managements Flashcards
IgA nephropathy
optimise BP
- ACEi
management of scabies
permethrin 5%
management of actinic keratosis
5% fluorouracil cream
Minimal change disease management
fluid restriction and reduced salt
corticosteroid therapy- prednisolone
human albumin and furosemide
management of pagets disease
bisphosphonates
NSAIDs for bone pain
vitD and calcium supplements
examples of bisphosphonates
Risedronate Alendronate Ibandronate Zoledronic Acid Pamidronate
management of otitis externa
Provide information on aural care.
Mild – do not swab. Acetic acid 2% continuing for 2 days after resolution (max 7 days).
Moderate – do not swab. Sofradex® or Otomize® tds. (antibiotic and steroid combo)
ENT for severe
fracture T4 or above suggests?
malignancy
management of kidney stones
NSAIDs for pain- IM diclofenac
watchful waiting
tamsulosin
surgical intervention
raised urinary:creatinine ratio with proteinuria in patient with diabetes
signs of end organ complications- diabetic neuropathy
what is seen on renal biopsy in patients with diabetic neuropathy
Kimmelstein-Wilson nodules
- regions of pink hyaline material that can be found in the glomerular capillary loops
glomerular crescents on renal biopsy
rapidly progressive glomerulonephritis
diagnostic features of glomerulonephritis
haematuria, oedema, hypertension and presence of risk factors
management of post-streptococcal glomerulonephritis
supportive
antihypertensive medications and diuretics if complication develop
diagnosis of post-streptococcal glomerulonephritis
history of tonsilitis- either positive throat swab results
and anti-streptolysin antibody titres
acute kidney failure and haemoptysis
good-pastures (associated with anti-GBM)
granulomatosis with polyangiits (ANCA)
Key to diagnosing IgA nephropathy
renal biopsy
what is seen on renal biopsy in IgA nephropathy
IgA deposits and glomerular mesangial proliferations
management of IgA nephropathy
monitoring
optimise BP- ACEi
management of minimal change disease
fluid restriction and reduced salt
corticosteroid therapy
human albumin and furosemide
management of BPH
alpha blockers- tamsulosin (relax smooth muscle, rapid improvement in symptoms)
5-alpha reductase inhibitors (finasteride)
diagnosis of varicocele
ultrasound with doppler
if left sided- could suggest renal cell carcinoma so US KUB
loin pain, haematuria, palpable mass
renal cell carcinoma
management of anti-phospholipid syndrome
low dose aspirin if they have no had a thrombosis yet
patients who experience venous or arterial thrombosis: life long warfarin
raynauds treatment of choice
Daily nifedipine
presentation of anti-phospholipid syndrome
CLOTS clots livedo reticularis obstetric complications thrombocytopenia- platelet deficiency
livedo reticularis
net-like mottling of the skin
Monteggia fracture
dislocation of the proximal radioulnar joint in association with an ulnar fracture
Galeazzi fracture
fracture of the distal radius with an associated dislocation of the distal radioulnar joint.
investigation for spinal stenosis
MRI
joint aspirate in rheumatoid arthritis
high WBC
management of SLE
Depends on manifestations For skin disease and arthralgia: - Hydroxychloroquine - Topical steroids - NSAIDs Inflammatory arthritis or evidence of organ involvement: - Immunosuppression: azathioprine Severe organ disease: - IV steroids and cyclophosphamide
Monitor anti-dsDNA and complement levels
Check urinalysis for blood or protein
management of septic arthritis
prolonged antibiotics 4-6weeks (fluxo?
pain exacerbated by walking on toes
plantar fasciitis
most common site of metatarsal stress fracture
2nd metatarsal shaft
treatment of hypoparathyroid
alfacalcidol
management of blepharitis
hot compress and gentle cleaning first line
lubricating eye drops
presentation of seborrhoeic keratosis
- Stuck on appearance
- Benign proliferation of epidermal keratinocytes
- Common in ageing skin
basically big crusty mole
management of seborrhoeic keratosis
- Reassure
- Cryotherapy if troublesome
management of nasal septal haematoma
urgent ENT referral
surgical drainage
intravenous antibiotics
Ptosis + dilated pupil
3rd nerve palsy
ptosis + constricted pupil
horners syndrome
In a child with an asymptomatic, fluctuant swelling behind the knee
Bakers cyst
Ankylosing spondylitis xray findings
subchondral erosions, sclerosis
and squaring of lumbar vertebrae
Oral ulcers + genital ulcers + anterior uveitis
Behcet’s
management of blepharitis
hot compress and cleaning of eyelids
argyll and roberston pupil
bilaterally small pupils that reduce in size on a near object, but do not constrict when exposed to bright light
what is vestibular neuronitis
inflammation of the vestibular nerve. This is usually attributed to a viral infection.
