SAQ facts Flashcards
What causes epigastric pain in appendicitis
Irritation of the visceral peritoneum which contains no somatic nerve endings at T10
What causes right iliac fossa pain later on in appendicitis
Irritation of the parietal peritoneum which does contain somatic sensation - localises the pain
Define diverticulosis
The outpouching of mucosa through the muscle wall
Define diverticular disease
Sympatic diverticulum
Define a hernia
Protrusion of a structure through the wall of cavity in which it’s usually contained
What causes an indirect inguinal hernia
Patent processus vaginalis
What is an obstructed inguinal hernia
Where GI contents cannot pass through that segment of the tract
What is the first line investigation of suspected appendicitis in women
Pregnancy test
What are howel jolly bodies
RBCs in which the nuclear remnant is still seen
Name two emergencies seen in acute pancreatitis
ARDS, DIC
Name two chronic complications of acute pancreatitis
Chronic pancreatitis
Pancreatic necrosis
How can we distinguish between small lbowel and large bowel on an X-Ray
Large bowels - look for haustrations
Components of gallstones
Bile salts, bile pigments, cholesterol and phosphlipids
Name tow types of gallstones
Pigment stones and cholesterol stones
What is Murphy’s sign
Two fingers are put under the RUQ - should cause pain.
Repeated in LUQ, if it does not cause pain - test is positive
What ligament separates the liver
Falicofrm ligament
When is a head tilt contraindicated
In head injuries where cervical spine injury is possible
If circulation is an issue in A-E, how many cannulas should be inserted
Two wide bore cannulas
What three structures typically break together in the knee
LCL
MCL
Medial meniscus
Why does the medial meniscus break with the LCL and MCL
Because it’s attached to the MCL tightly
What test is used to check for meniscal tears
McMurray’s
Where are autografts taken for ligament damaged in the knee
Hamstrings tendon
What criteria is used to classify intracapsular fractures
Graden criteria
What arteries supply to femoral head
Cervical vessels in the joint capsule , ligament tires, intramedullary bessels
What part of the arm does collet’ fractures affect
Radisu
What part of the bone does collet fractures affect
Metaphyses
What displacement and angulation is seen in a collet’ fracture
Dorsal displacement and angulation
Smiths’ vs Colles’ fractures
Smith’s sees a solar displacement and angulation
How should a collet’ fracture be followed up
Repeat X-Rays to see if reduction is adequate
Surgical management of colles fractures
Open reduction and internal fixation
How long does it take for collet’ fractures to resolve
6-8 weeks
Explain the mechanism of compartment syndrome
Swelling of healing tissues exceeds the space confined by the facia - this increases pressure in the compartment which compresses arteries and nervous supply = ischaemia
Two things to prevent compartment syndrome
Elevate the leg + use a back slab (allows injuries to swell)
Two benefits of a ‘box splint’
Limits bleeding and reduces NV compromise
What artery is affected if a STEMI is seen in the anterior leads
LAD
What defines a lateral lead MI
aVL, I, V5, V6
What artery is affected in a lateral lead MI
Left circumflex artery
Name two enzymes that are associated with MIs
Troponin and CK-MB
Examination findings in pulmonary oedema
Wheezing
Inspiratory crackles
Dullness to percussion
How does aspirin work
Inhibits Cox-2, causes reduced production of thromboxane 2 = less platelet aggregation
What is a capture beat on an ECG
Normal QRS complexes among VT signs
What part of the heart chamber is affected in I, II, aVF leads
Inferior
Signs of digoxin toxicity on an ECG
reverse tick pattern
ST Depression
T-wave inversion
V5-V6
How does cholesterol function
Inhibits HMG-CoA reductase - which stops cholesterol synthesis
Two signs of ypercholesterolaemia
Xanthelasmata and Corneal arcus
Name two drugs that can be used in pulmonary oedema
Furosemide and GTN/nitrates
At what BP should treatment for hypertension be definite
Over 160/100 mmHg
What criteria is used to check for Infective endocarditis
Dukes criteria
What first line investigation wouild you do for anyone with abdominal pain (gynecology)
Uriner Beta HCG - rule out a pregnancy!
