Miscellaneous Flashcards
what is relevant under the cartilaginous part of the nose?
Littles area - to be compressed during epistaxis
Which troponin binds to the tropomyosin complex?
Troponin C
Which troponins are only found in cardiac muscle after cardiac damage?
Troponin T and I
What autoantibodies are present in SLE?
ANA’s
Anti-SM
dsDNA
What are the initial symptoms of SLE?
Photosensitive rash Oral ulceration Arthritis - RA but reducible Seizure Psychosis Anaemia and Thrombocytopenia Nephrosis (toxic to kidney)
What would you expect to see on a patient with SLE’s urine dipstick?
Lots of protein present
Blood may also be present
How is mild SLE treated?
Topical NSAIDs
Lifestyle - avoid the sun
How is moderate SLE treated?
DMARDs (methotrexate, sulfasalazine, infliximab)
Steroid injections
what shape is clostridium difficile?
Gram positive bacillus
what is sarcoidosis?
Multisystem disorder characterised by non-caseating granulomatous inflammation.
What are possible causes of sarcoidosis?
Mycobacter- TB infection
What are the symptoms of sarcoidosis? A GRUELLING Disease.
ACE increase Granulomatous inflammation aRthritis Uveitis Erythema nodosum Lymphadenopathy - bilateral hilar Lupus pernio Idiopathic Non-caseating Gammaglobulinemia vitamin D deficiency
What lung problem is signature of chronic sarcoidosis?
Interstitial fibrosis - crackles, cough and dyspnoea.
What investigations may be used for acute or chronic sarcoidosis and how may they differ?
Both = CRP/ESR increase Chronic = Increased ACE, IgG, Calcium, ALP Both = pulmonary function tests - X-ray - HRCT
What is the treatment of sarcoidosis?
Stage 0-1
Stage 2
Severe
0-1 = spontaneously resolution
2+ = Bed rest and NSAIDs
If have parenchymal lung disease, uveitis, hypercalcaemia, neuro or CVS problems then put on low dose prednisolone.
Severe = IV methylprednisolone or immunosuppressants (methotrexate, cyclosporin)
What 6 conditions does hypertension increase the risk of?
Chronic kidney disease Heart failure Coronary artery disease stroke Peripheral artery disease Vascular dementia
What BP measurements would mean stage I hypertension? - Difference between home and GP?
140/90-159/99 - clinic
135/85-149-94 - at home
What BP measurements would mean stage II hypertension? - Difference between home and GP?
160/100 - 180/120 - clinic
150/95 or higher average at home
What BP measurements would mean stage III hypertension? - clinic only
180 or more systolic
120 or more diastolic
What has the difference between systolic measurements got to be to diagnose postural hypotension?
20mgHG
What antihypertensive drug would you start a patient who has type 2 diabetes or a patient who doesn’t but is under 55 and not of african heritage?
ACEI (ramipril) or ARB (candesartan)
What antihypertensive would you prescribe for a patient that is 55 or older or african heritage (any age) to start on?
CCB - amlodipine (dihydropyridine)
What anti-hypertensive drug would you introduce to add to a patients regime for the second step?
One of
Thiazide like diuretic (indapamide)
CCB/ARB/ACEI
Whatever hasn’t previously been used
What is the treatment for stage 3 of choice of antihypertensives?
ACEI/ARB + CCB + thiazide-like diuretic
What infection is most likely to be due to air conditioning or after a foreign holiday?
Legionella/ Legionairre’s disease
A patient returns from holiday with a flu like illness with hyponatraemia and deranged LFT’s. A day later a CXR shows a pleural effusion.
What is the next investigation would you like to do?
What is the most likely diagnosis?
What is the treatment?
Urinary antigen
Legionella infection
Clarithromycin/erythromycin
What syndrome is characterised by: venous/arterial thrombosis prolonged APTT recurrent foetal loss livedo reticularis thrombocytopenia ?
Anti-phospholipid syndrome
What are associated conditions of anti-phospholipid syndrome?
SLE. Rheumatoid arthritis. Systemic sclerosis. Behçet's disease. Giant cell arteritis. Sjögren's syndrome. Psoriatic arthropathy.
What is the management for antiphospholipid syndrome?
Low dose aspirin
