Laz Paper 8 Flashcards
What are the organisms that cause HAP?
- Staph aureus
- E.coli
- Klebsiella (aspiration pneumonia)
How should gastroenteritis be managed?
Bed rest and oral rehydration therapy as it is self limiting
What is neurofibromatosis?
Neurofibromatosis is an autosomal dominant condition that causes neural tumour formation
What are the features of neurofibromatosis type 1?
- Cafe au lait macule formation (flattened dark areas)
- Auxillary freckling
- Skin tag formation
- Renal artery stenosis
- Phaeochromocytomas
What are the features of neurofibromatosis type 2?
- Bilateral vestibular schwannommas
- Gilomas
- Meningiomas
What are the extra-articular features of ankylosing spondylitis?
5 As
- Apical lung fibrosis
- Aortic regurgitation
- Amyloidosis
- Anterior uveitis
- Achillies tendonitis
What are the causes of erythema nodosum?
LOST BUSH
Lymphoma (non-hodgekins), leukaemia, leprosy
OCP (+ pregnancy)
Sulphonamides and sarcoidosis
TB, toxoplasmosis
Behcet’s
Ulcerative colitis (+ crohn’s)
Salmonella and strep
Histoplasmosis
What is Murphy’s sign?
Asking the patient to inhale to push their gallbladder down and palpating, if the patient has cholecystitis the inflamed gallbladder coming into contact with the hand will cause pain
What is the inheritance pattern of Guilbert’s?
Autosomal recessive
What is the lifespan of a sickle cell?
20 days
What is an aplastic crisis?
An aplastic crisis is a reduction in the production of reticulocytes leading to an overall reduced number of red blood cells
What steps should be taken if a patient is in status epilepticus?
- A-E assessment (secure the airway and ventilate with high flow O2)
- IV lorazepam (PR) or buccal midazolam in the community
- If unresolved within 10 mins add IV phenytoin
- If still unresolved add IV thiopentone
Why are ECG and blood pressure monitored in status epilepticus management?
ECG and blood pressure should be closely monitored when IV phenytoin is administered as this can reduce heart rate and blood pressure
What are the 5 Ps of pleuritic chest pain?
- Pericarditis
- Pneumonia
- PE
- Pneumothorax
- Pleurisy
Why is there hypercalcaemia in sarcoidosis patients?
Sarcoidosis produces non-caseating granulomas which themselves produce 1-alpha hydroxylase which catalyses production of calcitriol, increasing Ca2+ absorption in the gut
What are the main breast cancer risk factors?
Over-exposure to oestrogen
- Early menarche
- Late menopause
- Lack of pregnancies
- Hormone replacement therapy
- OCP
What are the most common causative organisms of septic arthritis?
- Neisseria gonorrhea (young, sexually active people)
- Staph aureus
- Streptococci
What is the most common causative organism of septic arthritis in children?
Haemophilus influenzae
What is chronic kidney disease?
<60 mL/min/1.73m2 >3 months
What is the management for heart failure?
- Sit the patient upright
- Administer O2 and ECG
- Diamorphine
- Furosemide
- GTN
- CPAP (if not improving after pharmacological treatment)
What is Pemberton’s test?
The patient raises their arms above their head for one minute and then lowers them and their face remains red, inspiratory stridor and raised non-pulsatile JVP
Why can heart failure reduced ejection fraction lead to pulsus alternans?
Pulsus alternans= alternating strong and weak beats
Reduced ejection fraction means there is increased EDV which increases preload and therefore increases cardiac force of contraction
What is pulsus paradoxicus?
Drop in blood pressure with inspiration seen in constrictive pericarditis and cardiac tamponade
What is pulsus parvus et tardus?
Slow rising pulse seen in aortic stenosis
What is IgA nephropathy?
IgA nephropathy is the most common cause of nephropathy and leads to nephritic syndrome
What is the triad of nephritic syndrome?
- Haematuria
- Proteinurea
- Increased blood pressure
What is the triad of nephrotic syndrome?
- Proteinurea
- Hypoalbuminaemia
- Oedema
What is the clinical difference between IgA nephropathy and post-streptococcal glomerulonephritis?
IgA nephropathy develops within 5-7 days post infection whereas post-streptococcal glomerulonephritis develops 4-6 weeks after an infection
Both tend to follow pharyngitis