issues.
What is dyspnea?
Dyspnea is a medical term for shortness of breath.
Dyspnea refers to the subjective awareness of uncomfortable breathing.
What are the respiratory causes of dyspnea?
Respiratory causes include:
* Airway obstruction (e.g., foreign body inhalation)
* Secretion (e.g., bronchitis, bronchiolitis)
* Smooth muscle spasm (e.g., bronchial asthma)
These conditions can lead to difficulty in breathing due to various mechanisms.
What cardiac conditions can lead to dyspnea?
Cardiac causes include:
* Valvular heart disease
* Ischemic heart disease
* Cardiomyopathy
* Pericardial effusion
These conditions affect the heart’s ability to pump effectively, leading to breathlessness.
List other causes of dyspnea.
Other causes include:
* COPD
* Pneumonia
* Lung cancer
* Pulmonary fibrosis (ILD)
* Pulmonary embolism
* Pulmonary hypertension
* Pleural disease
* Anemia
* Shock (hypovolemic, cardiogenic, septic)
* Volume overload (renal failure)
* Diabetic ketoacidosis
* Obesity
* Pregnancy
* Pleurisy
* Pleural effusion
* Pneumothorax
* Hemothorax
* Empyema
These conditions can affect lung function or oxygen transport.
What is the difference between acute and chronic dyspnea?
Acute dyspnea develops over hours to days; chronic dyspnea develops for more than four to eight weeks.
Acute dyspnea may also occur on top of chronic dyspnea due to worsening of an underlying condition.
What are the grades of dyspnea?
Grades of dyspnea:
* Grade 0: I only get breathless with strenuous exercise
* Grade 1: I get short of breath when hurrying on level ground or walking up a slight hill
* Grade 2: On level ground, I walk slower than people of the same age because of breathlessness, or have to stop for breath when walking at my own pace
* Grade 3: I stop for breath after walking about 100 yards or after a few minutes on level ground
* Grade 4: I am too breathless to leave the house, or I am breathless when dressing
These grades help assess the severity of dyspnea experienced by an individual.
What is dyspnea?
Dyspnea is a medical term for shortness of breath.
Dyspnea refers to the subjective awareness of uncomfortable breathing.
What are the respiratory causes of dyspnea?
Respiratory causes include:
* Airway obstruction (e.g., foreign body inhalation)
* Secretion (e.g., bronchitis, bronchiolitis)
* Smooth muscle spasm (e.g., bronchial asthma)
These conditions can lead to difficulty in breathing due to various mechanisms.
What cardiac conditions can lead to dyspnea?
Cardiac causes include:
* Valvular heart disease
* Ischemic heart disease
* Cardiomyopathy
* Pericardial effusion
These conditions affect the heart’s ability to pump effectively, leading to breathlessness.
List other causes of dyspnea.
Other causes include:
* COPD
* Pneumonia
* Lung cancer
* Pulmonary fibrosis (ILD)
* Pulmonary embolism
* Pulmonary hypertension
* Pleural disease
* Anemia
* Shock (hypovolemic, cardiogenic, septic)
* Volume overload (renal failure)
* Diabetic ketoacidosis
* Obesity
* Pregnancy
* Pleurisy
* Pleural effusion
* Pneumothorax
* Hemothorax
* Empyema
These conditions can affect lung function or oxygen transport.
What is the difference between acute and chronic dyspnea?
Acute dyspnea develops over hours to days; chronic dyspnea develops for more than four to eight weeks.
Acute dyspnea may also occur on top of chronic dyspnea due to worsening of an underlying condition.
What are the grades of dyspnea?
Grades of dyspnea:
* Grade 0: I only get breathless with strenuous exercise
* Grade 1: I get short of breath when hurrying on level ground or walking up a slight hill
* Grade 2: On level ground, I walk slower than people of the same age because of breathlessness, or have to stop for breath when walking at my own pace
* Grade 3: I stop for breath after walking about 100 yards or after a few minutes on level ground
* Grade 4: I am too breathless to leave the house, or I am breathless when dressing
These grades help assess the severity of dyspnea experienced by an individual.
What are the characteristics of pain associated with myocardial ischaemia?
Trashing, bandlike pain
Myocardial ischaemia pain is often described as tight or pressure-like, commonly located in the chest area.
Where is the site of pain for myocardial ischaemia?
Central anterior chest
This pain may also radiate to the throat, jaw, or arms.
What factors exacerbate myocardial ischaemia pain?
Exertion, rest, glyceryl trinitrate
Glyceryl trinitrate is a medication that can relieve angina pain.
What associated features are commonly seen in patients with myocardial ischaemia?
Sweaty, breathless, shocked, nauseated
These symptoms indicate a potential severe cardiac event.
What type of pain is associated with pericarditis?
