Miscellaneous Conditions A Flashcards
Acquired Immunodeficiency Syndrome - Description
progressive immune system dysfunction due to CD4+ cell infection
Acquired Immunodeficiency Syndrome - Causes (1)
1) HIV
Acquired Immunodeficiency Syndrome - Risk Factors (6)
1) 19-24 years old
2) IV drug abuse
3) needle stick injury
4) unprotected sex (inc. anal)
5) mother to child transmission
6) herpes simplex 2 infection
Acquired Immunodeficiency Syndrome - Symptoms (3)
2-4 weeks post-exposure
1) fever (inc. night sweats)
2) myalgia
3) sore throat
Acquired Immunodeficiency Syndrome - Signs (4)
2-4 weeks post-exposure
1) erythematous/maculopapular rash
2) oral ulcers
3) angular cheilitis
4) lymphadenopathy (persists)
Acquired Immunodeficiency Syndrome - Complications (5)
1) tuberculosis
2) immunocompromised pneumonia (Pneunocystic jirovecii)
3) hepatitis
4) Kaposi’s sarcoma (human herpes 8)
5) lymphoma
Acquired Immunodeficiency Syndrome - Opportunistic Pathogen (6)
1) Pneumocystis jirovecii
2) Candidiasis
3) Cryptococcus neoformans
4) Toxoplasma gondii
5) Cytomegalovirus
6) Cryptosporidium
Acquired Immunodeficiency Syndrome - Investigations (5/0)
initial
1) saliva/serum HIV rapid test
2) serum HIV ELISA
3) serum HIV RNA viral load
4) serum HIV DNA PCR
5) CD4+ count (monitor) (<200 cells/μL)
Acquired Immunodeficiency Syndrome - Management (4/4/0)
conservative
1) monitor serum HIV RNA viral load (antiretroviral therapy)
2) monitor CD4+ count
3) risk education
4) vaccinations
medical
1) prophylactic antiretroviral therapy (postexposure, pregnant mother)
2) antiretroviral therapy (e.g. tenofovir)
3) opportunistic infection prophylaxis (e.g. trimethoprim for PCP)
4) multivitamin + multimineral
Breast Carcinoma - Description
malignant proliferation of breast cells
Breast Carcinoma - Risk Factors (11)
1) age (~2x every 10 years)
2) female
3) family history
4) genetics (BRCA1, BRCA2, TP53)
5) childless/>30 years old pregnancy
6) not breastfeeding
7) early menarche
8) late menopause
9) combined oral contraceptive
10) hormone replacement therapy
11) radiation exposure
Breast Carcinoma - Types (6)
1) invasive ductal carcinoma (70%)
2) invasive lobular carcinoma (10-15%)
3) non-invasive ductal carcinoma
4) non-invasive lobular carcinoma
5) oestrogen receptor positive (70%, better prognosis)
6) HER2 positive (30%, worse prognosis)
Breast Carcinoma - Signs (3)
1) tender breast mass
2) nipple discharge (watery, serous, milky or bloody)
3) axillary lymphadenopathy
Breast Carcinoma - Complications (1)
1) lympoedema
2) metastasis (esp. bone, brain, liver, lungs)
Breast Carcinoma - Investigations (1/4)
initial 1) mammogram (screening, 50-70 years old) consider 1) fine needle aspiration breast biopsy 2) breast ultrasound 3) OR testing 4) HER2 testing
Breast Carcinoma - Stages (4)
1) breast confined, mobile
2) breast confined, mobile, mobile ipsilateral axillary lymph node
3) skin involvement, muscle fixed, fixed ipsilateral axillary lymph node
4) distant metastasis, chest wall fixed
Breast Carcinoma - Management (1/6/1)
conservative
1) screening (mammogram, 50-70 years old)
medical
1) chemotherapy (post-op) (cyclophosphamide, methotrexate, fluorouracil)
2) radiotherapy (post-op)
3) oestrogen receptor blocker (e.g. tamoxifen) (OR+, premenopausal)
4) GnRH analogue (OR+, premenopausal)
5) aromatase inhibitors (e.g. anastrozole) (OR+, postmenopausal)
6) HER2 monoclonal antibodies (e.g. trastuzumab - Herceptin) (HER2+)
surgery
1) local resection —> radical mastectomy (1st line)
Paracetamol Overdose - Description
ingestion of a large amount of paracetamol (>4g/<1hr)
Paracetamol Overdose - Risk Factors (4)
1) self-harm history
2) pain-relief dependance
3) cytochrome P450 inducers (e.g. alcohol)
4) glutathione deficiency
Paracetamol Overdose - Symptoms (6)
1) asymptomatic (<24 hours)
2) abdominal pain
3) nausea
4) vomiting
5) confusion (fulminant hepatic failure)
6) loss of consciousness (fulminant hepatic failure)
Paracetamol Overdose - Signs (2)
1) jaundice (late)
2) asterixis (fulminant hepatic failure)
Paracetamol Overdose - Complications (1)
1) fulminant hepatic failure
Paracetamol Overdose - Investigations (4/1)
initial 1) serum paracetamol 2) LFT (high) 3) U+E 4) ABG (low pH, high lactate) consider 1) urine drug screen
Paracetamol Overdose - Management (0/3/1)
medical 1) acetylcysteine 2) activated charcoal 3) antiemetic surgery 1) liver transplant (severe)
