nd2 year help prt 1 Flashcards
What range do normal bowel habits fall under?
3 times/day - 3 times/week
What range do normal bowel habits fall under?
3 times/day - 3 times/week
what frequency of passing stool constitutes diarrhoea?`
more than 3 times per day
what frequency of passing stool constitutes constipation?
less than 3 times per week
What defines acute diarrhoea?
Diarrhoea lasting less than 2 weeks.
what defines chronic diarrhoea?
Diarrhoea lasting more than 2 weeks.
what is osmotic diarrhoea?
With osmotic diarrhoea, electrolyte transfer takes place but at a low rate. The majority of the fluid passed will be unabsorbed chyme with some fluid drawn osmotically from the cellular membrane. If you stop drinking the diarrhoea will stop
What is secretary diarrhoea?
With secretory diarrhoea a pathogen or other agent shuts down the bodies ability to absorb fluid while triggering the excess production of water in the small intestine.
Main anti-motility treatment?
Loperamide.Stimulate opioid receptors in the sphincter and slows gut motility.
What antibiotic family is used to treat campylobacter with?
Macroliides - claryth, eryth, azyth.
What do you treat campylobacter with?
Macroliides - claryth, eryth, azyth.
what frequency of passing stool constitutes diarrhoea?`
more than 3 times per day
what frequency of passing stool constitutes constipation?
less than 3 times per day
What defines acute diarrhoea?
Diarrhoea lasting less than 2 weeks.
what defines chronic diarrhoea?
Diarrhoea lasting more than 2 weeks.
what is osmotic diarrhoea?
With osmotic diarrhoea, electrolyte transfer takes place but at a low rate. The majority of the fluid passed will be unabsorbed chyme with some fluid drawn osmotically from the cellular membrane. If you stop drinking the diarrhoea will stop
What is secretary diarrhoea?
With secretory diarrhoea a pathogen or other agent shuts down the bodies ability to absorb fluid while triggering the excess production of water in the small intestine.
Main anti-motility treatment?
Loperamide.Stimulate opioid receptors in the sphincter and slows gut motility.
What are the reasons to query antibiotic use in diarrhoea in the uk?
Antibacterial drugs are generally unnecessary in simple gastro-enteritis because the complaint usually resolves quickly without them, and infective diarrhoeas in the UK often have a viral cause. Systemic bacterial infection
does, however, need appropriate systemic treatment.
What do you treat campylobacter with?
Macroliides - claryth, eryth, azyth.
What antibiotic is used to treat shigella and salmonella?
ciprofloxacin
What antibiotic is used to treat typhoid?
ceftriaxone (3rd generation cephalosporin).
What antibiotic is used to treat C. diff.
Metronidazol
If the diarrhoea is described as having rice water?
Cholera
What do Basophils do?
They are implicated in allergic reaction. they release histamine as a vasodilator which is important in inflamation and heparin to thin the blood. they are found in the blood stream.
If the diarrhoea is described as having fatty foul smelling stools?
Giardia lamblia
If the diarrhoea is described as having travelled to europe or south america for a conference?
travellers diarrhoea/ETEC Enterotoxic Escheria Coli
If the diarrhoea is described as being in an old person who has recently had antibiotic treatment?
C.diff
If the diarrhoea is described in a person who has eaten rice?
bacillus cereus
If the diarrhoea is described as being in chicken?
Campylobacter or salmonella. Salmonella is maximum of 2 days, campylobacter is 2-5 days.
when to use antibiotics in diarrhoea?
systemically unwell, elderly and immuno-suppressed.
Hypersensitivity types (ACID)
Type 1 - Allergic (bee sting, latex, penicillin), Type 2 - cytotoxic (myesthenia gravis), type3 - immuno-complex (Rheumatoid arthritis), type 4 - Delayed (contact dermatitis)
What is a Neutrophils?
First on the scene. Granulocyte making upto 75% of your white blood cells. It is also a proffessional phagocyte. they secret IL 10.
