Gen Med 4 Flashcards
ECG changes of tetralogy of fallot
Short duration peaked P wae in V1. Right axis deviation. Tall R waves in V1
ECG changes in VSD
No change if small.
Broad notched P-wave.
Right axis deviation if large VSD.
Deep Q and Tall R wave,
Tall T waves in V5, V6.
ECG changes in inferior myocardial infarction
Affects right coronary artery.
- ST elevation in lead II, III, aVF.
- ST depression in aVL
- Deep Q in II, III, aVF
10 diseases with cough
- Acyclic cough (pulmonary abscess),
- Bitonal cough (bronchiolitis),
- Chronic cough (rhinitis, bronchial asthma),
- Dry cough (acute bronchitis, laryngitis),
- Dry irritating cough (left-sided cardiac failure),
- Moist cough (bronchitis, smoker’s bronchitis)
- Paroxysmal cough (pertussis),
- Painful cough (pneumonia, osteomyelitis),
Complications of Diabetes
macro: c spad
micro: ran
macrovascular (coronary artery disease, stroke and peripheral arterial disease)
microvascular (retinopathy, nephropathy, and neuropathy)
Non Cardiac Chest Pain
Esophageal Sources of NCCP
- GERD
- achalasia
- esophageal Hypersensitivity
Non-esophageal sources that can cause NCCP
- Musculo-skeletal conditions of the chest wall or spine
- pulmonary (lung) disorders,
- pleural illness
- pericardial conditions
- digestive disorders such as
- ulcers, gallbladder, pancreatic diseases and rarely
tumors (particularly in patients past age 50).
- ulcers, gallbladder, pancreatic diseases and rarely
Acute complications of nephrolithiasis
- Acute pyelonephritis
- Abscess formation,
- infected hydronephrosis (most deadly),
- diminished renal function,
- Urinary fistula formation
List diseases with acute abdominal
pain
- Acute cholecystitis. Acute appendicitis or Meckel’s diverticulitis. Peptic ulcer disease. Acute pancreatitis.
- Ectopic pregnancy.Pelvic inflammatory disease.
- Intestinal obstruction, including paralytic ileus (adynamic obstruction). Gastroenteritis.
- Acute intestinal ischaemia/infarction or vasculitis.
- Gastrointestinal (GI) haemorrhage.
- Renal colic or renal tract pain. A
- cute urinary retention.
- Abdominal aortic aneurysm.
- Testicular torsion.
Non-surgical disease - eg,
- myocardial infarction, pericarditis, pneumonia, sickle cell crisis hepatitis, inflammatory bowel disease, opiate withdrawal, typhoid, acute
- intermittent porphyria, HIV-associated lymphadenopathy or enteritis.
5 groups of symptoms in palliative care patients
Pain: Physiologic, nociceptive/inflammatory, neuropathic, mixed
fatigue, physical weakness (anorexia), physical inactivity (can lead to constipation)
loss of appetite, nausea and vomiting
worry/anxiety, depression,
Substance Abuse (types + how to recognise)
Stimulant (nicotine),
Depressant (opiates heroin),
Psychedelic (LSD),
Marijuana, Alcohol
3 Models of consultation and description
Berne’s Transactional model
3 states of ego:
- parent (authority, critical/caring)
- adult (logical)
- child (intuitive, spontaneous/dependent)
Byne & Long model helps with structure of consultation
- DR establishes relationghip with patient & tries to find reason for visiting
- verbal&physical exam, consider the problem and plan of action, ends consultation
Stott & Davis model = 4 areas to be explored in each consultation.
- manage presenting problem
- manage continuing problems
- modification of self-seeking behaviours
- opportunistic health promotion
5 problematic Families
Abusive/domestic violence
single parent
addictions (substance or alcohol),
untreated mental illness,
How to test development in children
Assess physical and mental progress
Evidence Based Medicine definition
The main postulate of EBM is that any clinical decision and any technological operationshould be based on the strict scientific evidence.
Decreasing value of EBM
- Meta-analysis
- systemic review
- evidence from trials with precise design(cohort studies)
- expert analysis
- critical appraisal of evidence