How is methotrexate given
IM
Bedside investigations for HG
Urine dipstick to look fo rketones (starvation)
How should HG be managed
IV Thiamine and prochlorperazine
Two conservative management of menorrhagia
Mirena coil and endometrial albation
Describe CIN
CIN is the premalignant condition in qhixh abnormally dividing cells invade the epithelial layer but not the basement membrane
Management of CIN III
Large loop excision of the transition zone
How to check for cervicla mets
CT
Name two characteristic signs of Endometriosis on examination
Uterosacral liagemnt nodules
Fixed retroverted uterus
Two risk factors of endometriosis
FH
Smoking
What is seen in a clotting profile of someone with a placental abruption
Hypofibrinogemia: as placental damage causes thromboplastin to be released into circulation = DIC. Fibrinogen gets used up
Risk Factors of a placental Abruption
IGR
Previous Abruption
Smoking
Cocaine
Hypertension
Pre-Eclampsia
Define antepartum haemorrhage
Bleeding from the genital tract after 24 weeks’ gestation
Risk Factors of placenta praaevia
Twin/Multiple Pregnancy
Age
Scarred Uterus
Symptoms of Pre-Eclampsia
Nausea, vomiting, headaches, brisk reflexes, oedema
Name three causes of CAP
S. pneumoniae, h. influenzae, m. pnuemoniae
IN which condition is bronchial breathing seen in
Consolidation
Two differentials that can be mistaken for pneumonia
Pleural effusions
Pneumothoraxes
Why is RIPE given in TB
To combat multidrug resistance
How long is RIPE given for Tb meningitis
12 months
Two complictaions of bronchiectasis
Pneumoia and pneumothoraxes
What test is used to check for superior vena cava onstruction
Pemburton’s test
Name two causes of extrinsic allergic alveolitis
Farmer’s lung
Bird fancier’s lung
Two findings on an X-Ray for pulmonary fibrosis
Honeycomb lung and reticulnodular shadowing
Symptoms of exterinsic allergic alveolitis
4-6 hours after being exposed to the allergen, they develop a fever and dry cough
Two risk factor for obstructive sleep apnea
Enlarged tonsils
Enlarged Adenoids
ECG findings in cor pulmonale
Right axis deviation
Lifestyle changes for sleep apnoae
Lose weight, stop alcohol intake
What is seen under a biopsy for sarcoidosis
Non-caseating granulomas
Extra pulmonary manifestations of sarcoidosis
Erythema nodosum
Anterior Uveitis
Neuropathy
hepatosplenomegaly
Two peices of advice to tell someone starting on steroids
Bring a steroid card at all times
Do not stop taking it suddenly
Management of a persistent pleural effusion
Pleurodesis with lac, bleomycin and tetracycline
Where should a pleural tap be done; above or below the rib
Above the rib to avoid hitting the neurovascular bundle under the rib
Two reasons we would check a renal USS in AKI
To check renal size and exclude obstruction
Two causes of ckd
Hypertension
Glomerulonephirtis
PCKD
Pyelonephritis
What is stage 5 CKD
< 15
Symptoms of stage 5 ckd
Pallor
uraemic tinger
Hypertension
Calcium levels in tertiary Parathyroidism
HIgh
What test would you order to check for rhabdomyolysis
Urinary myoglobin
Three features of hyperkalaemia
Tall tented t waves
Broad qrs complexes
Flat p waves
How is Calcium gluconate given
10ml of 10% IV over 5 minutes
Management of granulomatosis with polyarthritis
Steroids
Define nephrotic syndrome
Proteinuria (>3 g/24 hours) AND hypoalbuminaemia (<30g)
Most common cause of nephrotic syndrome in adults
Membranous nephropathy
Dietary management of nephrotic syndrome
Salt restirtcion and normal protein intake
Two complictaions of nephrotic syndrome
Thromboembolism and Hyperlipidaemia
How to calculate serum osmolality
positive cations * 2 + glucose + urea
What is a consequence of overcorrection of low sodium ions
Central pontie myelynolysis
Three ways to prevent urinary tract infections
Wipe front to back
Cranberry juice
Urinate after sexual intercourse
Name two contraindications to a renal biopsy
Abnormal coagulation studies
CKD with small kidneys
Three complications of a renal biopsy
Infections
Haematuria
Right flank pain
What histological finding would be found in IGA nephropathy
C3 deposits and IgA deposits
three signs of rheumatoid arthritis on an x ray
Juxtaarticular erosions
Loss of joit space
Soft tissue swelling
how to nsaids work
COX inhibitors - causes less prostaglandins to be released so reduces inflammation
Two x-ray findings in gout
Soft tissue swelling and periarticular erosions (happens later on)
Where is pseudogout typically found
Knee, hips and wrists
Two causes for pseudogout
Hypothyoridisjm and hyperparathyroidism
What murmur is heard in Ankylosing Spondylitis
Aortic Regurgitation
6 signs of Acromgealy
HIGH blood pressure
Bitemproal hemianopia
Prognathism
Headaches
Voice changes
Frontal bossing
Why is an OGTT done in acromgealy
An increase in glucose will stop GH production - does not happen in acromegaly
Where does the thyroid gland originate embryologically
Foramen caecum
Where is ADH produced
Posterior pituitary gland
Where is IGF-1 produced
Anterior pituitary gland
What is the oral glucose tolerance test
A 300ml drink containing 75g of glucose is taken/ A pre drink glucose level is taken and a post drink after 2 hours is taken
