SAQ paper 2 notes/corrections Flashcards
features of an iron deficiency anaemia
hypochromic red cells
microcytic red cells
poikilocytosis
thrombocytosis
what symptoms would you enquire about in a patient with suggested iron deficiency anaemia
menorrhagia (heavy periods!)
haematuria
haematemesis
PR bleeding
nose bleeds
gum bleeding
PREGNANCY
features of iron deficiency anaemia on physical examination
pallor
pale conjunctiva
angular stomatitis
koilonychia (spoon shaped nails)
brittle nails
tachycardia
postural hypotension
which serum protein carries iron around the body
transferrin
which blood test is used to diagnose iron deficiency anaemia
serum ferritin
would serum ferritin be high or low in an iron deficient anaemic?
low
what symptoms does graves disease present with
D+
heat intolerance
agitation/anxiety
fatigue
exopthalmos
double vision
reduced vision
what other causes than graves disease is there for hyperthyroidism
toxic nodular goitre
excessive iodine consumption
iodine goitre
pregnancy
multi nodular goitre
thyroiditis
What is a TSH receptor antibodies test used for
confirm diagnosis of graves disease
what are the three modalities of treatment for graves disease
anti thyroid drugs
radioactive iodine
thyroidectomy
risk factors other than age and sex for osteoporosis
family history of OP
previous history of fractures
BMI<18.5
inactivity
smoking
alcohol
what medications are given as a primary for osteoporosis
vitamin D and calcium
ADCAL
what are relevant questions in a history of epilepsy
previous head injury, underlying brain disease, fever, history of fits, taken any drugs or alcohol
what is the brain scan used after someone has an epileptic seizure
EEG
electroencephalography
what features in a history of diarrhoea point to IBD
presence of blood or mucus in the stool, abdo pain, family history of bowel problems, presence of bloating, weight loss
give histological features of ulcerative colitis
increase in plasma cells in the lamina propria, crypt distortion/branching/abcess/ulceration
what features of a history would suggest asthma
diurnal variation, exertional shortness of breath, exertional wheeze
what other investigations of asthma should be used, other than spirometry with reversibility
chest Xray, sputum, peak flow
neoplasm, infection, resp function test
what feature of spirometry confirms obstructive airways disease
FEV1/FVC less than 0.7/70%
in spirometry with reversibility what suggests asthma rather than COPD
Increase in FEV1 of > 400ml or 20% after 10 puffs of salbutamol
what are the pathophysiological elements of asthma
airways inflammation
airways hypersensitivity
bronchospasm
bronchoconstriction
what receptor does salbutamol work on
beta 2 adrenergic receptors
three routes by which a carcinoma may metastasise
haematogenous (blood)
lymphatic
trans coelomic
iatrogenic spread
which cancers can metastasis to bone
breast, thyroid, kidney, prostate, lung
list diagnostic criteria for nephrotic syndrome
proteinuria >3g/l
hypoalbuminaemia <25g/l
oedema
list complications of nephrotic syndrome
hyperlipidaemia- abnormal catabolism
thrombosis- due to renal loss of antithrombin III
infections- renal loss of Ig
renal impairment- due to hypovolaemia
anaemia- due to renal loss of ferritin
hypothyroid- renal loss of thyroid binding globulin
what is the most likely histological classification of a patient with no underlying conditions and a failure to respond to treatment in nephrotic syndrome?
focal segment glomerulosclerosis
if a urine culture of a suspected UTI has mixed growth what is the next step
ignore the result, send a second CSU, investigate other causes
when is it appropriate to send urine samples for culture
pregnancy- if symptomatic or during first antenatal visit for asymptomatic bacteriuria
men with symptoms of UTI
severe symptoms
failed ABX tx
give clinical features which support the diagnosis of SEVERE aortic stenosis
slow rising carotid pulse
reduced volume carotid pulse
ejection systolic murmur
heaving apex beat
systolic thrill
which three initial tests would be used in a patient SOB with a suspected aortic stenosis
transthoracic echocardiogram
echocardiography
full blood count
chest Xray
what is the best treatment option for severe aortic stenosis
surgical aortic valve replacement
what is an alternative approach to a surgical aortic valve replacement?
transcatheter aortic valve implantation
well established, more effective and safer than balloon aortic valvuloplasty
possible symptoms of severe anaphylactic shock
diffuse erythema
coughing, wheezing
faintness, hypotension
abdominal pain, v+ D+
what is the mechanism of action of adrenaline
alpha and beta adrenergic receptor agonists
in anaphylaxis which other drugs are given to reduce the severity of the reaction
IV chlorphenamine
IV hydrocortisone
