Other Flashcards
Glandular fever is infection with
Epstein-Barr virus - type of Herpes
Symptoms of glandular fever include (3)
small purple spots on roof of mouth, pain behind eyes, jaundice
foeto-maternal haemorrhage is when
foetal blood cells enter maternal circulation
foeto-maternal haemorrhage is due to disruption of
membrane in placenta (cytotrophoblast and synctiotrophoblast)
how can a mother develop rhesus haemolytic disease?
mother RhD-/ foetus RhD+ -> anti-D antibodies -> cross placenta
kleinhauer test
blood test that measures amount of foetal Hb transferred to mother
In Rh- mothers, postnatal Anti-D prophylaxis prevents
rhesus disease in future Rh+ children
adrenal gland releases ….. in response to long term stress
hydrocortisone
adrenal gland releases ….. in response to short term stress
adrenaline
RHEUMATIC FEVER: ….. infection with ….. streptococci
Pharyngeal; group A
RHEUMATIC FEVER: affects (4)
heart, skin, joints, CNS
RHEUMATIC FEVER: usually affects (age range)
5-15 years
RHEUMATIC FEVER: ….. reaction triggered by molecular mimicry between cell wall … ….. of streptococci pyrogens and cardiac myosin and lamini
autoimmune; M proteins
RHEUMATIC FEVER: what type of hypersensitivity reaction
Type II hypersensitivity reaction
RHEUMATIC FEVER: characteristic lesion of rheumatic carditis =
Aschoff nodule
RHEUMATIC FEVER: rheumatic valves have increased expression of …… (mediates adhesion of lymphocytes)
VCAM1
RHEUMATIC FEVER: inflammation and valve scarring mainly due to …… …. infiltration
CD4+ T cell
RHEUMATIC FEVER: presents suddenly with (4)
fever, joint pains, malaise, lack of appetite
RHEUMATIC FEVER: diagnosis based on …
Modified Jones criteria
RHEUMATIC FEVER: diagnosis needs to meet 2 major / 1 major +»_space;> minor of Jone’s criteria
2
RHEUMATIC FEVER: major criteria (5)
carditis, polyarthritis, chorea, erythema marginatum, subcutaneous nodules
RHEUMATIC FEVER: minor criteria (7)
fever, arthralgia, previous rheumatic fever, leukocytosis, raised ESR/ C-reactive protein, prolonged PR interval on ECG, evidence of antecedent streptococcal infection
RHEUMATIC FEVER: more than 50% of people who had rheumatic fever with carditis suffer 10-20yrs later from
chronic rheumatic valvular disease
RHEUMATIC FEVER: chronic rheumatic valvular disease mainly affects
mitral/aortic valves
Renin-angiotensin-aldosterone system regulates blood volume and ……. therefore influencing Co and arterial pressure
systemic vascular resistance
Renin =
proteolytic enzyme, released by kidneys and stimulates angiotensin formation and release of aldosterone from adrenal cortex
primary site of storage for renin
juxtaglomerular cells associated with afferent arteriole
renin release is inhibited by
increase of NaCl in tubular fluid
vascular endothelium (particularly in lungs) has
ACE
Renin-angiotensin-aldosterone system regulated by (2)
mechanisms stimulating renin release and natriuretic peptides released by heart
5 important functions of renin-angiotensin-aldosterone system
stimulate cardiac and vascular hypertrophy; stimulates aldosterone release from adrenal cortex; stimulates brain thirst centres; stimulates release of vasopressin from posterior pituitary (kidney fluid retention); enhances sympathetic adrenergic function
PERIPHERAL OEDEMA: definition
soft tissue swelling due to accumulation of interstitial fluid
PERIPHERAL OEDEMA: causes (15)
pitting dependent oedema, varicose veins, cardiac, drugs, hepatic, renal, gastrointestinal, pregnancy, high altitude, iodiopathic, post-thrombotic syndrome, pitting localised limb oedema, non-pitting lower limb oedema, lyphoedema, allergy
PERIPHERAL OEDEMA: pitting dependent oedema leads to peripheral oedema because
immobility ? increased fluid pressure from venous stasis
PERIPHERAL OEDEMA: varicose veins lead to peripheral oedema because
obesity > sodium ion and water retention
PERIPHERAL OEDEMA: cardiac problems lead to peripheral oedema because
increased fluid pressure, right heart failure, constrictive pericarditis
PERIPHERAL OEDEMA: drugs can lead to peripheral oedema becausae
sodium and water retention from calcium antagonists, NSAIDs, insulin, prolonged steroid therapy
PERIPHERAL OEDEMA: 4 symptoms
anaemia, breathlessness, lung cancer, pleural effusions
PERIPHERAL OEDEMA: dependent oedema seen in
otherwise well patients
PERIPHERAL OEDEMA: depend oedema usually due to
benign cause such as immobility and varicose veins
PERIPHERAL OEDEMA: pulmonary or ankle oedema usually due to
cardiac failure
PERIPHERAL OEDEMA: of hands / face usually due to
hypoproteinaemia (seen after lying down), angiodema
PERIPHERAL OEDEMA: ascites usually due to (3)
liver failure, protein malnutrition, nephrotic syndrome
PERIPHERAL OEDEMA: unilateral swelling (particularly calf) usually due to
DVT
PERIPHERAL OEDEMA: scrotal sac usually due to
hydroceles (nephrotic syndrome)
CHEST X RAY: anterior-posterior (AP) projection used if patient is
too unwell to stand
CHEST X RAY: Can tell if AP because medial border of scapula
overlaps lung
Purulent sputum contains (5)
pus, WBCs, cellular debris, dead tissue, mucus
rusty coloured sputum indicates
pneumococcal bacteria (pneumonia)
blood streaked sputum indicates
inflammation of throat, bronchi, lung cnacer
pink sputum indicates
sputum evenly mixed with blood from alveoli/small bronchi
lots of blood in sputum indicates
cavity TB of lung, lung abscess, infarction, embolism, bronchiectasis
yellow-green (mucopurulent) sputum can be treated with
antibiotics
green sputum indicates
neutrophil myeloperoxidase
frothy pink sputum indicates
pulmonary oedema
foamy white sputum indicates
obstruction or sometimes oedema
white, milk, opaque (mucoid) sputum suggests
antibiotics will be ineffective