After 2hours: 11.1 mmol/l = diabetes
Before drinking: Over 7 = diabetes
Name two ways DKAs occur physiologically
More gluconeogenesis by the liver and lipolysis of fatty tissues
What should people on steroids be advised
How to convert dose changes during intercurrent illness, carry a steroid card and bring an ampoule of hydrocortisone when oral itake is limited
Management of prolactinomas
Cabergoline
Or Surgery/Radiotherapy
A diabetic woman comes into the clinic complaining of vomiting, what’s ahppening
Autonomic gastroparesis (a typce of neuropathy)
What is the first sense to go in diabetic neuropathy
Vibration senses
Signs of iron deficiency anaemia
Tacchycardia
Pale conjunctiva
Ejection Systolic murmur
Why does sickle cell anaemia present later (6 months)
Due to foetal haemoglobin - does not get replaced by adult beta chains until 6 months of age
Name four complications of multiple myeloma
Hypercalcaemia
Spinal cord compression
Hyperviscocity
Acute Renal Failure
Chronic vs Acute Leukamia on a blood film
Chronic: Will show mature white cells
Acute: Will show immature blast cells
How is imatinib given
Orally
Name an acute cause of a transfusion reaction
Acute haemolytic reaction
Name a late onset complication of blood transfusions
Infections
Define am assive blood transfusion
Transfusion of the entire patient’s blood volume over 10 units of blood within 24 hours
What is the main cause of a blood transfusion reaction
Giving the wrong blood product to the wrong patient
How to manage a an acute haemolytic reatcion after stopping the transfusion
Send the product back to be cross-matched again - check if it is the correct product given
What is an acute presentation of haemophilia
COmpartment Syndrome
In which condition is a cobblestone appearance seen in
Crohn’s
Which condition in IBD has a transmural affect
Crohn’s
Pharmacology of infliximab
TNF alpha blocker - stops inflammation
Name two complications of crohn’s disease
Fistulas and GI cancers
What sign would I be looking for on an erect chest x ray to look for peptic ulcer perforation
Pneumperitoneum = free air under the diaphragm
Increased gastrin levels = what syndrome
Zollinger-Ellison syndrome (pancreatic gastrinoma)
Define GORD
Excessive movement of aicd from the stomach into the oesophagus through the gastro-oesophageal junction
Gold standard test for diagnosing reflux
pH manometry
What two infections can someone with Hepatitis B be co-infected with
Hep C and D, HIV
Two risk factors for hepatitis B
Occupation health workers + Sex workers
Name two cancers associated wit coealiac’s
GI T-cell lymphoma + Gastric carcinoma
Name two autoimmune conditions associated with coeliac’s
Hypothyroidism + T1DM
Why is lactulose given for hepatic encephalopathy
Because more bowe movements = less nitrogen producing bacteria in teh gut
Sign of SAH on a CT head
Mixing of blood with the CSF in the interhemispheric fissures
What is kernig’s sign
SHows meningeal irritation, bend hip and knee to 90 degrees and extends = pain
Most comon cause of a stroke
Carotid artery atherosclerosis
Needs a carotid endarterectomy
Define a seizure
Transient abnormal electrical activity in the brain that leads to disruptive symptoms
What two structures are damaged to causes homonymous hemianopia
Visual cortex and optic radiation
Name the three layers of the meninges
Dura mater, arachnoid mater and pia mater
What needs to be prescribed with Levo-dopa
Peripheral dopa-decarboxylase inhibitor to reduce peripheral breakdown - causes less side effects
What lesions would be foundin the brain of someone with parkinson’s
Lewy Body
What is the triad for parkinson’s
Bradykinesia, Rigidity and Unilateral pill-rolling tremour
Postural instability
What surgery is indicated for bladder tumours T1
Trans urethral resection of the bladder tumour
What treatment is indicated for T2/T3 bladder tumours
Radical cyctsectomy
Sensitivty vs positive predictive value
Sensitivtity: True positives/ True positives/False negatives
Positive Predictive Value: True positives/ False positives
What would a low PPV mean for a patinet
They would have to udnergo invasive treatment for conditions they don’t have
What medications are given prior to a prostate biopsy and why
Metronidazole and ciprofloxacin as gut flora may enter the prostate and cause infections
Two consequences of orchidectomy
Infertility and delayed puberty/stunted puberty
Two characteristics of a renal mass on examination
MOves up and down with respiration and able to get above the mass
Four risk factors of renal cancer
Age
Male
Smoking
Obesity
Why do we get loin pain in kidney stones
Visceral nerve supply to the ureter and kidneys follows a similar course to the somatic nerve supply of th egonads . Brain intereprets these interchangeable
What causes ureteric colics
Spasming caused by peristalsis to push the stones down - causes local ischaemia and pain
When is stenting of the ureters contraindicated
If there are signs of infection
Name trhee anatomical sturtcures that are most prone to stones
Renal pelvis, Pelvic-ureteric junction and vesico-ureteric junction
T1 dermatome sensation?
