Family Med Flashcards
Adrenal glands
Hyperadrenocorticism - Primary hyperaldosteronism - Symptoms
1) HYPERTENSION :
- often severe,
- RESISTANT TO HYPOTENSION TREATMENT .
2) MUSCLE WEAKENING AND MUSCLE CRAMPS
3) Tetany
*In case of severe hypokalemia, when metabolic alkalosis occurs.
4) Polyuria
5) Increased thirst
6) Paresthesia
Migraine
Prevention
- lifestyle change ,
- psychological support,
- pharmacological prevention:
- SODIUM CHANNEL BLOCKERS (sodium valproate, topiramate)
- CALCIUM CHANNEL BLOCKERS ( flunarizine )
- β-BLOCKERS (propranolol , metoprolol),
- TRICYCLIC DRUGS (pizotifen, amitriptyline )
- acupuncture.
Hypertension
Treatment – Follow-up visits
- It is recommended to achieve a blood pressure of <140/90 within 3 months and
then quickly achieve the final goal of <130/80 mmHg. - In the first period, visits should take place once a month .
- Once good CT control is achieved, visits may take place once every 3 months .
Division of anemia according to its severity:
mild
moderate
severe
life threatening
1) mild – Hb 10–12.0 g/dl in women, 13.5 g/dl in men
2) moderate – Hb 8–9.9 g/dl
3) severe - Hb 6.5–7.9 g/dl
4) life-threatening – Hb <6.5 g/dl.
The following tests must be performed on every patient with newly diagnosed hypertension:
A) Na+, K+ concentrations
B) creatinine concentration with estimated GFR
C) peripheral blood morphology
D) lipid profile.
Acarbose has
~100,000 times greater affinity for α-glucosidase (the enzyme of the brush border of intestinal villi) than oligosaccharides and by binding to the active site of this enzyme, it temporarily almost completely blocks its action . - Blocking α-glucosidase inhibits and slows down the final enzymatic stage of digestion of polysaccharides, oligosaccharides and some disaccharides (maltose, sucrose), which results in a reduction of postprandial glycemia and insulinemia, and contributes to a reduction in triglyceride synthesis.
Neoplasms of mature lymphocytes and plasma cells
The diagnosis of multiple myeloma is suggested by the presence of symptoms included in the acronym CRAB :
- C - calcium level –> calcium concentration 4 mmol/l (norm 2.1 - 2.6 mmol/l) –> hypercalcemia;
- R - renal insufficiency –> creatinine concentration 2.1 mg/dl (norm 0.6 - 1.3 mg/dl);
- A - anemia –> mild normocytic anemia;
- B - bones –> previous fracture of the radius after a minor fall, periodic pain in the lumbar spine –> suspected lytic changes in the bones.
endocrine syndromes:
paraneoplastic syndromes in lung cancer include:
- Cushing’s syndrome;
- hypercalcemic syndrome;
- syndrome of increased secretion of vasopressin (SIADH);
- gynecomastia;
- hypo- i hyperglycemia;
neurological syndromes:
paraneoplastic syndromes in lung cancer include:
- peripheral neuropathy;
- cerebellar degeneration
- Lambert-Eaton myasthenic syndrome;
hematological teams:
paraneoplastic syndromes in lung cancer include:
- anemia;
- DIC syndrome;
- dysproteinemia;
dermatological teams:
paraneoplastic syndromes in lung cancer include:
- dermatomyositis;
- brown keratosis.
Zollinger-Ellison syndrome (ZES)
Define:
- is a set of symptoms and complications of excessive secretion of hydrochloric acid by the gastric mucosa caused by a gastrin-secreting neuroendocrine tumor, most often located in the pancreas or duodenum.
Zollinger-Ellison syndrome is characterized by:
- increased fasting serum gastrin concentration
- positive result of secretin gastrin stimulation test
- clinical symptoms:
a. recurrent, refractory or complicated peptic ulcer disease
b. Gastroesophageal reflux disease
periodic diarrhea.
The drugs of choice for the treatment of whooping cough are
- macrolides (azithromycin, clarithromycin, erythromycin).
- In case of intolerance or allergy to them, cotrimoxazole can be used.
The following groups of drugs are used to treat urinary incontinence in seniors:
- anticholinergics,
- estrogen preparations,
- serotonin and noradrenaline reuptake inhibitors,
- adrenergic receptor antagonists.
