Other Flashcards
How many L/min should you put nasal cannulae on?
1-4 (no more than 6) litres/L
Causes of macroglossia
Down’s syndrome
Acromegally
Congenital hypothyroidism
Amyloid
Colours and % of Venturi masks
Blue 24% White 28% Orange 31% Yellow 35% Red 40% Green 60%
Causes of fat embolism syndrome
Most common = closed fracture of a long bone (pelvis, ribs)
Orthopaedic procedures - intramedullary nailing, hip/ knee replacement
Massive soft tissue injury
Severe burns
Bone marrow biopsy
Presentation of fat embolism syndrome
24 to 72 post injury Sudden onset: - Breathlessness - ± chest pains. - progress to respiratory failure - tachypnoea, SOB, hypoxia. - Fever - often > 38.3°C - raised HR - Petechial rash - CNS syx - headache, restlessness, disorientation, confusion, seizures, stupor or coma - Renal - oliguria, haematuria, anuria.
What happens in cholesterol embolism syndrome
Plaque in a proximal, large-calibre artery
Plaque rupture - either spontaneous, traumatic, or iatrogenic.
Embolisation of plaque debris = cholesterol crystals, platelets, fibrin, calcified detritus
Lodging of the emboli in small/medium arteries –> mechanical occlusion.
Foreign-body inflammatory response.
End-organ damage due to mechanical plugging + inflammation.
Presentation of cholesterol embolism syndrome
Embolism from aorta –> blood supply disruption of visceral organs + lower limb.
Can directly affect all tissues except the lungs.
But systemic inflammation may affect pulmonary tissues.
Fever. Cachexia. Nonspecific malaise. Myalgia. Acute respiratory distress syndrome (ARDS) due to circulating inflammatory mediators. Hypercatabolic state. renal failure, gut ischaemia. Dermatological = livedo reticularis, blue toe syndrome
What is a Hickman line?
it is an IV catheter, mainly used in chemotherapy.
They are also sometimes used in dialysis
What’s the immune response to heparin and when does it occur
Heparin induced thrombocytopenia
More common with unfractionated heparin than LMWH.
What type of hypersensitivity reaction is allergy and anaphylaxis
Type 1 - IgE mediated
What disease is anti-acetylcholinesterase antibody associated with
myasthenia gravis
What disease is anti-adrenal antibody associated with
Addisons
What disease is anti-gliadin antibody associated with
Coeliac
What disease is anti-endomyseal antibody associated with
Coeliac
What disease is anti-glomerular basement membrane antibody associated with
Goodpastures
What disease is anti-hu / anti-Yo / anti-Ri antibody associated with
Cerebellar degeneration
What disease is anti-intrinsic factor antibody associated with
Pernicious anaemia
What disease is anti-parietal antibody associated with
Pernicious anaemia
What disease is anti-LKM (liver-kidney-microsomal) antibody associated with
Auto immune hepatitis
What disease is anti-mitochondrial antibody associated with
Primary biliary cirrhosis
What disease is anti-smooth muscle antibody associated with
Autoimmune hepatitis
What disease is anti-thyroid peroxidase antibody associated with
Hashimoto’s thyroiditis
What disease is antibody to voltage gated calcium channel associated with
Lambert-eaton syndrome
What disease is anti-thyroid stimulating antibody associated with
Graves
Management of iron tablet overdose
Desferrioxamine
What is the definition of sensitivity
Ability to detect a true positive
How is sensitivity calculated
Number of true positives ÷ (true positives + false negatives)
As a %
Define specificity
Ability of a test to detect true negatives
How is specificity calculated
True negatives ÷ (true negatives + false positives)
As a %
Define positive predictive value
The probability that a condition can be confirmed given a positive result
How is positive predictive value calculated
True positives ÷ total number of positives
As a %
Define negative predictive value
The probability that a condition can be ruled out given a negative test result
How is negative predictive value calculated
True negatives ÷ total number of negatives
As a percentage
Define likelihood ratio
Likelihood that a test result will be positive in the patient with a condition compared to the likelihood that the same positive result would be expected in a patient without that condition
Sensitivity ÷ (1 - specificity)
What disease is anti-centromere antibody associated with
Limited scleroderma (CREST)
What disease is rheumatoid factor associated with
Rheumatoid arthritis (RA)
What disease is anti-double stranded DNA antibody (anti-dsDNA) associated with
systemic lupus erythematous (SLE)
What disease is anti-smith (anti-sm) antibody associated with
Systemic lupus erythematous (SLE)
What disease is anti-jo-1 antibody associated with
Dematomyositis
What disease is cANCA associated with
Wergener’s granulomatosis
What disease is pANCA associated with
Microscopic polyangiitis
What disease is anti-cardiolipin antibody associated with
Anti phospholipid syndrome
What disease is lupus anticoagulase associated with
Anti-phospholipid syndrome
What disease is anti-topoisomerase antibody associated with
Diffuse scleroderma
What disease is anti-U1-RNP antibody associated with
Mixed / overlap connective tissue disease
What disease is anti-Ro antibody associated with
Sjögren’s syndrome
What disease is anti-La antibody associated with
Sjögren’s syndrome
Causes of metabolic acidosis with a normal anion gap
Diarrhoea
Renal tubular acidosis
Causes of metabolic acidosis with a raised anion gap
Ketoacidosis Lactic acidosis Methanol Ethylene glycol Salicylate toxicity
Causes of a metabolic alkalosis
Vomiting
Diuretic use
Hyperaldosteronism
Cystic fibrosis
What is a hepatitic LFT picture
Raised AST
Raised ALT
What is an obstructive LFT picture
Raised ALP
Raised bilirubin
Raised GGT
Approximate oxygen delivery of nasal cannulae
24-44 %