Inner arm to the medial epicondyle
Dermatome of the umbilicus
T10
Dermatome at the level of the nipple
T4
Dermatome of the middle and lateral aspect of the anterior thigh
L2
Dermatome supplying the medial malleolus
L4
Dermatome supplying the perineum
S4/5
Myotome of shoulder shrugs
C4
Myotome for finger abduction
T1
Myotome for hip flexion
L2
Myotome for wrist extension
C6
Myotome for shoulder abduction
C5
Myotome for elbow extension
C7
Myotome for elbow flexion
C5
Myotome for wrist flexion
C7
Myotome for finger flexion and thumb extension
C8
Myotome for Knne Extension
L3
Myotome for big toe extension
L5
Myotome for ankle dorsiflexion
L4
First line treatment of a generalised tonic clonic seizure
Valproate in men
Lamotrigine in women
First line medication in absence seizures
Sodium valproate in men, Ethosuxamide in women
Ethosuxamide second line in men
First line management of myoclonic seizures
Sodium valproate
First line management of infantile spasms
High dose prednisolone and vigabatrin
First line management of focal seizures
Carbamazepine or lamotrigine NOT valproate
When should someone with Chron’s be admitted to hospital
> 8 stools a day and systemically very unwell
Drug to induce remission in crohn’s
Prednisolone
If untolerated: 5-ASA
What is added to predniosolone in crohn’s disease if not working
Add azathioprine
Infliximab is last line really
What medication is used to maintain remission in Crohn’s
Azathioprine or mercaptopurine
What myotome can causefoot drop
L5
What nerve root causes difficulty with walking on toes
S1
Nerve root for bicep jerk
C5/6
Nerve root for tricep jerk
C7/8
Nerve root for supinator jerk
C5/6
What abbreviated mental test score suggets confusion
<6
What are two complications of TURP surgery
TURP syndrome
Retrograde ejaculation
Two complication of taking gout the prostate
Erectile Dysfunction
Urinary incontinence
Two risk factors of stress incontinence
Obesity and Childbirth
Four lifestyle changes to stop stress incontinence
Stop alcohol, caffeine, smoking cessation and weight loss. Avoid drinking at night time
A long term complication of raised intravesicular pressure of the bladder
Bladder diverticulum
Surgical management of a urethral stricture
Urethroplasty
Two complictaions of a urethral stricture
Stones and UTIs
Two causes of a urethral stricture
Gonorrhoea and catheters.