Sharp (may be crushing)
This pain can be similar to myocardial ischaemia but with different characteristics.
Where is the site of pain for pericarditis?
Central anterior
Unlike myocardial ischaemia, pericarditis usually does not radiate.
What factors exacerbate pericarditis pain?
Lying back
Pain is relieved by sitting forward, which is a distinguishing feature.
What type of pain is described as pleuritic?
Sharp
Pleuritic pain is typically associated with respiratory movements.
What type of pain is associated with gastrointestinal issues?
Burning
This pain is often localized and can be mistaken for cardiac pain.
Where is gastrointestinal pain typically located?
Anywhere (usually very localized pain)
The location can vary depending on the specific gastrointestinal issue.
What factors exacerbate gastrointestinal pain?
Breathing, coughing, moving
Pain may be relieved by antacids, especially in cases like peptic ulcers.
What type of pain is associated with aortic dissection?
Sharp, stabbing, tearing
Aortic dissection pain is often severe and sudden.
Where is the location of pain for aortic dissection?
Retrosteral
This pain may radiate to the arms or around the chest to the back.
What are the common associated symptoms with aortic dissection?
Unequal radial and femoral pulse, blood pressure differences
Aortic regurgitant murmur may be heard on auscultation.
What is a common complication associated with pulmonary embolus?
Shock, breathlessness, cough, haemoptysis
These symptoms indicate a serious respiratory issue.
What is the primary site of pain in cholecystitis?
Right hypochondrial
The right hypochondrial area is where the gallbladder is located.
What type of radiation is associated with cholecystitis pain?
Right shoulder
Pain may radiate to the right shoulder due to nerve pathways.
What characterizes the pain experienced in cholecystitis?
Sharp ache
The pain is often described as sharp and can vary in intensity.
What is a common precipitating factor for cholecystitis?
Fatty meals
Consumption of fatty foods can trigger symptoms.
List some relieving factors for cholecystitis symptoms.
- Antacids
- Water brush
- SL nitrates
- Cold drink
- Hot drink
These factors can help alleviate symptoms.
What are some associated symptoms of cholecystitis?
- Anorexia
- Nausea
- Vomiting
- Heartburn
- Esophageal spasm
These symptoms often accompany the pain.
True or False: Cholecystitis can cause retrosternal burning.
True
Retrosternal burning can occur in relation to esophageal spasms.
Fill in the blank: Cholecystitis can be triggered by _______ and _______.
[spicy food], [smoking]
Both spicy food and smoking can exacerbate symptoms.
What type of pain is associated with herpes zoster in relation to cholecystitis?
Girdle pain (dermatomal), lancinating and associated with vesicles
This type of pain relates to the dermatome affected by herpes zoster.
What musculoskeletal conditions can mimic cholecystitis?
- Myositis
- Rib fracture
- Costochondritis
These conditions can cause similar pain and tenderness.
What is the nature of musculoskeletal pain compared to cholecystitis pain?
Aching, variable in site and severity, accompanied with local tenderness
Musculoskeletal pain can often be less sharp and more diffuse.
What is a common symptom of aortic dissection?
Severe stabbing pain
Pain is often retrosternal and may refer to the back.
What imaging study shows a widened mediastinum in aortic dissection?
Chest X-ray
What is the best test to evaluate for aortic dissection?
CT angiography
What are the three stages of aortic dissection?
- Stage 1: Rupture of Intima
- Stage 2: Dissection of Media
- Stage 3: Rupture of vessel
What happens to the aortic knob in aortic dissection?
Loss of aortic knob
What is a key symptom of pulmonary embolism?
Tachypnea and tachycardia
How does pulmonary embolism present in comparison to pleurisy?
More severe
What is the best confirmatory test for pulmonary embolism?
CT pulmonary angiogram (CTPA)
What alternative test can be used for pulmonary embolism diagnosis?
VQ scan
Fill in the blank: Aortic dissection is characterized by _______ pain.
severe stabbing
What are the common sites of pain in Angina Pectoris?
Retrosternal, left shoulder, back, throat, epigastrium, jaw
What type of pain characterizes Angina Pectoris?
Compressing, heaviness, heartburn, tightness, discomfort, heartburn
What are typical precipitating factors for Angina Pectoris?
Emotional stress, exercise, heavy meal, sexual intercourse
What are common relieving factors for Angina Pectoris?
Sublingual nitrate, rest
What is the typical duration of Angina Pectoris?
3 - 5 minutes up to 20 minutes
What associated symptoms may occur with Angina Pectoris?
Dyspnea, palpitation, dizziness
How does the pain duration in Myocardial Infarction (MI) differ from Angina?
Prolonged
What is a common associated symptom of Myocardial Infarction (MI)?
Sweating
What are the common sites of pain in Pericarditis?
Retrosternal, left shoulder
What type of pain characterizes Pericarditis?
