Random high yield facts Flashcards
Ix for cellulitis?
Diagnosis can be made clinically
FBC (WCC) , ESR, CRP
wound swab
blood cultures
USS for DVT
Xray for osteomyelitis
risk factors for cellulitis?
breaks in skin / trauma
diabetes
immunocompromise
IVDU
venous insufficiency
complications of cellulitis?
necrotising fasciitis - hosp for IV abx and debridement
osteomyelitis
sepsis
Prophylaxis for contacts in meningitis?
if close contact within 7 days - ciprofloxacin
no prophylaxis if pneumococcal meningitis
Mx of chlamydia?
Gonorrhoea?
Syphilis?
chlamydia - doxycycline 7 days
gonorrhoea - IM ceftriaxone or oral cefixime + oral azithromycin if needle-phobic
syphilis - IM benzypenicillin
TB key mx steps?
2 months RIPE, 4 months RI
latent = 3 months RI or isoniazid for 6
causes of nephritic syndrome?
GRIP
Goodpastures
Rapidly progressive glomerulonephritis
IgA nephropathy
Post streptococcal glomerulomephritis
causes of nephrotic syndrome?
diabetic nephropathy
MMF:
minimal change disease
membranous glomerulonephritis
focal segmental glomerulonephritis
Define CKD
a gradual decline in kidney function (eGFR) for over 3 months
Irreversible
Results in proteinuria
Define AKI
a sudden reversible decline in kidney function over hours - weeks
results in raised creatinine and oliguria
Risk factors for AKI?
CKD
heart failure
sepsis
increasing age (>65)
diabetes
use of contrast / nephrotoxic drugs
Causes of CKD?
APCKD
diabetes
hypertension
glomerulonephritis
renal vascular disease
Staging of CKD?
eGFR
stage 1 : >90
stage 2 : <90-60
stage 3a: 59 - 45
stage 3b : 44 - 30
stage 4 : 29 - 15
stage 5 : 14- 0
proteinuria:
stage 1 : less than 3mg/mmol
stage 2: 3 - 30 mg/mmol
stage 3: 30 + mg/mmol
Staging of AKI?
stage 1 : 0. 5 ml/kg of urine for 6-12 hours
1.5 - 1.9 x baseline creatinine
stage 2 : 0. 5 ml/kg for 12-24 hours
2 x baseline creatinine
stage 3 : 0.3ml/kg for >24 hours or anuria for 12 hours
3 x baseline creatinine
Complications of glomerulonephritis?
DVT
CKD
hypertension and hyperlipidaemia
Mx of glomerulonephritis?
steroids, blood pressure control, LMWH for DVT
Basic steps in mx of meningitis?
IV antibiotics:
3 months - 50 yrs: cefotaxime (or ceftriaxone)
> 50 yrs: cefotaxime + amoxicillin for adults
IV dexamethasone : don’t give if post surgery or meningococcol (rash)
Bloods in meningitis?
full blood count
renal function
glucose
lactate
clotting profile
CRP
What should CSF be tested for in meningitis?
glucose, protein, microscopy and culture
lactate
meningococcal and pneumococcal PCR
enteroviral, herpes simplex and varicella-zoster PCR
consider investigations for TB meningitis
When should LP be delayed in meningitis?
signs of severe sepsis or a rapidly evolving rash
severe respiratory/cardiac compromise
significant bleeding risk
signs of raised intracranial pressure
causes of AF?
hypertension
hyperthyroidism
pneumonia
mitral stenosis
what is paroxysmal AF? mx?
episodes come and go, and usually stop within 48 hours without any treatment
DOAC if high CHADS-VASc
flecainide ‘pill in pocket’
Complications of CKD?
bone mineral disease
IDA
AKI
acidosis and hyperkalaemia
IHD
Investigations for CKD?
FBC, U&Es, CRP
bone profile
diabetes screen - Hba1c and BM
BP
USS for APCKD, renal biopsy
autoantibodies for lupus
complications of renal transplant?
rejection
disease recurrence
CVD
opportunistic infection
SCC
causes of AKI?
pre renal :
dehydration
hypotension
heart failure
renal:
glomerulonephritis
interstitial nephritis
ATN
post renal:
BPH, stones , cancer, strictures
Ix for AKI? Mx?
urinalysis, monitor urine output, USS KUB
Mx: fluid resus, stop nephrotoxic meds, relieve obstruction e.g. insert catheter
complications of AKI?
progression to CKD
fluid overload, HF, pulmonary oedema
hyperkalaemia
metabolic acidosis
uraemia (encephalopathy, pericarditis)
