Part B 07 Flashcards
Most common
Transfusion transmitted bacterial infx
Yersinia enterocolitica
HEART score
Used for
Cardiovascular disease assessment tool
Predicts 6 week adverse events
HCO3-
Normal values
22-26mmol
Giardiasis
Ix
Stool ova and parasite examination
Brugada syndrome
Genetics and defect
Autosomal dominant
Na channel defect
Brugada syndrome
Dx
> 2mm ST elevation in >1 lead V1-3
Followed by negative T wave
Plus 1 of fHx sudden death fHx ECG changes VF or VT episode Suncopal episode
Brugada syndrome
Tx
ICD
Implantable cardioverter defibrillator
qSOFA score
sBP<100
RR>22
Reduced GCS
Amiodarone
Action
Membrane stabiliser
Increases duration of refractory period
Cough with red rash on face, exposure to birds
Dx and name of rash
Chlamydia psittaci
Horders spots
Pleural aspiration
Process
Upright Mid scapular line (~10cm lat to spine) Needle above upper border to rib (1-2 ribs below fluid level)
Pleural aspiration
Indication
Tx: symptomatic relief
Ix: suspected unilateral educative effusion
Boerhaaves syndrome
Sx
Resp distress
Subcutaneous emphysema
Acute abdomen
Haematemesis
Duodenal ulcer
Complication
Perforation
GI haemorrhage
(Gastro duodenal artery)
Strictures causing obstruction
Acute diverticulitis
Nice reasons for admission
Pain not managed Hydration not maintained Cannot tolerate oral Abx Frail patient, +++ comorbidity Complication - transfusion, perf, abscess, fistula Sx >48h despite conservative management at home
Raised amylase
Causes
Pancreatitis Renal failure DKA Mesenteric ischaemia Perforated duodenal ulcer Ectopic Pancreatic Ca Mumps
Genital warts
Aka
Condylomata acuminata
Signs fetal distress
Reduced movements
Increased/decreased HR
Decreased variability in HR
Late decelerations
Placental abruption without PV bleed
Aka
Concealed placental abruption
Digoxin therapeutic levels
1-1.5nmol/L
Von willebrands ds
Tx
Mild
- desmopressin
> releases vWF from endothelial cells
Severe > cryoprecipitate
ECG
Calculate rate
300/no large sq (R-R)
Atropine uses
Increase HR
Mydriatic
Decreases secretions
Tx organophosphate OD
Delayed haemolytic reaction
Cause
Low titre Ab too weak to detect in X match
Delayed haemolytic reaction
Ix
Positive Coombs test on presentation
Delayed haemolytic reaction
Management
Benign course
Monitor renal function and Hb
TACO
Stands for
Transfusion associated circulatory overload
HEART score
0-2 for each History ECG Age (>45,>65) RF (>1,>3) Troponin (>normal limit, >3x)
HEART score
Management
0-3: discharge w’ FU
4-6: admit, serial trop, further Ix
>7: early PCI
Status epilepticus
Management
2x benzo
Phenytoin infusion
GA
Status epilepticus
If GA started continue for how long
- anaesthesia continued for 12-24h after last clinical or EEG seizure
Status epilepticus
Dose phenytoin infusion
15mg/kg
50mg/min
Abx that increase effect of warfarin
Ciprofloxacin Co trimoxazole Doxycycline Macrolides Metronidazole
LBBB
ECG appearance
Dominant S wave in V1
Broad monophonic R wave in lateral leads
QRS>120
Diagnose st elevation in presence of LBBB or paced rhythm
Sgarbossa criteria
Pericarditis
Sx
SOB
Pleuritic CP
Tachycardia
Pericardial friction rub
Pericarditis
ECG
Saddle ST elevation
PR depression
Pericarditis
Causes
80% viral
Eg coxsackie virus
Uraemia, Dressler’s syndrome, traumatic, autoimmune, paraneoplastic, drug induced
Pyelonephritis
Tx
Gent or cipro
?ceftriaxone