Passmed Flashcards
What is first line for status epilepticus? What is classified as status epilepticus?
IV Lorazepam
Any seizure >5 mins or 2 seizures within 5 mins without recovery between them
What is rabies?
RNA rhabdovirus with bullet shaped capsid causing acute encephalitis
Where is rabies prevalent?
Poor rural areas of africa and asia
How does rabies present?
Prodrome of headache, fever, agitation
Hydrophobia - water provoking muscle spasms
Hypersalivation
Negri bodies - cytoplasmic inclusion bodies in infected neurones
If untreated, nearly always fatal
How is rabies managed?
Considered no risk in UK and most developed countries
If bitten in at risk country:
- wash out
- vaccinated before –> 2 further doses of vaccine
- Not vaccinated –> HRIG + full course of vaccine
How does myxoedema coma normally present?
Hypothyroidism
Hypothermia
Confusion
Others - bradycardia, hypotension, hypoventilation
What is pre-tibial myxoedema a manifestation of?
Grave’s disease
What is myxoedema coma?
Reduction in brain function due to long standing hypothyroidism
Medical emergency - fluids, steroids, thyroxine, correct electrolytes
How are wounds classified in terms of tetanus risk?
Clean - less than 6hr old, non penetrating and negligible tissue damage
Tetanus prone - puncture in contaminated environment, FB, compound fracture, systemic sepsis, animal bite/scratch
High risk - heavy contamination, show devitalised tissue, req. surgical intervention
How are wounds managed in terms of tetanus vaccines?
If immunised and last dose <10 years - nothing
Full course, last dose >10 yr
- tetanus prone - reinforcing dose of vaccine
- high risk - vaccine + IG
Incomplete vaccine/unknown
- vaccine regardless of severity
- tetanus prone/high risk - vaccine + IG
How are patients with features of tetanus managed?
Tetanus IG + IM tetanus vaccine
Supportive care, debridement, benzo, abx