What lymph node is specific to tonsilitis
Jugulodiagastric lymph node
Define vertigo
The room is spinning in a certain direction
Pathophysiology of BPPV
Displacement of otolith in th esemicircular canals. Heavier otolith causes abnormal movement of the endolymph
Name three ways we can manage BPPV
Cyclizine + Hyoscine Hydrobromide
Reassurance
Reduce alcohol intake
betahistine
Two parts of the ear drum
PArs flaccida and pars tensa
What is a positive rinne’s test
AIR conduction > bone conduction
Main differential of a vestibular schwannoma
Meningioma
Define a paranasal sinus
An air filled cavity in the facial bones that connects to the nasal cavity
Name two causes of sinusitis
Infections and swimming
Namme two management methods for sinusitis
Decongestants and analgesia
What gland in the face usually has tumours
Parotid glands
Most common type of parotid gland tumour
Pleomorphic adenomas
Name three causes of parotid gland inflammation
Parotitis, mumps and duct blockages
What ives preferance to EVAR over a open repair for an AAA
EVAR if there are multiple comorbdities
Disadvantages of EVAR
Long term follow up needed and high reintervention rate
Name the three layers oft he blood vessel wall
Intima, media, externa and aventitia
Someone gets black digits following an open repair fo their AAA, what is this
Cholesterol embolism from surgery
Critical limb ischaemia vs acute limb ischaemia
Critical limb ischaemia is a gradual form of PAD - happens at rest/night
Acute limb ischaemia is a sudden onset of symptoms
How long can tissue go without recieving blood supply
6 hours
What is pre-clinical trial
Animal testing
What is a phase 0 trial
Small group of volunteers to assess pharmacokinetics (not comon)
What’s a phase 1 trial
Helathy volunteers to find dosing
What’s a phase 2 trial
Tetsing of drug on large group of patients to check for safety
What’s a phase 3 trial
Final testing to check effectiveness again to compare between existing interventions
If a 95% confidence interval includes 1. something, what does this mean
There is NO signfiicant increase or decrease in the prevalence
What is the strongest type of interventional trial
Randomised control trial
Define risk ratio
Probability of an event in an exposed group compared to the probability occuring in the non-exposed group
In what studies can an odds ratio be the only way to calculate something
Case-control and cross-setcional studies
Define a cohort study
Where one group is exposed to a certain risk factor and the other is not to establish a link in a health related outcome
Usually prospective
Define case-control study
Examines the association between an outcome and an exposure to a risk factor
Name four of the bradford hill criterions
Strength
Consistency
Specificty
Temporarilty
Biologic Gradient
Plausibility
Coherence
Analogy
Name two advantage sof a cross-sectional study
Multiple outcomes can be studied
Can be used to generate hypotheses
Cheap and easy
Name two disadvantages of cross-sectional studies
Do not show causality
Chances of recall bias
Advantage of meta analysis
Increases statistical power and reliability of data
Disadvantage of meta analyses
Cannot control biases introduced in separate studies
Role of a RCT
To determine causality
How can we improve an RCT value
Meta analysis - increases stiatsical power
What is a type I error
incorrect rejection of th enull hypothesis if it’s true
What is a type 2 error
failure to reject th enull hypothesis when it is false
At what p value do we reject the null hypothesis
p< 0.05
What is the intention to treat analysis
Analysing the resuls with the patient in their allocated group - even if they leave halway throuogh
How to adjust for confounding factors
Multivariable analysis
Define a power of a study
The ability of a study to detect a difference bwtee study groups if such a difference exists
Name two structures that can be damaged in a carotid endarterectomy
Hypoglossal nerve and internal jugular vein
Two complications of carotid endarterectomy
MIs and strokes
Define an ulcer
Abnormal break in the epithelial surface
Management of ulcer infections
Broad spectrum antibiotics + debridement of dead tissue
What mechanical intervention can be given for people recurrently suffering from DVTs
Inferior Vena Cava Filter
Two complications of DVTs
PEs and CHronic venous insufficiency
Name trhee parts of virchow’s triad
Hypercoagulable state, endothelial wall damage and flow stasis
Risk factors for varicose veins
Obesity and pregnancy
Two skin changes seen in venous ulcers
Lipodermatosclerosis and Ulcers
Two lifestyle changes to improve varicose veins
Support stockings + Weight loss
Two complication of varicose veins
Ulcers and bleedings
What nerve may be damaged in surgical management of venous ulcers
Saphenous nerve - loss of pain in medial and anterior aspect of the calf
What causes varicose veins
Valve insufficiency
Name two treatments other than Emolients and topical steroids for eczema
Ciclosporin and oral steroids
Two features of eczema
Scaly, erythematous excoriations
Two features of plaque psoriasis
Well demarcated, scaly plaques
Two tests for phemigoid vulgaris
Biopsy and auto antibody screen
