General mix Flashcards
is myocardial infarction pain gradual or sudden in nature
gradual in nature
- example of sudden would be a pneumothorax
how to determine if there is left bundle branch block
V1 negative - W
V6 positive- M
how to determine if there is right bundle branch block
V1- M
V6- W
right axis deviation
IIII largest
left axis deviation
aVL largest
example of Trifascicular block
Prolonged PR interval + RBBB + left axis deviation
describe
saddle shaped
- most sensitive for pericarditis
describe
PR depression
- most specific for pericarditis
investigation for aortic stenosis
transthoracic echocardiogram
- may show left ventricular hypertrophy
investigation for endocarditis
transosophogeal echocardiogram- better image of vegetation of valve
signs of pulmonary oedema of x-ray
- Bat wing sign
- Kerley B lines
infective endocarditis antibiotics: Initial blind therapy
Native valve
- amoxicillin, consider adding low-dose gentamicin
If penicillin allergic, MRSA or severe sepsis
- vancomycin + low-dose gentamicin
Native valve endocarditis caused by staphylococci
Flucloxacillin
Endocarditis caused by fully-sensitive streptococci (e.g. viridans)
Benzylpenicillin
PCOS
- Multiple ovarian cysts
- Infertility
- Infrequent periods
- Hyperandrogenism
- Hirtuism
- Acne
- Insulin resistance
- OBESITY
PCOS test finding
Hormonal blood tests typically show:
- Raised luteinising hormone
- Raised LH to FSH ratio (high LH compared with FSH)
- Raised testosterone
- Raised insulin
- Normal or raised oestrogen levels
TOM TIP: The key thing to remember for your exams is the raised LH, and the raised LH:FSH ratio.
management of PCOS
- weight loss
- reduce risk of endometrial cancer
- mirena coil
- COCP
- treat other symptoms normally e.g. for acne
chicken pox virus
varicella-zoster virus
HIV is what sort of virus
retrograde ssRNA
scabies manageemnt
- permethrin
- second line malathion
croup symptoms
barking cough- viral
epliglottis is
bacteria
- a severe sore throat.
- difficulty and pain when swallowing.
- leaning forwards.
- stridor
- drooling
risks for GA: common
- sore throat
- PONV
risks for GA: significant
- aspiration
- dental injury
- malignant hyperthermia
- accidental awareness
Osgood-Schlatter disease
is caused by the constant pulling of the tendon in the knee. It’s seen in growing children and teens. This is an age where the bones are typically growing faster than the muscles and tendons. As a result, the muscles and tendons tend to become tight.
what is erythema infectiosum
fifth disease
fifth disease
slapped cheeked- parvovirus
- lace rash on face
- general illness
viral wheeze management in children
salbutamol and prednisolone
where are anal fissures most common
- posterior midline of the anal canal.
management of anal fissure
- soften stool
- high fibre
- laxative
- Topical glyceryl trinitrate (GTN) is first-line treatment for a chronic anal fissure
Sign of PE on ECG
- Sinus tachy
- RBBB
- Right axis deviation
where does the anaesthetic get injected for epidural
epidural space- outside the dura mater
- An epidural involves inserting a small tube (catheter) into the epidural space in the lower back. This is outside the dura mater, separate from the spinal cord and CSF. Local anaesthetic medications are infused through the catheter into the epidural space, where they diffuse to the surrounding tissues and spinal nerve roots, where they have an analgesic effect. This offers good pain relief during labour. Levobupivacaine is often used, with or without fentanyl.
germ cell tumours- most common
-
Seminomas
- Remain localised- very good prognosis
-
Non-seminomatous GCTs (metastasise early)
- Yolk sac tumours
- Choriocarcinoma
- teratoma
Non germ cell tumours (NSGCT)
A
- Usually benign
- Comprise
- Leydig cell tumour
- Sertoli cell tumours
criteria for inpatient admission- stones
- Post-obstructive acute kidney injury- renal impairment
- Uncontrollable pain from simple analgesics
- Evidence of an infected stone(s)
- Large stones (>5mm)
definitive management of renal stones
-
Extracorporeal shock with lithotripsy
- <2mm
-
Percutaneous nephrolithotomy
- for larger stones e.g. staghorn
adverse reaction to dialysis
- septicaemia
- endocarditis
- thrombosis
- AV fistula steal syndrome- causing ischaemic limb
risk factor for ectopic pregnancy
previous pelvic surgery
PID
intrauterine contraceptive device
FeverPAIN score
- Fever
- Pus on tonsils
- Attends rapidly
- Inflamed tonsils
- No cough
>4 consider abx
fungi which causes skin rash
Trichophyton rubrum
- Terbinafine- topical
- itraconazole
CGA
comprehensive geriatric assessment
- problem list
- medication rveiew
- nutritional status
- functional capacity- ADR
- social
- home environemnt
- mental health
MUST
BMI
%weight loss
effective acute illness
UTI in pregnancy
Cephalexin safe throughout
- nitro- safe in first
- tri- safe in third
kawasaki
- aspirin
- do an echocardiogram
features of insulinoma
- Hypoglycaemia: typically early in morning or just before meal, e.g. diplopia, weakness etc
- rapid weight gain may be seen
- high insulin, raised proinsulin:insulin ratio
- high C-peptide
diagnosis: 72 hour fast
Blood test findings in acromegaly
- high IGF-1
- GH will not be suppressed after glucose
low cortisol can be split up into
- Primary cortisol insufficiency- Addisons → damage to the adrenal gland
- Secondary cortisol insufficiency - Damage directly to the pituitary (not enough ATCH)
Ottawa rules
where does lumbar puncture go through
L3/L4
inserted through the dura mater and arachnoid mater into a region called the subarachnoid space i.e. deeper than an epidural. This is done to take a sample of the cerebrospinal fluid (that fills that space) for disgnostic purposes, i.e. to test it to find out what is wrong with a patient.
Bronchiolitis- auscultation
fine inspiratory crackles
fine inspiratory crackles
pulmonary fibrosis
coarse inspiratory crackles
bronchiectasis
coarse crackles and green phlegm
- Moxella catarrhalis
- Haemophalis influenza
- Strep pneumonia
diff between pneumonia and bronchitis
will not show up on x-ray
management of bacterial bronchitis (although usually viral)
- first choice- doxycycline,
- second choice amoxicillin
*
Chlamydia psittaci
atypical pneumonia- parrott
lyme disease treatment
doxyxycline
- bulls eye rash- ticks
Contraindication to lumbar puncture
raised intracranial pressure e.g. reducing GCS
Suspected meningitis in the community- give
benzylpenicillin
Empyema classic symptom
swing fever, complication of pneumonia
heard failure on x-ray
Empyema – swing fever, complication of pneumonia
Heart failure on x-ray
- Cardiomegaly
- Alveolar oedema
- Kerley B
antibodies for hashimotos
ant-Thyroid peroxidase
antibodies in graves
anti TSH receptor
