Pink summary book 1/3 Flashcards
coffee ground vomiting (haematemesis)
occurs due to coagulated blood in vomit
- alcohol abuse
- viral hepaittis
- fatty liver
- cancer of oesophagus, pancreas or stomach
urinary retention
- enlarged prostate
- bladder obstruction (stricture, calculi)
- constipation (DO PR)
- infections (UTI, STI, prostatitis)
- trauma to pelvic, urethra or penis
neuropathic pain ‘burning pain’
morphine doesnt work
what does work?
- tramadol
- amitriptyline
- pre-gabalin
bristol stool chart
T1= very hard
T7= very soft
what is used to emasure frailty
clinical frailty score
Infectious diseases’ specific history
- think about incubation period
- fever? rigor?
- periodicity
- sexual history
- IVDU? Hep B/C/ HIV
- travel
- occuption
- hobbies/pet
- prophylaxis- vaccines, antimicrobials, physical prevention
sexual history
- how long have you been together
- have you had unprotected sex
- how many sexual partners
hepatitis disease
IV
- Hep B/C
foecal oral
- Hep A/E
travel history
last 12 months
- where? endemic disease
- what? what did you do e.g. water sports, river swimming
- when? does time frame fit? e.g. falciparum has a long IP (hypnozoites sequestering in the liver)
pets history
parots and cats (toxoplasma- cat litTer)
Prophylaxis history
vasscines
anti-microbes- DEET for malaria
physical prevention - nets, sprays etc
systemic/ constitutional symptoms
caused by B cells
- fevers
- night sweats
- weight loss (change)
- fatigue
cardiovascular symptoms
- chest pain
- palpitations
- dyspnoea
- syncope
- orthopnoea
- peripheral oedema
respiratory symptoms
- SOB
- cough
- sputum (type and when?)
- wheeze
- haemoptysis
- pleuritic chest pain (sharp and well localised)
GU symptoms
- change in urine output or colour
- infectious symptoms
- UI
- obstructive symptoms
- uraemia symptoms
neurological
- visual
- headache (bilateral and thunderclap)
- motor or sensory (muscle weakness, numbness, parasthesia
- LOC
confusion
MSK symptoms
- Bones and joint pain
- muscular pain
- trauma
dermatological symptoms
rashes and skin color change
dermatological symptoms
rashes and skin color change
causes of clubbing
portal hypertension
infective endocarditis
bronchiectasis
lung Ca
iD
DEFINE CLUBBING
Increased longitudinal and horizontal curvature of the nail and increased angle of the nail bed
liver flap ‘asterixis’
CO2 retention
uraemia
hepatic encephalopathy
cullens sign
haemorrhagic pancreatitis
- bruising of tissue surrounding umbilical region
Grey-turner
haemorrhagic pancreatitis
- bruising in the flanks
spider naevi
liver cirrhosis
glossitis
enlargement of tonuge
- iron, B12, folate deficiency
antbiotics for osteomyelitis
rifampicin and vancomycin
need to penetrate the bone
felodipine
CCB for hypertension
PRN
pro re nata “as needed’
ABG and asthma attack
if low O2 should also be low CO2 “blowing off”-→ due to hyperventilation
if CO2 high pt may need intubation -→ patient too tired to breathe
montelukast
leukotrienes antagonist-→ asthma prophylaxis
outline asthma exacerbation management
- SABA and ICS (nebulised)
- O2 if needed
- ipratropium bromide
- aminophylline + magnesium sulfate
types of asthma exac
mild mod severe/life-threatening
discharge after asthma exacerbation
- O2 stopped
- nebuliser stopper for 24hr
- no infection markers (CRP)
- 75% of peak flow
opacification on CT/X-ray
tumour
infection
fluid
SoB treatment
oromorph (morphine)- symptomatic control - palliation
sources of potassium
orange
avo
strawberry
grapefruit
name 2 SABAs
salbutamol
terbutaline sulfate
carbocisteine
mucolytic
spiriva
triotropium bromid= LAMA
non-epileptic seizures
not caused by abnormal electrical activity in the brain
causes
- low blood glucose
- dissociative seizures
- heart problem
CURB-65
confusion
urea
respiratory rate
blood pressure
>65
ground glass opacification
‘hazy radiopacity, often fairly diffuse, in which the edges of pulmonary vessels may be difficult to appreciate’
- infection
- chronic interstitial disease
- acute alveolar disease
causes of pulmonary fibrosis (drug induced)
- amiodarone
- nitrofurantoin
- bleomycin
which system used to stage COPD
GOLD
venturi valves
what causes eosinophilia
condition most often indicates a parasitic infection, an allergic reaction, asthma or cancer
what causes low eosinophils
steroids
cough with wheeze
asthma
viral induced wheeze
productive cough
LRTI
productive cough
LRTI
dry cough
allergies, TB
hoarse voice
laryngitits
hot potato bpice
peritonsillar abscess
acute stridor
croup
foreign body
bacterial tracheitis
epiglottis
chronic stridor
laryngomalacia
subglottis steroid
if suspciious of PE e.g. high D-dimers
CT PA pulmonary angiogram
controlled O2
principle of avoiding over oxygenation
-→ target sats will depend on underlying resp disease e.g. 88-92% for COPD
when to do ABG
sats <94%
normal breath sounds
vesicular
bronchial breathing
harsh-sounding
pause between inspiration and expiration
→CONSOLIDATION e.g. pneumonia
quiet breath sounds
reduced air entry into that region of lung e.g. pleural effusion or pneumothorax
REDUCED AIR SOUNDS rather than reduced air entry
added sounds
wheeze
stridor
coarse crackles
fine end- inspiratory crackles
respiratory illness
wheeze
continuous, coarse, whistling
- asthma
- bronchiectasis
stridor
high-pitched noise breathing in (narrowe airway)
- foreign body (acute)
- subglottic stenosis
coarse crackles
discontinuous, brief, popping sounds
- pneumonia
- bronchiectasis
- pulmonary oedema
fine end-inspiratory crackles
VELCRO
pulmonary fibrosis
obstructive resp illness
COPD (chronic bronchitis and emphysema) and asthma
<70% FEV1/FVC ratio
restrictive resp illness
ILD and scoliosis
types of ILD
-
Exposure
- drugs e.g. bleomycin
- environment e.g. dust
-
Autoimmune related
- RA
- SLE
-
Idiopathic
- idiopathic pulmonary fibrosis