Waht do Eosinophil do?
Used in parasite infection. they also control mechanism associated with allergy.
What do Basophils do?
They are implicated in allergic reaction. they release histamine as a vasodilator and heparin to thin the blood. they are found in the blood stream.
What do Mast cells do?
mast cells live in all tissues. they have a similar role to basophils being implicated in allergic reaction and the release of Histamine.
What do Dendritic cells do?
Dendritic cells Phagocytose pathogens and the present the composite parts to the adaptive immune system (t cells and b cells).
what do Macrophages do?
they Phagocytose pathogens, and other biological debris.
Anti and pro infammation cytokine release.
What do Natural Killer cells do?
NK cells play a major role in the host-rejection of both tumours and virally infected cells. NK cells are cytotoxic; small granules in their cytoplasm contain special proteins such as perforin and proteases known as granzymes
what do B cell (memory) do?
memory cells remember the same pathogen for faster antibody production in future infections
what do B plasma cells do?
They produce a single kind of antibody but do it at an incredible rate.
what do t helper cells do?
CD4 cells activate cytotoxic T cells and macrophages to attack infected cells, or they stimulate B cells to secrete antibodies.
What do T killer cells do?
CD8 Killer T-cells find and destroy infected cells that have been turned into virus-making factories.
Function of IL-1
promotes inflammation and fever
Function of IL-2
regulates and activates white blood cells
function of TNF
is involved in systemic inflammation
Function of IFN gamma
IFNγ is an important activator of macrophages and inducer of Class II major histocompatibility complex (MHC) molecule expression.
If I breath in and out normally,What is this called?
tidal volume (approx. 500mls)
If I take normal breath in - the amount you
breathe in after that. what is this called?
Inspiratory reserve volume (IRV)
If I take normal breath out -the amount you can
blow out after this. what is this called?
Expiratory reserve volume ERV
What is it called when you take your deepest breath in and now exhale as much as you can?
Vital capacity
If you take a forced breath in and a normal breath in to equal the total breath in possible, this is?
Inspiratory capacity. IRV+TV
What is the volume left in you lungs when you have exhaled everything else?
Residual capacity
The sum of all air potential in and out of my lungs is called?
Total lung capacity.
Example of SABA/LABA
Salbutemol/Salmeterol
Symptoms of and Antidote used in treatment of opioide overdose?
Myosis (costricted pupils) + Low resp rate. Naloxone
SAMA/LAMA
Ipitropium/tiotrpium
What equation is used to measure the Physiological dead space?
The Bohr equation. Bohr = boring, physiology = boring
what test measure the anatomical dead space?
The Fowlers method or a nitrogen washout.
How do we measure functional residual capacity?
Helium dilution test.
What should be encouraged at all stages of COPD
Giving up smoking.
what improves quality of life and reduces mortality in COPD?
Pulmonary rehabilitation
stages of pharmalogical treatment for COPD?
First SAMA/SAMA then LABA/LAMA the inhaled corticosteroids.
name a corticoseroid used to treat COPD?
Beclomethesone. Anti-inflammatory
Based on cortisol - immunosuppression
Used in exacerbations
Example of SABA
Salbutemol
Example of a LABA
Salmeterol
SAMA
Ipitropium
Symptoms of and Antidote used in treatment of benzobiazapene overdose?
treat with Flumazenil. diazapenes are a powerful sedative. hypotonia, hyporeflexia and hypotension
Symptoms of and Antidote used in treatment of paracetemol overdose?
Jaundice, bruising around the abdomen, vomiting + nausea. Treat with N-acetylsisteine. cosnult nomogram.
Symptoms of and Antidote used in treatment of MDMA
Melting (very hot), Delirium, Mydriasis (dilated pupils), Agitation. Address ABCs, monitor, administer short acting Diazepene if necessary. (lorazepam)
Symptoms of and Antidote used in treatment of beta blockers (propanolol, bisoprolol).
