general diseases Flashcards
what causes anaemia
reduced production of haemoglobin
increased loss
increased demand
what investigations should be carried out for anaemia
full blood count including haematinics
renal function test
endoscopy - ulceration, colonoscopy - bowel disease
name sources of haematinics
ferritin - iron - meat
vitamin b12 - animal products - dairy, meat
folate - green leafy veg
how can you differentiate between deficiency and bleeding in anaemia
MCV - will be normal in bleeding
HCT - haematocrit will be reduced
what are common causes of blood loss in young and elderly
young - more likely to be due to internal damage from drinking alcohol
old - polyps of large intestine, turn malignant
young females - menstration
what are causes of iron loss
gastric ulcers
ulcerative colitis, crohns
colon cancer
haemarrhoids
what is pernicious anaemia and how is it treated
lack of intrinsic factor - required for absorption of vitamin b12 into blood
requires injections of vitamin b12
what are symptoms of asthma
cough
wheeze
shortness of breath
what is asthma
reversible airflow obstruction
what is the triad of asthma
bronchial smooth muscle constriction
bronchial mucosal oedema - inflammatory mediators
excessive mucous secretion into airways
what are common triggers for asthma
cold, dust, smoke
what is the action of salbutamol
reduced bronchial constriction - smooth muscle dilation - opening of airways, short acting 2-5minutes
how are corticosteroids effective for asthma treatment
removes triad - reduces broncho constriction
reduces inflammation
reduces mucous production
what is copd
combination
obstructive - inflammation, mucous production and constriction
destruction - emphysea destroying alveoli - less surface area for gas exchange
what is haemiphillia a
sex linked recessive disease - deficiency in factor VIII in clotting cascade - makes more prone to bleeding
what is haemiphillia b
sex linked recessive disease - deficiency in factor IX in clotting cascade
what is von willebrand disease
autosomal dominant disease with combination of deficiency of factor VIII and platelet aggregation
how are haemiphilias treated
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
what drugs does warfarin interact with
NSAID
Azoles
what is the effect on long term steriod use on production of cortisol
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
when would you consider steroid prophylaxis for a patient
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
what are side effects of steroids
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
