Other Flashcards
Primary pneumothorax
<2cm - observe 4-6hrs, discharge and safety net
>2cm - cannula aspiration, 4-5th IC space in mid axillary line. Aspirate, then when no further air needs CXR repeat. If 2x unsuccessful attempts then chest drain.
Secondary pneumothorax
If in presence of underlying lung disease, COPD/TB/malignancy/pneumonia
if <1cm - observation and O2
if 1-2cm - aspirate
if >2cm or older - chest drain
Tension pneumothorax
Immediate needle decompression = needle thoracocentesis
Unless traumatic - cardiothoracics
Thyroid cancers
Papillary - most common, hormone producing, spread by lymph
Follicular - second most, hormone producing, local spread eg to lung
Medullary - rare, non-hormonal
Anaplastic - rare, rapidly growing with local invasion affecting eg voice and swallow
Thyroglossal cyst
Embryological remnant of the thyroid gland due to incomplete closure of the thyroglossal duct
So present in children or young adults
Midline of the neck, elevation on swallowing or protrusion of the tongue
Can become infected or fistulate, recommend excision
Inguinal hernia
Superior and medial to pubic tubercle
Indirect - congenital or injury
Direct - older men with weak abdominal wall, heavy lifting, rarely obstructs
Femoral hernia
Inferior and lateral to pubic tubercle
More common in women
Often present strangulated needing urgent intervention
Obturator hernia
Medial thigh, rare
After weight loss in multiparous women (pelvic floor dysfunction)
Pain worsens when extended/medially rotated/abducted
High mortality rate and often presents obstructed
Ramsay Hunt syndrome
Unilateral peripheral facial palsy, severe ear/facial pain, and a vesicular ear rash
From reactivation of VZV in facial nerve
In elderly or immunosuppressed
High dose steroid and antivirals promptly
Meniere’s disease
Tinnitus, sensorineural hearing loss and vertigo
Episodic lasting few hours
Aural fullness
Type I hypersensitivity reaction
Immediate, IgE-mediated reaction involving mast cell degranulation and eosinophil activity
eg asthma, anaphylaxis, atopy
Type II hypersensitivity reaction
IgG or IgM antibody-mediated cytotoxic reaction
Occurring in hours to days
eg haemolytic disease of the newborn, autoimmune haemolytic anaemia and Goodpasture’s syndrome
Type III hypersensitivity reaction
Antigen-antibody immune complex-mediated reaction
Occurs over hours, days or weeks
eg rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and post-streptococcal glomerulonephritis.
Type IV hypersensitivity reaction
Delayed, CD4+ T cell-mediated reaction which results in tissue damage after sensitisation then prompting cytokine release
48-72 hours later, an inflammatory reaction
eg scabies, contact dermatitis and multiple sclerosis.
CHADSVASc
Congestive HF 1
Hypertension 1
Age >75 2
Diabetes 1
Stroke/TIA 2
Vascular disease 1
Age 65-74 1
Sex female 1
