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EDAIC Online course (BCSAC 2021) > Other systems: UT, MSK, Neuro & Endocrine > Flashcards

Other systems: UT, MSK, Neuro & Endocrine Flashcards

1
Q

Stroke?

A
  1. About 88% ischaemia and 12% haemorrhage

2. High is males than females > 75yo

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2
Q

Elective surgery ?

A
  1. Delayed for 9 months
  2. Allows for return of cerebral autoregulation
  3. Treatment of a cause if identified
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3
Q

Myasthenia gravis

A
  1. Common 1 in 7,500
  2. Chronic autoimmune - Destruction or inactivation of AchR by antibodies (Produced in thymus gland)
  3. Weakness: Ptosis, dysphagia & diplopia
  4. Marked sensitivity to NMB
  5. High risk for aspiration

6 May be associated with - Hyperthyroid, rheumatoid, SLE, anaemia.

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4
Q

Grading of MG?

A
  1. Type (I): Only EOM
  2. Type (IIa): Slowly progressing, spares respiratory muscles
  3. Type (IIb): Rapidly progressing
  4. Type (III): Acute onset and reapid deterioration
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5
Q

Factors affecting MG?

A
  1. Infection
  2. Electrolyte disturbances
  3. Pregnancy
  4. Stress
  5. Surgery
  6. Aminoglycosides.
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6
Q

Tx of MG?

A
  1. Anticholinesterases - Pyridostigmine
  2. Thymectomy
  3. Immunosuppression
  4. immunotherapy
  5. Plasmapherasis
  6. Immunoglobulin
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7
Q

Difference between MG & Myasthenic syndrome ?

A

See picture

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8
Q

CKD?

A
  1. Autoregulation between 50-150mmHg

2.

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9
Q

Liver?

A
  1. HBF 1.5L/min (25% of CO)
  2. Blood supply: Hepatic artery (30%) & Portal vein (70%)
  3. MELD > 15 should have elective surgery postponed
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10
Q

Contraindications to elective surgery in liver disease?

A

See picture

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11
Q

Child-pugh classification?

A

See picture

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12
Q

MELD - Model for end-stage liver disease?

A
  1. Predicting survival in patients wirh cirrhosis
  2. Selecting patients for liver transplant
  3. Perioperative risk stratification
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13
Q

Types of Diabetes

A
  1. Type 1A - Autoimmune destruction of beta cells within pancreatic islets (10%)
  2. Type 1B - Non-immune, absolute insulin deficiency (Rare)
  3. Type 2 - (90%) Non-immune defect in insulin receptors - Insensitive
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14
Q

Risks of hyperglycaemia?

A
  1. Increases poor surgical outcome
  2. Delayed wound healing
  3. High rates of infection
  4. Prolonged hospital stay
  5. High rate of post-op mortality
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15
Q

Hormonal changes with surgical stress?

A

Increase in the following:

  1. Cortisol
  2. Glucagon
  3. Growth hormones
  4. Catecholamines
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16
Q

Endocrine changes induced by hormone secretions?

A
  1. Decreased insulin secretion
  2. Increased insulin resistance
  3. Reduced peripheral uptake of glucose
  4. Increased lipolysis and proteolysis
  5. Increase gluconeogenesis
  6. Increased glycogenolysis
17
Q

Stress hyperglycaemia ?

A
  1. Osmotic diuresis
  2. Electrolyte imbalance
  3. Ketogenesis
  4. Increased pro-inflammatory cytokines
  5. Immune deregulation
18
Q

When to postpone surgery ?

A
  1. If HbAiC > 10%
19
Q

Risks posed by oral antidiabetic drugs?

A
  1. Metformin - Lactic acidosis
  2. Sulfonylureas - Hypoglycaemia
  3. SGLT-2 inhibitors - Euglycaemic ketoacidosis
  4. Glucagon-like-peptide-1 receptor (GLP-1) agonists - Delays gastric emptying / Increases N/V
20
Q

Thyroid gland?

A
  1. Parathyroid glands located on the posterior aspect.
  2. Has adrenergic and cholinergic innervation
  3. Follicles containing thyroglobulin - Iodinated glycoprotein for thyroid hormone synthesis.
  4. Parafollicular C cells containing calcitonin
  5. Thyroid hormones are dependent on exogenous iodine (diet)
  6. Thyroid hormones regulate hypothalamus and pituitary glands
  7. T4:T3 ratio 10:1 - T3 being more potent
21
Q

Function of thyroid hormone?

A
  1. Growth and maturation of tissue
  2. Enhances tissue function
  3. Stimulates protein synthesis
  4. Promotes lipid and carbohydrate metabolism
22
Q

Hypperthyroidism?

A
  1. Risk of thyroid storm
  2. Wait 6-8 weeks for surgery
  3. Give IV B-blockers, iodate, steroids (dex) and propylthiouracil
  4. Check upper airway for evidence of tracheal deviation / compression secondary to goitre
23
Q

Common features of myasthenic syndrome?

A

See pictures for answer

EDAIC Online course (BCSAC 2021) (35 decks)

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