lectures A-E Flashcards
Paradoxical respiration (seesaw motion) is a hallmark of inhibition of gas exchange due to diaphragmatic or respiratory muscle fatigue seen in what
chest wall retracts and abdomen pushes out
COPD or airway obstruction
Features of airway obstruction in comatose pt
snoring gurgling , lack of misting on oxygen mask , seas saw and intercostal recession as well as cyanosis
SCOOP guidelines
management of haematoma after thyroid surgery
contact crash team
steri strips - remove
cut sutures
push fingers into wound
open skin to expose strap msucles
open strap musclesto expose the trachea
cover wound with a pack
anaphylaxis adrenaline how mnay mintues apart
5 mins
what is asthma called before 2years of age
viral induced wheeze
where do you insert an epi pen
upper outer thigh
adrenaline in small doses causes vadodialtion what does it do in higher doses
vasoconstriction
Although α receptors are less sensitive to epinephrine, when activated, they override the vasodilation mediated by β-adrenoceptors. The result is that high levels of circulating epinephrine cause vasoconstriction.
what is an allergy
An allergy is a reaction your body has to a particular food or substance. - a condition of hypersensitivity to an allergen - considered harmless to msot people
what is atopy
Atopy - a hypersensntivie response on a apart of the body not in direc contact with allergen - atopic dermiaitis
what is anaphylaxis
Anaphylaxis - acute life threatening hypersensositvry reaction
4 types of hypersensitivity
Type 1 hypersensitivity- anaphyalcitc reaction - short time from exposure to sx
IgE mediated with mast cell and basophilis
Type 2- cytotocix - IgM anad iGg binds to target natigen on a host cell cauin gimmune response - autoimmune response - eg graves disease , myasthenia, goodpastures
Type 3 - immune complex - intial exposure to antigen formation of immune complex - igG - serum sickness, lupus
Type 4 - delayed or cell mediated - T cell - contact with antigen - contact dermatitis or due to forming of granulomas (TB_)
Prukary mode of damage eg coealiacs or contact dermatitis - belt rash or ring
How to be primed first. Sensitization event - allergen b cells ige to mast cells
Allergic reaction - allergen to mast cell and hsitmaien released rom mast cel
anaphylaxis is what type of shock
distributive
angioodema caused by what drugs
ACEi
what shocks have a narrow or wide pulse pressure
Shock
Narrow pulse pressure( difference between systolic and diastolic) shock - less fluid trying to fill same space
Hypovolaemic
Haemorrhaic
Cariogenic
Obstructive - tamponade or PE
Wide pulse pressure - unrecordable diastolic potentially
Septic shock
Anaphylactic
what enzyme measure of anpahyalctic reaction
Tryptase - remains elevated for around 6 hours and highest afyer 3 - normal value is under 10
A seventy-two-year-old woman with rheumatoid arthritis is recovering on the ward 6 days following a left hemi-colectomy for a tumour in the descending colon. She complains to the nurse looking after her that she has developed pain in her abdomen. The pain is diffuse and came on suddenly but has gradually been getting worse since onset. She ranks it an 8/10. She has not opened her bowels or passed flatus since the procedure.
On examination:
Blood pressure: 105/68 mmHg; Heart rate: 110/minute; Respiratory rate: 16/minute; Temperature: 38.2 ºC; Oxygen saturations: 98%.
Abdominal exam: abdomen is distended. Diffusely tender upon palpation and evidence of guarding throughout. No organomegaly. No pulsatile masses. Kidneys are non ballotable. No shifting dullness. Absent bowel sounds.
There is feculent matter in the abdominal wound drain.
Which of the following imaging modalities is the most appropriate investigation?
abdomianl CT for anastamotic leak - risk facotrs include steriods
Pseudocholinesterase deficiency (also known as suxamethonium apnoea) is a rare abnormality in the production of plasma cholinesterases. This leads to an increased duration of action of muscle relaxants used in anaesthesia,
suxamethonium. Respiratory arrest is inevitable unless the patient can be mechanically ventilated safely while waiting for the circulating muscle relaxants to degrade.
difference between pleomorphic adneoma dn warthin tumour
pleomorphic most common, slow growing and warthin associated with smoking, bilateral disease
tx of ramsay hunt syndrome
Oral aciclovir for 7 days and oral prednisolone for 5 days
gingival hyperplasia caused by what
phenytoin, ciclosporin, calcium channel blockers and AML
otitis externa tx
Topical antibiotics with or without steroid are first line treatment in otitis externa
Topical antibiotic + a topical steroid for 1-2 weeks
persistant mouth ulcer think
Persistent mouth ulcer → ?squamous cell carcinoma
ototoxic meds
gentamicin, quinine, furosemide, aspirin and some chemotherapy agents
Tonsilar SCC is associated with
HPV infection
two types of dental abcess
Periapical abscess (dentoalveolar abscess) — originates in the dental pulp (centre of the tooth), and is the most frequently occurring type, in both adults and children.
Periodontal abscess — originates in the supporting structures of the teeth (such as the periodontal ligament) between the tooth and the gum.
`CP causes
Heart attack (lack of blood to your heart).
Coronary artery disease (CAD, a narrowing or blockage in your heart’s arteries).
Coronary artery dissection (tear in a heart artery).
Pericarditis (inflamed sac around your heart).
Hypertrophic cardiomyopathy (thick heart muscle).
PE
Pulmonary hypertension. …
Collapsed lung. …
Gastroesophageal reflux disease (GERD) …
Esophageal Rupture. …
Hiatal Hernia. …
Costochondritis. …
Muscle Strain.
syncope what do you need to know
what doing 10mins before build ip
Carotid sinus hypersensitivity is an exaggerated response to pressure applied to the carotid sinus located in the carotid bifurcation, resulting in bradycardia, vasodilation, and hypotension.
how to treat
cardiac pacing
what part of the ECG is synchronized during cardioversion
peak of the QRS
to maintain sinus rhythm after dc cardioversion what drug can you give
IV amiodarone
cx of LBBB
Aortic stenosis
Ischaemic heart disease
Hypertension
Dilated cardiomyopathy
Anterior MI
Lenègre-Lev disease: primary degenerative disease (fibrosis) of the conducting system
Hyperkalaemia
Digoxin toxicity
