other stuff Flashcards
pericarditis can be caused by
uraemia
key conounders of creatinine
muscle maass and diet
overflow proteinuria
myeloma
most common proteinuria
glomeruli
what does microalbumuria mean
excretion of albumin in abnormal quantities but still below the limit of protein detection by dipstick
what is used to assess tubular function
urine osmolality
if urine osmolality is exactly the same as serum osmolality this indicates
tubules are not function
especially at risk of what if on dialysis
osteopaenia
are water and food restricted on dialysis
yes
dialysis happens via
diffusion
what is downside with fistula for dialysis
needs 6-12 weeks before can be used
haemodialysis involves
diffusion, conventionna and adsorption
adsorption affects what
plasma proteins
haemofiltration mainly removes solutes via
convection
key difference of haemofiltration as opposed to haemodialysis
haemofiltration- there is replacements of the ultra convective ultrafiltrare through the dialysis period
in peritoneal dialysis solute removal is via .. and water removal is via…
diffusion, osmosis
what dialysis is driven by high glucose concentration of the dialyse fluid
peritoneal dialysis
complication sof HD/HDF
hypotension, haemorrhage
tunneled catehter venous catheter infection is most likely due to … can lead to endocarditis
staph aureus
antibiotics for TCVC infection
vancomycin and gentamicin
complications of peritoneal dialysis
peritonitis, fluid overload, uraemia, hernias
when to start dialysis
resistant hyperkalaemia, egfr <7, urea >40, unresponsive metabolic acidosis
complaint of too rapid a correction of toxins in dialysis
disequilibrium syndrome- cerebral oedema and possible confusion and death
patient needs to have a life expectancy of what to get kidney transplant
> 5years
what events can make you have antibodies that make you less likely to respond to kidney transplant
blood, transfusion, pregnancy or previous transplant
drug that can help with desesnsitation
rituximab
when kidney is transplanted it is attached to what
external iliac artery and vein
what rejection can be treated with immunosuppression
acute
what is an important morbidity in immunosuppressed patients in first 3 months of transplant
CMV
common malignancies after kidney transplant
non melanoma and lymphoma
referred to urology if got asymptotic non visible ahematuria and over
40
what is best to see on CT with no contrast
calculi
CT contrast induced nephropathy is when
impaired renal function occurs within 3 days follwoign contrast and get rise in serum creatine and urea
how to avoid CT contrast induced nephorpathy
oral hydration before and after scan
MR renal angiogram is only used to
see vessels only eg renal artery stenosis
MR is used for
renal cystic disease
CT urogram main indication isi
macroscopic ahematuria to look for filling defects suspicious of transitional cell carinoma
MR urogram is a
poor test not very good
ultrasound of the bladder requires what
full bladder to assess outline
Ct gold standard in bladder for
nodal and metastatic disease staging
MRi is gold standard for
local tumour staging
what scan to image urethra in males
urethrogram
scan to image urethra in females
MRI
uterus, ovaries and prostate imaging
biopsies
hysterolsapingofram assesses
tubal patency
what is used for prostate cancer
MRI
what tones can be used for those with tinnitus
warble
normal hearing is between
-10 to 20
damage to what occurs naturally as part of the ageing process
cochlear
rubella causes what kind of hearing loss
sensorineural
in conductive hiring loss what is within normal limits
boen conduction
charts notch at 2000
otoscerlsosi
tympanoemtry measures function of what part of the ear
middle
to get orlistat need to lose what % of weight in first 3 moths
greater than 5%
BMi for bariatic suregry
> 30 or greater than 28 with co- morbidities
what deficit is recommended for diabetes
600kcal
glycemic index is
rate at which food makes blood glucose rise
hypoglycaemia from exercise can occur how long after
12-24
alcohol increases activity of what
insulin
battery
acting without consent
blood glucose should be tested at least how many times a day
5
diabetic who is unwell and stops eating they should still take
insulin
illness and infection raise
blood glucose levels
what is ultimately used to inform guidelines
critical appraisal
main issue with cohort study
confounders
case control
subjects with disease or condition are indentified
difference between cohort and case control
cohort - people with disease
case controlled - select disease and non disease
nonsense
generation of stop codon
