eoiaio Flashcards
First line for anaphylaxis?
IM adrenaline
Fluids
Note: why not IV adrenline? would send patient into arrhythmias
When do you give IV adrenaline?
Cardiac arrest
Fine crepitaiotn
Fibrosis
Pulmonary oedema
Coarse crepitations suggests
PNEUMONIA
Amoxicillin would cover which pneumonias?
Streptococcus
Name a macrolide
Clarithromycin
Which organisms are covered by clari for CAP?
Atypical organisms
Legionella
Mycoplasma
Chlamydia
What would make you think of deranged
Low sodium
Deranged LFTs
Recent travel
Coarse crepitations and bronchial breathing suggests
Pneumonia
What would you order if someone has microcytic anaemia?
Haematinics Coeliac screen (tissue transglutaminase antibody)
OGD / colonoscopy (top and tail)
What would be seen in biopsy of coeliac disease?
Villous atrophy
Red flags in microcytic anamiea
Weight loss
anaemia
dyspepsia
Adenosine is used to treat
SVT
Treatment of AF less than 48 hours
DC cardioversion
Treatment of AF MORE than 48 hours
Rate control (e.g. digoxin, metoprolol) and anticoagulate
Amiodarone is used to treat
VT
Trousseu’s sign suggests
Pancreatic cancer
What causes Grey Turner’s/Cullens?
Haemmorhage due to acute pancreatitis
Causes of portal
Encephalopathy
Ascites
SBP
Variceal bleed
Diarrhoea plus schistocytes - what does it suggest?
Haemolysis
Maybe DIC or HUS
What happens in DIC?
Low platelets
Low fibrinogen
High PT/APTT
High D-dimer
due to lots of clots being formed around the body
What are the classifications of haemolytic anaemia?
Hereditary
Acquired
Red cell membrane problem
Hereditary spherocytosis
Red cell enzyme deficiency
G6PD deficiency
Haemoglobinopathy
Sickle cell disease
Thalassemia
Four acquired causes of haemolytic anaaemia
Autoimmune
MAHA
Drugs
Infection
Microangiopathic haemolytic anaemia
Clots form in small vessels, so as the
Circular folds are called?
Valvulaecoliventi
Circular folds are called?
Valvulae conniventes
Where are haustra found and what do they suggest?
Large bowel obstruction
What is the short SynACTHen test done for?
Adrenaline function
Normal range for sodium?
135-145
Normal range for potassium
3.5-5
If you have someone with hyponatremia, what else are you looking at?
Whether they have hypovolemia, euvolemia or hypervolemia
Hypovolemia can be due to
Diarrhoea
Vomiting
Diuretcs
What’s the sodium like in hypovolemia?
Low urine sodium
What could be the problem if you have euvolemia and hyponatremia?
Hypothyroidism
Adrenal insufficiency
SIADH
What investigations would you do if someone has euvolmia and hyponatremia?
TFTs
Short Synacthen Test
Plasma and urine osmolality
What could it be if you have hypervolemia and hyponatremia? e.g. with oedema
Cardiac failure
Cirrhosis
Nephrotic syndrome
What is the most common cause of hyponatremia?
Too much ADH
Rarer causes of hyponatremia?
Excess water intake
Sodium-free irrigation solutions such as those used in transurethral prostate resection (TURP)
Causes of SIADH
CNS pathology (hence do brain MRI)
Lung pathology (DO CXR)
Drugs
Tumours
Causes of oncholysis
Trauma
Thyrotoxicosis
Fungal infection
Psoriasis
Abdo pain and vomiting in someone with T1DM
CBG
Capillary ketone
Loin pain with blood, what investigations do you do?
CT KUB
CATCH UP ON SLIDES 29-30
??????????
Alkaline phospohatase goes up in what?
High in obstructive liver disease
Bone diseases e.g. malignancy, fracture, Paget’s disease
If someone has hypercalcemia with low pth and normal alp (in bone cancer it’s normally high), what kind of cancer is it?
Multiple myeloma
Features of multiple myeloma
Calcium (high)
Renal impairment
Anaemia
Bone
(CRAB)
Common cause of small mobile lump in breast in young person
Fibroadenoma
Causes of cavitating lung lesions (solid/fluid bits)
Infection: TB, staph, klebsiella
Inflammation: RA
Infarction: PE
Malignancy
Oedema plus hypoalbuminaemia - what do you do next?
Urinalysis
nephrotic syndrome
Facial telangiectasia suggests?
Hereditary haemorrhagic telangiectasia
if not then maybe cirrhosis
Hereditary haemorrhagic telangiectasia is autosomal dominant or recessive? What’s the problem?
autosomal dominant
Abnormal blood vessels in skin, mucous membranes, lungs, liver, brain
Low sodium and potassium suggests
Low aldosterone
Low aldosterone plus low cortisol suggests
adrenal insufficiency
Why might you get high prolactin in hypothyroidism?
TRH stimulates prolactin as well
Differentiate between thyroiditis and multinodular goitre
TFTs normal in multinodular goitre
Hyperthyroid picture in goitre