Coma (decreased level of consciousness or unresponsiveness) Confusion, Convulsions, Drowsiness. Treat with Glucagon
Antidote used in treatment of iron overdose
Desferrioxamine
Symptoms of and Antidote used in treatment of digoxin
digibind
What is GORD?
Gastro-oesophageal reflux disease (GORD) is a common condition where acid from the stomach leaks out of the stomach and up into the oesophagus.Can lead to Barrets oesophagus.
Durkheims model of Altruistic suicide?
suicide bombers, old person killing themselves because of financial burden of care on their family.
Durkheims model of egoistic suicide?
people feel totally detached from society, elderly people
Durkheims model of fatalistic suicide?
when a person is excessively regulated, when their futures are pitilessly blocked and passions violently choked by oppressive discipline
Pneumothorax?
Normally due to trauma, hyper-resonant percussion tone.
Treat by simple aspiration using a 16-18g canula.
What type of ulcer gets better during and just after a meal?
Duodenal ulcer.
Findings in Tension Pneumothorax?
Trachial deviation. Medical emergency. treat with a chest drain (needle thoracostomy)
What is transudate?
Clear fluid. Pleural fluid with low protein content. less than 25g/l. normally due to systemic pump failure (Heart, Liver, Renal failure)
What is Exudate?
Puss like fluid. Pleural fluid with a high protein content, greater than 30g/l. normally due to infection, malignancy (cancer, TB)
What is Zollinger-ellison syndrome?
A condition in which a gastrin-secreting tumour or hyperplasia of the islet cells in the pancreas causes overproduction of gastric acid, resulting in recurrent peptic ulcers.
What is GORD?
Gastro-oesophageal reflux disease (GORD) is a common condition where acid from the stomach leaks out of the stomach and up into the oesophagus
What is Barrets oesphagus?
When the lower ⅓ of the oesophagus changes from squamous epithelium (normal oesophageal epithelium) to columnar (stomach). Metaplasia leading to dysplasia.
GORD investigations
Endoscopy to look for epithelial change
24 hour pH study
what type of Fluid shift is associated with addison’s (inadequate secretion of hormones by the adrenal cortex) disease and loop diuretics?
hyposmotic contraction
Pharmacology for GORD
Antacids - Aluminum causes constipation, Magnesium causes diarrhoea. PPI - lansoprazole, omeprazole. Histamine2 receptor - ranitidine, cimetindine. antifoaming agent - Simethicone.
What type of ulcer gets better during and just after a meal?
Duodenal ulcer.
What type of ulcer gets worse during and just after a meal?
Gastric ulcer.
H.pylori test?
carbon‑13 urea breath test
H.pylori triple therapy?
Amoxicilin (metronidazole in allergy), Clarythromicin, + PPI (omeprozole)
What is the surgical intervention for GORD?
Fundoplication.
What is the First line treatment for GORD?
PPI - Omeprozole
what type of Fluid shift is associated with diarrhoea or blood loss?
Isosmotic contraction
what type of Fluid shift is associated with an infusion of fluid?
Isosmotic expansion
what type of Fluid shift is associated with SIADH,Right heart failure, Cirrhosis, Nephrotic syndrome and compulsive water drinkers?
Hyposmotic expansion
what type of Fluid shift is associated with excessive sweating, Insensible water loss in fever, diabetes insipidus, alcohol?
Hyperosmotic contraction.
what type of Fluid shift is associated with Infusion of sodium bicarbonate, sodium containing antibiotics?
Hyperosmotic expansion.
how much fluid do youyou give an adult in hypovolemic shock?
20mls/kg weight
how much fluid do youyou give an child in hypovolemic shock?
10-20mls/kg weight
normal range for sodium in the body?
135-145
normal range for oPtassium in the body?
3.5 -5
What is durkheims anomic model of suicide?
Durkheim’s third type of suicide is Anomic Suicide. This kind of suicide is related to too low of a degree of regulation. This type of suicide is committed during times of great stress or change. market crashes.
Life is too much for them to handle and it becomes meaningless to them.