test for single gene
genration sequencing
next generation sequencing uses for
disease with genetic heterogeneity
pituitary gland is well seen on
MRi
what sinus is anterior to pituitary
sphenoid
what arteries are lateral to pituitary
carotid
thyroid is in what relation to the trachea and oesophagus
it is anterior
thyroid scintigraphy of throidits
very dark grey
right adrenal lies posterior to what
IVC
deontology
patients right to refuse treatment
criteria used to clear c spine in minor trauma
nexus
CT in major trauma
bone scan is a map of what activity
osteoblastic
scan to see ligaments
ONLY MRI
damaged ligaments wil be what colour
light
best test for sciatica
MRI
soft tissue swelling is seen in
RA
what is the hallmark fo RA
marginal erosions
pannus in ra is
inflamed thickened synovium
seronegative arthritis characterised by
synovitis and enthesitis
Reiters tends to affect what kind of joints
large lower limb
early sign of inflammatory joint disease
periarticular bone marrow oedema
what fractures tend to occur with a shearing force
oblique
communication fracture has
3 or more fragments
segmental injury is when
bone is fractured in 2 separate places
bone that is a common mimic of avulsion fracture
sesamoid bone
intra articular fractures have a greater risk of what
stiffness, pain and OA
bone appears sclerotic in
impaction
spinal canal is also a
bony ring
what are often invisible on radiograph that are foreign bodies
plastic and wood
tomogram is used in what kind of fractures
mandibular
US good for seeing
tendons
what are good for detecting stress fractures
Technetium bone scans
what becomes visible if an elbow effusion is present
posterior fat pad sign
fracture mimic
sesamoid bones:
5th metatarsal in adolescents
posterior calcaennous in kids
fabella- femur
ostrigonum - talus
toxic shock organism
staph aureus
commonest cause of toxic shock
TSST-1
fever, hypotension and diffuse macular rash
toxic shock
what binding is seen in osteomyelitis
collagen
PVL has a specific toxicity for
leukocytes
PVL associated with
necrotising fasciitis
what comprises the most of strep A
progenes
pharyngitis associated with
s. pyrogens
necrotising fasciitis (2) moat common is caused by
pyrogens and aureus
nec. fasciitis type 1 is caused by
clostridia
layers of scalp
Skin
Conenctive tissue
Aponeurosis
Loose connective tissue
Periosteum
lignocaine
is an an anaesthetic
curettage and cautery involves
scraping of abnormal tissue
what holes from punch biopsy do not always heal well
round
heuristics
quick judgement based on previous experiences
uva or B penetrates the skin more
A
which phototherapy if first line
UVB
what is first line for pustular psoriasis or erythrdermsi psoriasis
UVA
UVB COMMON SIDE EFFEECT
erythema
PUVA is
Psoralen and UV A
treatment for granuloma annaualre
UVA1
birth by c-section can reduce what
transmission of HIV
should women in the Uk with HIV breastfeed
it is recommended to avoid
does breast size affects the amount of milk produced
no
what inhibits prolactin, inhibiting milk production
progesterone
oxytocin levels are greater when
mother and baby are in contact
what is the first form of milk produced immediately following delivery of the newborn
colostrum
colostrum paraticlary has
lactoferrin
painful swelling of the breasts
engorgeemtn
what is positive sign in terms of nappies within first 24hrs
6+ wet and 3+dirty
all pregnancy and breastfeeding mothers should take what supplement
vit d
do breast fed or formula fed babies need to take vitamin D up to 1 year of age
breastfed
do breast fed or formula fed babies need to take vitamin D up to 1 year of age
breastfed
is dried powder formula sterile
no
parental feeding
into bloodstream
exclusive breastfeeding recommended for
first 6 months
when can solid foods start
6 months
consequcen of late wearing
deficiency of iron and zinc
greater than what percentile is overweight
91st
greater than what percentile ic clinically obesity
98
what gender affected by x linked recessive
female
who are more severely affected by x linked dominant
males
is the test fro sex determination and trisomy testing invasive
no
you can terminate pregnancy before
13 weeks
first line for acutely unwell child with likely momongenetic disorder
tri exome sequencing
ngs to look for
small mutations
parental responsibility cut off sat
4 may 2006
difference between passive and active immunity
active- produced by individual own immune system
passive - passed from mother to baby
MMR, rotavirus are what vaccines
live
pertisos and typhoid are what vaccines
inactivated
can’t give yellow fever or flu vaccine if got allergy to what
egg
