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Amir Sam Lectures > Lecture 3 - Mixed > Flashcards

Lecture 3 - Mixed Flashcards

1
Q

What is the first line treatment in Anaphylaxis?

A

IM Adrenaline

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2
Q

Which antibiotics would you prescribe in a case of atypical pneumonia?

A

Amoxicillin and a macrolide, such as clarithromycin.

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3
Q

Which organisms cause atypical pneumonia?

A

Mycoplasma pneumoniae

Chlamydia pneumoniae

Legionella pneumophila

Implicated in up to 40% of community-acquire pneumoniae.

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4
Q

How would you investigate a Microcytic Anaemia?

A

Haematinics

Coeliac Screen (TTG Antibody)

Remember the Red Flags

Top & Tail (OGD, colonoscopy)

Order depends on upper/lower symptoms.

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5
Q

What does this blood film show?

A

Schistocytes (RBC fragments)

In this case, due to Haemolytic Uraemic Syndrome

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6
Q

Which conditions are included in the term ‘Microangiopathic Haemolytic Anaemia?

A

Disseminated Intravascular Coagulation

Haemolytic Uraemic Syndrome

Thrombotic Thrombocytopenic Purpura

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7
Q

What is Disseminated Intravascular Coagulation?

A

Disseminated coagulation leads to the formation of abnormal clots and fibrin deposits. These narrow blood vessels, causing RBCs to fragment.

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8
Q

How is DIC investigated?

A

Increased clot formation leads to low platelets and fibrinogen and increased PT/APTT

D-dimer and fibrin degradation products are high due to increased clot breakdown.

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9
Q

How is Haemolytic Uraemic Syndrome investigated>

A

Haemolysis (Decreased Hb, raised Bilirubin)

Uraemia

Decreased Platelets

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10
Q

How does Thrombotic Thrombocytopenic Purpura present?

A

Haemolytic Uraemic Syndrome +

Fever +

Neurological manifestations

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11
Q

How would you classify the causes of Haemolytic Anaemia?

A

Hereditary:

RBC Membrane (Hereditary Spherocytosis)

Enzyme Deficiency (G6PD Deficiency)

Haemoglobinopathy (Sickle Cell / Thalassaemias)

Acquired:

Autoimmune

Drugs

Infection

MAHA (Microcytic Angiopathic)

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12
Q

What does this AXR show?

A

Valvulae Conniventes

Small Bowel Dilatation (Obstruction)

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13
Q

How would you classify the clinical thinking about a patient presenting with hyponatraemia?

A

Hypovolamia:

  • Diarrhoea
  • Vomiting
  • Diuretics

Euvolaemia:

  • Hypothyroidism
  • Hypoadrenalism
  • SIADH

Hypervolaemia

  • Cardiac Failure
  • Cirrhosis
  • Nephrotic Syndrome

Hyper/Hypo - Low urine Na

Eu-High urine Na

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14
Q

What are the causes of SIADH?

A

CNS Pathology

Lung Pathology

Drugs (SSRI, TCA, opiates, PPIs, carbamazepine)

Tumours

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15
Q

What is the name of this sign?

A

Onycholysis

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16
Q

What are the causes of onycholysis?

A

Trauma

Thyrotoxicosis

Fungal Infections

Psoriasis

17
Q

What are the main complications of Diabetes?

A

Microvascular:

  • Retinopathy
  • Nephropathy
  • Neuropathy

Macrovascular:

-MI/Stroke/PVD

Metabolic:

-DKA/HHS/Hypoglycaemia

18
Q

What would you see on the ECG of someone experiencing a Posterior STEMI?

A

Prominent R wave in V1

19
Q

What would you hear on auscultation of a patient with pericarditis?

A

Scratching Sound

20
Q

What is the gold standard investigation for Ureteric Colic?

A

CT KUB

21
Q

What are the causes of a raised ALP?

A

Obstructive Liver Disease

Bone Disease (Malignancy, fracture, Paget’s Disease)

22
Q

What should a patient’s ALP be if they have Multiple Myeloma, and why?

A

Normal.

Osteoblasts make ALP

Plasma Cells suppress Osteoblasts.

23
Q

What are the presenting signs of Multiple Myeloma?

A

Raised Calcium

Renal Impairment

Anaemia

Bone Pain

24
Q

What is the most common cause of a lump in a young woman, that is

Small,

Smooth &

Mobile

?

A

Fibroadenoma

25
Q

What is Nephrotic Syndrome?

A

Increased permeability of the Glomerular Basement Membrane to protein.

>g/day Proteinurea

Hypoalbuminaemia

Oedema

26
Q

What is Hereditary Haemorrhagic Telangiectasia?

A

Autosomal Dominant

Abnormal Blood Vessels in the:

  • Skin
  • Mucous Membranes
  • Lungs
  • Liver
  • Brain
27
Q

What would be the expected result in a normal Short Synacthen Test?

A

The cortisol should have increased by 450 in the first 30 minutes.

28
Q

What effect does a Prolactinoma have on other hormones?

A

High levels of Prolactin suppresses FH and LSH.

This leads to a suppression of Testosterone.

All go down.

29
Q

How do you investigate possible Acromegaly?

A

Serum IGF-1.

Not GH as it is pulsatile.

IGF-1 is made in the liver in response to GH.

Amir Sam Lectures (6 decks)

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