Integrative Flashcards
normal range ph
7.35 - 7.45
how anion gap calculated
NaK - ClHCO3
causes of metabolic acidosis with normal anion gap
diarrhoea, renal tubular necrosis
how t1dm lead to shock
DKA causing dehydration
what is patient safty incident, near miss, serious untoward incident, never event
PSI - unintended event leading to pt harm
near miss - potential for harm
serious untoward incident - incident which may have legal or media reprecussions
never event - serious and largely preventable
how report clinical incident
datix reporting, inform key line managers
where haemotpoeisis in fetus
0-2 mths - yolk sac
3-5 mths - liver and spleen
6+ - BM
what is red an dyellow BM
red - haematopoeitic
yellow - fatty
what is red and white pulp of spleen
red - sinuses lined by endothelial macrophages
white - like lymph follicles
anatomy of lymph node. where are b and t cells found
see book
cortex - B cell
paracortex - t cell
what causes splenomegaly
increased work load, congestion e.g. portal hypertension, infilatration by WBC eg. brucellosis
causes of hyposplenism
coeliac and sickle cell
wat is aplastic anaemia
pancytopenia with hypocellular BM
what is ataxia telangiectasia. treat?
thymic hyperplasia leading to reduced B cells. treat with BM transplant
what is myelodysplasia
BM failure - reduced mature blood cells and increased erythrocytes. Abrnomal RBCs in blood
what are stellate cells of liver
secrete collagen scar tissue in damage
how does diastolic and systolic heart failure occur
diastolic - hypertrophy leading to stiff ventricles, improper diastole
systolic - dilated cardiomyopathy
what is clonus
3+ beats
what is folate
vit b9
what is hoffman reflex
tap middle or ring results in flexion of thumb. pathological if asymmetrical (UMNL)
haemorrhagic stroke causes
hypertension, anti coag, blood abnormalities, tumoue
symptoms of TACS
all of following - hemianopia. hemiparesis, hemisensory loss, cortical dysfunction - HHHC
symptoms of PACS
2 of HHH or cortical dysfunction
symptoms of anaemia and signs
symptoms - tired, dizzy, palpitations, headaches, SOB, weakness, angina, HF
signs - palor, tachycardia, systolic flow murmur
microcytic anaemia causes
TAILS - thalassemia, anemia of chronic disease, iron, lead, sideroblastic anemia
macrocytic anemia causes
alcoholism, b12 or folate deficiency, hypothyroidism
normocytic anemia causes
Bm failure, anaemia of chronic, mixed Fe and B12 def, bleeding(?)
name for increased neutrophils and causes
neutrophilia - smoking, infection, cancer, haemorrhage, inflammation,
name for increased monocytes and causes
monocytosis - chronic inflamm, chronic infection (TB), leukaemia
name for increased eosinophils and causes
eosinophilia - drug hypersens, allergic disease, parasite infection
name for increased basophils and causes
basophilia - UC, RA
what causes leukoerythroblastic anemia and result?
SOL in BM leads to immature blood cells in blood
what tests extrinsic and instrinsic clotting
extrinsic - INR
intrinsic - APTT
reduces platelet function?
uremia, NSIADs, hypergammaglobulinaemia
haemophilia factors A and B?
A - eight
B - nine
caues of non epileptic seizures
trauma, hypoglyc, hypoxia
give type1-4 hypersensitivty pathology and examples
1 - IgE - asthma, anaphylaxis
2 - IgG against cell surface antigens - autoimmune haemolysis, blood transfusion reaction
3 - Ag/Ab complex deposited in tissues leading to inflammation - RA, lupus
4 - Th1 cells activate macrophages which damage - graft rejection, hashimoto, TB
vit b12 drug?
hydroxocobalamin
metabolic pathways in RBC?
NADPH and (glucose to lactate and ATP)
tests for haemolysis
bilirubin, blood films, reticulocyte count, DCT, haptoglobin
anemia test
ferritin levels
explain anemia of chronic disease and how treat and test
inflammation goes to increased IL-6 which increases hepcidin which reduces ferroportin.
test - high ferritin with low % transferrin sat
treat - EPO
fluid in body?
40% of TBW in ICF
20% of TBW in ECF - 20% in plasma and 80% in ISF
how much g of solute in 5% solution
5g of solute in 100g of solution
where is parotid fascia come from
investing layer of deep cervical fascia
how is CSF circulated
help from ependymal cells in spinal cord
name of segments in small bowel and large bowel? difference?
small - valvulae conniventies (go all the way)
large - Haustra only half way
what happens to cells in hyperkalemia?
cell depolarised - Na channels inactivated. less AP
give factors to identify biliary colic
fatty meal is worse. referred to back pain. R hypochondriac
Diabetes type 2 management plan
lifestyle to metformin then sulphonylureas (above 7%) then TZD or insulin (above 7.5%)
Define standardised mortality rate
taking into account confounders, death comparison
