general diseases

Question 1

what causes anaemia

Answer 1

reduced production of haemoglobin
increased loss
increased demand

Question 2

what investigations should be carried out for anaemia

Answer 2

full blood count including haematinics
renal function test
endoscopy - ulceration, colonoscopy - bowel disease

Question 3

name sources of haematinics

Answer 3

ferritin - iron - meat
vitamin b12 - animal products - dairy, meat
folate - green leafy veg

Question 4

how can you differentiate between deficiency and bleeding in anaemia

Answer 4

MCV - will be normal in bleeding
HCT - haematocrit will be reduced

Question 5

what are common causes of blood loss in young and elderly

Answer 5

young - more likely to be due to internal damage from drinking alcohol
old - polyps of large intestine, turn malignant
young females - menstration

Question 6

what are causes of iron loss

Answer 6

gastric ulcers
ulcerative colitis, crohns
colon cancer
haemarrhoids

Question 7

what is pernicious anaemia and how is it treated

Answer 7

lack of intrinsic factor - required for absorption of vitamin b12 into blood
requires injections of vitamin b12

Question 8

what are symptoms of asthma

Answer 8

cough
wheeze
shortness of breath

Question 9

what is asthma

Answer 9

reversible airflow obstruction

Question 10

what is the triad of asthma

Answer 10

bronchial smooth muscle constriction
bronchial mucosal oedema - inflammatory mediators
excessive mucous secretion into airways

Question 11

what are common triggers for asthma

Answer 11

cold, dust, smoke

Question 12

what is the action of salbutamol

Answer 12

reduced bronchial constriction - smooth muscle dilation - opening of airways, short acting 2-5minutes

Question 13

how are corticosteroids effective for asthma treatment

Answer 13

removes triad - reduces broncho constriction
reduces inflammation
reduces mucous production

Question 14

what is copd

Answer 14

combination
obstructive - inflammation, mucous production and constriction
destruction - emphysea destroying alveoli - less surface area for gas exchange

Question 15

what is haemiphillia a

Answer 15

sex linked recessive disease - deficiency in factor VIII in clotting cascade - makes more prone to bleeding

Question 16

what is haemiphillia b

Answer 16

sex linked recessive disease - deficiency in factor IX in clotting cascade

Question 17

what is von willebrand disease

Answer 17

autosomal dominant disease with combination of deficiency of factor VIII and platelet aggregation

Question 18

how are haemiphilias treated

Answer 18

severe - require replacement of factor they are deficient in, requiring blood transfusion

moderate - DDAVP works in A and VWB - pull factor VIII off of cells, transexemic acid - stops blood clots from breaking down

Question 19

what drugs does warfarin interact with

Answer 19

NSAID
Azoles

Question 20

what is the effect on long term steriod use on production of cortisol

Answer 20

therapeutic steroids are much more potent than cortisol, reduces bodys need to produce cortisol, dampens down production - atrophy of adrenal cortex
when patient comes off of steroids, their body is unable to produce cortisol initially
also, if a patient is on therapeutic steroids but has an infection - their body is unable to produce additional cortisol to deal with the stress

Question 21

when would you consider steroid prophylaxis for a patient

Answer 21

if the procedure is likely to cause stress on the body - minor oral surgery, difficult extraction

if the patient is on 1-15mg of prednisolone

if the patient has stopped taking steroids in the past 3 months after long term use

Question 22

what are side effects of steroids

Answer 22

increased sodium and water reabosrption - increased weight gain

type 2 diabetes mellitus

increased risk of infections - candidal, reduce immune system

hyperpigmentation - raised levels of ACTH