Q to work on #2 Flashcards
What is Giant Cell arteritis also called and why?
Temporal arteritis because it is a condition of inflammation of artery linings, that most commonly occurs in the temporal arteries. This causes swelling and artery blockage
Common symptomatic presentation of Giant Cell arteritis?
- Jaw claudication
- Headaches (especially in temples)
- Abrupt onset visual disturbances
- unexplained fever or anaemia
- Unexplained weightloss
- High ESR or CRP
What conditions are closely linked with giant cell arteritis?
Polymyalgia Rheumatica (unexplained inflammation of muscles)
About half of people who have GCA also have PMR.
Treatment of Giant Cell Arteritis
High dose Corticosteroids (eg; prednisone)
This is often given prior to temporal artery biopsy
Major clinical manifestations of hyperkalaemia?
- Cardiac arrhythmias
- Muscle weakness or paralysis (flaccid paralysis that mimics Guillian Barre)
- Cardiac conduction abnormalities
Describe the ECG changes seen with Hyperkalemia as it worsens over time?
1) Tall peaked T waves and shortened QT
2) PR interval and QRS complex lengthens
3) P wave can disappear and QRS becomes sine wave
4) Flat-line
Impetigo is? What are some features of it?
An acute superficial skin infection
Features:
- Pustules and ‘Honey’ crusted erosions (“school sores”)
- Mainly on face and hands, can be on perineum and truck
What predisposes you to impetigo
- Atopic eczema
- Scabies
- Skin Trauma
Treatment of impetigo?
- Clean sores
- Antiseptic 3x daily
- cover
-Antibiotics if severe (otherwise should resolve in 2-4wks)
What should you be thinking if a baby is having lots of episodes of cough and wheeze?
Croup (URTI)
Pneumonia and bronchiolitis (LRTI)
Don’t miss CF, bronchiectasis etc
What is the danger of croup?
it is a viral illness that affects the upper lungs, vocal cords and trachea. It is highly contagious and can cause airway obstruction and breathing difficulty.
Cyanosis, severe stridor and indrawing should be noted.
What is the criteria threshold for an aortic aneurysm to be surgically repaired?
Observation only for asymptomatic aneurysms <5.5cm
-If >5.5cm or rapidly expanding then repair
How much surveillance of AAA do you do?
- 0-3.9 every 3 years
- 0-4.9 every 12 months
- 0-5.4 every 6 months
What is Cor Pulmonale
PH-induced altered structure (eg, hypertrophy or dilatation) and/or impaired function of the right ventricle (RV) that is associated with chronic lung disease and/or hypoxemia.
Features of Cor Pulmonale
- Fainting spells during activities
- Central chest pain
- Swelling of the feet or ankles
- Cyanosis
- Features of lung disease
Check for liver/oesophageal varices, ascites, heart murmurs, raised JVP
Red flags of non-accidental injury
- Injuries to face, head or neck
- Unusual bruises
- Fractures in non-common areas
- Fractures in non-moving children
- Burns
Dry vs Wet Age-Related Macular Degeneration?
90% of AMD patients have “dry” AMD, where the macula gets progressively thinner and atrophies over time. This is seen as colour change and the presence of “drusen”
10-20% develop “wet” AMD where new blood vessels grow in the choroid layer behind the retina. These vessels are weak and leak fluid which gets into the layers, causing scarring and dysfunction.
Features of Diabetic retinopathy
- micro-aneurysms
- Hard exudate: lipid and protein leakage
- cotton wool spots: nerve fibre infarct
- Papilloedema
-Neovascularisation (if proliferative)
Features of hypertensive retinopathy
- cotton wool spots
- Flame haemorrhages
- Copper wiring
“dryer appearance then in DN”
What are the stages of diabetic retinopathyy
Early stage: non-proliferative
Later: Proliferative and characterised by neovascularisation
Because of neovascularisation, what kind of haemorrhages do you see?
Flame haemorrhage
Blot haemorrhage
Vitreous Haemorrhage: leads to temp. vision loss
