Placement AMU Flashcards
what is functional pain syndrome FAPS
dx of FAPS made off
made on the basis of positive symptom criteria and a longstanding history of symptoms; in the absence of alarm symptoms, an extensive diagnostic evaluation is not required.
what are alarm symtpoms
vomiting, bleeding or anemia, abdominal mass or unintended weight loss, and dysphagia
causes of rectal bleeding
hard stools (poo)
haemorrhoids (also known as piles), which are often associated with constipation
anal fissure (a small tear in the opening of the anus) or fistula (a small channel that develops between the anus and skin)
Less common causes include:
colon polyps
rectal trauma (for example, an injury caused by accident or sexual assault)
stomach or duodenal ulcers
infections of the bowel
gastroenteritis
bowel conditions, such as diverticular disease or bowel cancer, Crohn’s disease or ulcerative colitis
sexually transmitted infections
alcohol - Consuming too much alcohol may tear away at tissue and cause it to become more sensitive. These tears, called Mallory-Weiss tears, can cause significant bleeding and may lead to pooping blood. The tears can form anywhere in the digestive tract,
what is penumobilia
Pneumobilia, or air within the biliary tree of the liver, suggests an abnormal communication between the biliary tract and the intestines, or infection by gas-forming bacteria. Pneumobilia usually can be distinguished from air in the portal venous system by its appearance on computed tomography (CT) scan.
where does a pudendal nerve block enter
aims to block the nerve as it enters the lesser sciatic foramen, 1 cm inferior and medial relative to the attachment of the sacrospinous ligament to the ischial spine
half life of morphine
2hours
where is morphine metabolised
primarily metabolized in the liver by uridine-5′-diphosphate (UDP) glucoronosyltransferase
codiene to morphine
divide by 10
moa tramadol
inhibits ascending pain pathways by binding to mu opiate receptors in the central nervous system, l
-Tramadol inhibits serotonin reuptake and (-)-tramadol inhibits norepinephrine reuptake
causes of recurrent stroke disease
In particular, hypertension and diabetes mellitus, atrial fibrillation, angina pectoris, ischemic heart disease, cardiomyopathy, and smoking
Contraindications to thrombolysis:
Previous intracranial haemorrhage
- Seizure at onset of stroke
- Intracranial neoplasm
- Suspected subarachnoid haemorrhage
- Stroke or traumatic brain injury in preceding 3 months
- Lumbar puncture in preceding 7 days
- Gastrointestinal haemorrhage in preceding 3 weeks
- Active bleeding
- Pregnancy
- Oesophageal varices
- Uncontrolled hypertension >200/120mmHg
secondary prevention of stroke
clopidogrel 1st line
2nd - aspirin and MR dipyridamol e
TTO
to take out
why would you order magnesium testing when blood taking
Magnesium testing may be a follow-up to chronically low blood calcium and potassium levels. It also may be ordered when you have symptoms possibly due to a magnesium deficiency, such as muscle weakness, twitching, cramping, confusion, cardiac arrhythmias, and seizures.
first line investigation for a stroke
A non-contrast CT head scan is the first line radiological investigation for suspected stroke
acute ischaemic strokes show what on CT
may show areas of low density in the grey and white matter of the territory.
These changes may take time to develop
other signs include the ‘hyperdense artery’ sign corresponding with the responsible arterial clot - this tends to visible immediately
acute haemorrhagic strokes show what on ct
typically show areas of hyperdense material (blood) surrounded by low density (oedema)
what is ischaemic penumbra
Ischaemic penumbra denotes the part of an acute ischaemic stroke that is at risk of progressing to infarction but is still salvageable if reperfused. It is usually located around an infarct core which represents the tissue which has already infarcted or is going to infarct regardless of reperfusion.
penumbra
the partially shaded outer region of the shadow cast by an opaque object.
when is a biers block used
The Bier block technique provides analgesia, muscle relaxation and a relatively bloodless field. It involves injection of local anaesthetic into the venous system of an extremity which has previously been exsanguinated by gravity or compression. The local anaesthetic diffuses into the surrounding nerves. Local ischaemia, caused by the tourniquet, contributes to the analgesic effect.
what type of anaeatheisa is directly into the bone and whne is it used
The intraosseous injection allows placement of a local anesthetic solution directly into the cancellous bone adjacent to the tooth to be anesthetized.
what is a colles fracture
the Colles fracture is defined as a distal radius fracture with dorsal comminution, dorsal angulation, dorsal displacement, radial shortening, and an associated ulnar styloid fracture.
radius normall 10 degrees froward tilt in lateral view
and should sit higher than ulnar nomrall
broken wrist what things will change the way you manage this patient
skin tightening - could do from closed to opne
neurovasuclar copromise
open or closed
You are teaching a man about how to use an EpiPen (adrenline auto-injector). What is the most appropriate advice about where to inject the pen?
Anterolateral aspect of the middle third of the thigh
76%
IM adrenaline should be injected in the anterolateral aspect of the
middle third of the thigh
gold standard for dx of contact dermatitis
skin patch test
food allergy testing
skin prick test
what are stop and start meaning
STOPP identifies medications where the risk outweighs the therapeutic benefits in certain conditions and START suggests medications that may provide additional benefits ie proton pump inhibitors for gastroprotection in patients on medications increasing bleeding risk