presentation of vestibular neuronitis
acute onset of vertigo
associated with nausea and vomiting (may be severe) and balance problems
history of viral upper respiratory tract infection
management of vestibular neuritis
Prochlorperazine for symptoms
Antihistamines
management of scarlet fever
oral penicillin
notify ph
cause of mumps
paramyxovirus
slapped cheek syndrome
erythema infectiosum
caused by parvovirus
management of croup
steroid dose ?
- dexamethasone
epiglottitis management
immediate ent help
Ceftriaxone IV
bronchiolitis management
supportive
oxygen
NG tube
whooping cough management
diagnosed by nasal swab
oral macrolide
hanging rope sign on xray
perthe’s disease
displaced klein lines on xray
slipped upper femoral epiphysis
management of DDH
mild: serial examinations + US
moderate: pavlik harness
severe/ >18 months: surgical open reduction/osteotomy
hearing loss, tinnitus, family history of early hearing loss
otosclerosis
management of ramsay hunt syndrome
aciclovir
prednisolone
first line treatment in treating pain from peripheral neuropathy
amitriptyline, duloxetine, gabapentin or pregabalin
management of renal complications in systemic sclerosis
ACEi
management of acute closed angle glaucoma
Intravenous acetazolamide and topical pilocarpine, beta-blockers, and steroids are used initially- NICE
1st- prostaglandin analogue (PGA) eyedrop (latanoprost)- PASSMED
bilateral conjunctivitis management
Chloramphenicol or fuscidic acid eye
positive straight leg raise test
sciatic pain
which Ig is found in mucosa
IgA
What produces endotoxin
gram negative
enzyme affected in PCT
uroporphyrinogen decarboxylase causing buildup of coproporphyrinogen iii
presentation of PCT
blisters, skin fragility, hyperpigmentation, hypertrichosis, solar urticaria and morphoea
sun exposed sites
red urine
type 1 PCT
acquired
liver damage
type 2 PCT
genetic
investigations for PCT
porphyrin plasma levels
examine under wood lamps- pink fluorescence
management of PCT
avoid iron, alcohol and oestrogen
sun cream
treat underlying
if still symptomatic- chloroquine, venesection
enzyme affected in Erythropoietic protoporphyria
ferrochelatase causing buildup of protoporphyin ix
presentation of EP
early- vesicles, blisters, skin fragility, pain and itch in sun
late- pitted scars, keratinised crusty skin
investigations for EP
fluorocytes, quantitative RBC porphyrins
monitor for liver disease
enzyme affected in acute intermittent porphyrias
PBG deaminase causing buildup of hydroxymethylbilane
complications of colles fractre
median nerve compression
EPL rupture
CRPS
loss of grip strength
What rheumatoid drug is nephrotoxic?
Gold, penicillamie
Which insulin do you give once a day
basal
management of anterior uevitis
urgent referral to ophthalmology
steroids- eye drops, topical or oral
Cycloplegic-mydriatic medications such as cyclopentolate or atropine eye drops- relieve the pain
enlarged blind spot
Pain on eye movement
Impaired colour vision
Relative afferent pupillary defect
optic neuritis
management of optic neuritis
urgent referral to ophthalmology
steroids
Haemolytic anaemia
Acute kidney injury
Low platelet count (thrombocytopenia)
HUS
most common cause of HUS
shiga toxin produced by e.coli
management of HUS
Antihypertensives
Blood transfusions
Dialysis
extra renal presentation of ADPKD
Hepatic cysts- appears later
SOB, pain, ankle swelling
Intracranial aneurysms- seen in clusters of family members, screen patients
Cardiac disease: mitral/aortic valve prolapse
Diverticular disease
management of ADPKD
tolvaptan- slow development of cysts
plus management of complications
SGLT2 mechanism of action
Increase renal loss > resulting in glucose reduction and weight loss