Throbbing, stabbing
What are typical relieving factors for Pericarditis?
Lying flat, leaning forward, analgesics
What associated symptoms may occur with Pericarditis?
Fever
What are the common sites of pain in Pleurisy?
Lower axillary
What type of pain characterizes Pleurisy?
Tearing, stabbing
What precipitating factors can trigger pain in Pleurisy?
Inspiration, coughing, stop breathing
What are typical relieving factors for Pleurisy?
Analgesics
What associated symptoms may occur with Pleurisy?
Fever, cough
Fill in the blank: The Levine sign is associated with _______ pain.
Closed fist
What is the primary method for preventing fecal-oral transmission?
Careful hand washing
This is crucial in preventing the spread of diseases transmitted through the fecal-oral route.
What are the key components of ensuring a safe water supply?
Proper sewage disposal
This helps prevent contamination of water sources.
What standard precautions should be taken in hospitals and labs to prevent parenteral transmission?
Standard safety precautions
* Proper sterilization of surgical instruments
* Use of disposable syringes
* Safe sexual contact
These practices minimize the risk of infection through needles and other instruments.
What is the dosage for passive immunization with Anti HAV Ig?
0.06 ml/Kg IM
This is administered to close contacts of individuals infected with Hepatitis A.
When is Anti HBV Ig given?
Exposure to needle sticks, instruments, blood products
This is also given to infants born to HBs Ag positive mothers.
What is the regimen for active immunization against Hepatitis A (HAV)?
Single dose
Immunity lasts for over 10 years.
Who should receive the Hepatitis A vaccine?
- Travelling to endemic areas
- Chronic liver disease patients
- Workers in contact with hepatitis patients
These groups are at higher risk for Hepatitis A infection.
What is the universal recommendation for Hepatitis B (HBV) vaccination?
Developed countries and endemic areas
Universal vaccination is advised to prevent HBV transmission.
Who are considered high-risk groups for Hepatitis B vaccination?
- Health care personnel
- Hemophilia patients
- Dialysis patients
- Homosexuals
- IV drug abusers
These populations have a higher risk of exposure to HBV.
What is the vaccination schedule for Hepatitis B?
3 doses (0, 1 & 6 months)
This schedule ensures adequate immunity against Hepatitis B.
How long does immunity from the Hepatitis B vaccine last?
3-5 years
Regular boosters may be necessary for continued protection.
What is the typical range for transaminases in laboratory findings?
> 500 - 1000 IU/L
Transaminases are enzymes that help assess liver function, with ALT usually higher than AST in viral hepatitis cases.
Which transaminase is typically greater in viral hepatitis?
ALT
ALT (alanine aminotransferase) levels are usually higher than AST (aspartate aminotransferase) during viral hepatitis.
What is the bilirubin pattern observed in laboratory findings?
Biphasic
The biphasic pattern indicates an initial rise followed by a decrease in bilirubin levels.
What is the expected level of alkaline phosphatase in cases of viral hepatitis?
Normal or mild elevation
Alkaline phosphatase levels may not significantly rise in viral hepatitis.
What is the expected albumin level in laboratory findings for viral hepatitis?
Normal
Albumin levels typically remain normal in cases of viral hepatitis.
What is the prothrombin time status in viral hepatitis unless severe impairment occurs?
Usually normal
Prothrombin time can indicate liver function, remaining normal in most viral hepatitis cases.
What is the typical CBC finding in viral hepatitis?
Neutropenia + Lymphocytosis
A complete blood count (CBC) may show low neutrophil counts alongside elevated lymphocyte counts.
What finding is typically positive in urine tests for viral hepatitis?
+ve Bilirubin
Urine tests often show the presence of bilirubin during hepatitis.
When is imaging rarely needed in the diagnosis of viral hepatitis?
In cases of profound cholestasis
Imaging is not commonly required unless there is significant bile duct obstruction.
What are the laboratory tests used to diagnose Hepatitis A virus (HAV)?
HAV IgM + HAV PCR
These tests help confirm an active HAV infection.
What laboratory findings indicate Hepatitis B virus (HBV) infection?
HBs Ag + HBc IgM
The presence of these antigens confirms HBV infection.
What is the testing method for Hepatitis C virus (HCV) after exposure?
HCV - PCR: 2 weeks after exposure
PCR testing is used to detect HCV RNA shortly after exposure.
What laboratory test is used to diagnose Cytomegalovirus (CMV) infection?
CMV IgM
IgM antibodies indicate a recent CMV infection.
What laboratory test is used to diagnose Epstein-Barr virus (EBV) infection?
EBV IgM
The presence of IgM antibodies confirms recent EBV infection.
What is the primary management strategy for viral hepatitis?
Supportive
Management focuses on supportive care, including bed rest and avoiding hepatotoxic substances.