What can precipitate phemigoid vulgaris
Auto immune an ddrug induced
Managedment of phemigoid vulgaris
Steroids
Risk factors for melanomas
Lenigo maligna + family history
What is moh’s micrographic surgery
Done to take out BCCs
Differentials of Basal cell carcinomas
Amenolitic melanoma + Actinic Keratosis
What causes acne pathophysiology
Increased produtcion of sebum due to blockage of the pilosebaceous follicles
Differentials for squamous cell carcinomas
BCCs, keratocanthoma and pyogenic granuloma
Where should you inspect on the body otehr than the SCC lesion itself
Lip and Ear - lymph nodes
What strain of virus causes shingles
Human herpes virus 3 (VZV)
Describe the waterlow pressure score
Grade I: Non-blanching erythema over intact skin
Grade II: Partial thickness loss
Grade III: Full thickness loss extending into fat
Grade IV: Extensive destruction with involvement of muscle an dtissues
Symptoms of lichen sclerosus
Itching, constipation and dyspareunia
Gold tsnard invetsigation for lichen sclerosus
Biopsy
Management of lichen sclerosis
TOpical steroids and emiolients
Paired vs unpaired student t test
Paired t test compares study subjects at 2 different times vs unpaired t test which compared two different groups of study subjects
When is an embolectomy firtst line in acute critical limb ischaemia versus thrombolysis with heparin
When motor symptoms have gone
What is a paradoxical embolus
A complication of DVT where it moves through the inferior vena cava and into the left circulation to cause infarcts in the lower leg
Management of placental abruption
Foetal distress: Emergency c section
No foetal distress < 36 weeks: Give steroids and admit
No foetal distress > 36 weeks: Deliver vaginally
When is placenta praevia diagnosed
20 weeks for low lying
Then 32/36-37 weeks to confirm if elective c section is needed
When are elective c-sections ordered for
38 weeks
Contraindications for external cephalic version
Abnormal CTG
Antepartum haemorrhage
Previous c-section
Contraindications for vaginal delivery for breech position
Macrosomic baby: >3,800g
Footling
<2000g
Foetal compromise
Previous C-section
How should being small for gestational age be managed
Offer induction IF umbilical artery doppler is abnormal + steroids
Define an informal patient
Someone who has voluntarily agreed to a treatment of mental illness and is not being detained against their will.
Name three things that need to be measured at baseline for lithium:
ECG: for prolongued QT syndrome
TFTs
U&Es
Why is the hospital anxiety depression scale
Diagnosis, monitors symptoms and for research of depression in hospitals
Name two problems of teh HADS score
Culturally varied in scores/ can only be used in hospitals
Delirium vs Dementia
Delirium: Organic cause of a fluctuating altered consciousness with conufsion and disorientation, as a result of memory loss
Dementia: Chronic deteriorating condition caused by the disease of the brain. This causes global cognitive dysfunction
Name two components of the mini-mental state examination
Orientation to time
Orientation to place
Name two ways we can manage delirium
MOderately lit and quiet rooms
Ensure calming non-agressive voice to orientate the patient
Acamprosate mechanism of action
Gaba agonist
Disulfiram mechanism of action
Blocks acetyl dehydrogenase which stops its breakdown into acetic acid - large amounts of alcohol in the blood can cause hangover like symptoms
Define an auditory/visual hallucination
The perception of sounds or visions in the absence of a stimuli
Define Delusions
A false held belief with strong convictions despite evidence against it - that goes against the person’s cultural or social norms.
How can someone refuse to be sectioned? What can they do about it
Send in an appeal wihtin 14 days of detention
diagnosis of bronchiolitis
Nasopharyngeal aspiration
What two ways we can manage a hcild with bronchiolitis in hospitals
Oxygen and NG Tubes
What is seen on an X-Ray for extreme bronchiolitis
Hyperinflation
Management of severe croup if dexamethasone has not worked
Nebulised adrenaline for the wheeze
What prenatal investigation can be done to check for heart defects
ECHOcardiogram
What is seen on an X-Ray for IRDS
Ground glass shadowing
What causes AF in mitral stenosis
Increased pressure in the left atrium causes it to enlargen - this resultselectrical remodelling of the left atrium due to stress resulting in AF
Method of action of allopurinol
Xanthine Oxidase inhibitor - it stops the production of urice acid from xanthine, so it won’t build up and cause gout
WHat is a QALY
A measure of the value of health outcomes. One QALY = 1 year of life in perfect health
Two types of economic evaulations
BENEFIT-COST ANALYSIS
COST-EFFECTIVENESS ANALYSIS
Cost-utility analysis
Cost consequenct analysis
Define efficiency in health economics
Measures whether health resources are being used to get the best value for its cost
Define opportunity cost
It refers to the economic benefit which is relinquished while choosing one therapeutic alternative over the other
Nmae 4 contraindications to thrombolysis
POssible aortic dissection
Active internal bleeding
High Blood pressure (180/100+)
Recent major surgery
