Extras Flashcards
What are the Korotkoff sounds?
Sounds heard over brachial artery as pressure released from cuff
1-tapping=systolic as bp>cuff pressure so turbulent flow
2-murmurs between sys and Dias
3-loud, crisp tapping sound
4-within 10mmHg above diastolic=thumping and muting
5-silent=cuff pressure=diastolic
Which out of PT, APTT, bleeding time and platelets is affected by warfarin?
Increase in PT
Which out of PT, APTT, bleeding time and platelets is affected by DIC?
Increase in PT, APTT and bleeding time, reduction in platelets
Which out of PT, APTT, bleeding time and platelets is affected by haemophilia?
Increase in APTT
Which out of PT, APTT, bleeding time and platelets is affected by aspirin?
Increased bleeding time
Which out of PT, APTT, bleeding time and platelets is affected by thrombocytopenia?
Increase in bleeding time, decrease in platelets
Which out of PT, APTT, bleeding time and platelets is affected by early liver failure?
Increase in PT
Which out of PT, APTT, bleeding time and platelets is affected by late liver failure?
Increase in PT, APTT and bleeding time
Decrease in platelets
If INR>1.0, what does this mean in terms of clotting?
Less clotting/longer to clot
What is the auscultatory gap?
Period of abnormal silence during the Korotkoff phases (normally second)
Pulse can be palates during this period so this helps prevent underestimation of BP
What is a tympanitic percussion sound and when would it be heard?
Drum-like over abdominal air
What is a resonant percussion sound and when would it be heard?
Normal chest sound from the air
What is a hyper-resonant percussion sound and when would it be heard?
Higher pitch in pneumothorax or COPD
What is a dull percussion sound and when would it be heard?
Lower pitch due to solid mass or liquid (organ, ascites or cancer or pneumonia)
What is a stony dull percussion sound and when would it be heard?
Pleural effusion
What is a thrill?
Palpable murmur
What is a heave?
Feel your hand move and is a sign of left ventricular hypertrophy
What is rombergs sign used for?
To distinguish between sensory and cerebellum ataxia. Sensory ataxia is a proprioception deficit so visual correction is lost when eyes are closed and person becomes more unsteady (+ve rombergs)
Which modalities does dorsal column carry?
Fine touch, vibration, proprioception
What modalities does spinothalamic tract carry?
Pain, temperature, crude touch, pressure
A unilateral lesion between the midbrain and the medulla will cause what pattern of sensation loss?
All sensations contralaterally as both dorsal columns and spinothalamic have deccusated
A hemi-section of the spinal cord will cause what pattern of sensory loss?
Spinothalamic already deccusated so pain/temp/crude touch/pressure lost contralaterally
Dorsal columns not yet deccusated so proprioception/fine touch/vibration lost ipsilaterally
This is brown-sequard syndrome
A lesion in a peripheral nerve will cause what pattern of sensation loss?
Loss of all sensations to that dermatome
Why does an UMN lesion cause hyperreflexia?
UMN has inhibitory effect on reflex so without this the reflex is more pronounced
A negative Rinnes on the left ear means what?
Conductive hearing loss in left ear
A negative webers means?
Either conductive hearing loss on ipsilateral side to where they hear it loudest or sensorineural loss contralaterally to where they hear it loudest
Give some causes of conductive hearing loss
Ear wax, perforated eardrum, otitis externa, foreign body, otitis media, otosclerosis
Give some causes of sensorineural hearing loss
Meningitis, gentamicin/furosemide, cochlear damaged by skull base fracture, neuroma
List some plasma protein bound drugs
Warfarin Phenytoin Gliclazide (Sulphonylureas) Aspirin (NSAIDs) Methotrexate Amlodipine (Dihydropyridine) Sodium valproate
