Study Flashcards
RDT
FN, FP, SN, SP
- Sensitivity = , Specificity =
- Has lower false negativity and false positivity rate as compared to microscopy
- FN due to h2rp gene deletion, brand issues, low parasitemia < 100
- RDT has sometimes been used as a rescue when microscopy wrong
- Low parasitemia a reason for both microscopy and RDT FN
- Ghana protocol : repeat at 0,12, 24hrs if you think malaria is possible, other conditions ruled out
MALARIA, RDT
Epidemiology - GHANA
About 1 to 12% non falciparum
2nd most common after falciparum is malariae
RDT uses… for non falciparum RDT
RDT for non falciparum has 2 bands
Can have a cross reaction
VENTRICULAR SEPTAL DEFECT
How does it cause chf
Is murmur present at birth
What are common clinical association
How does it differ from ASD in termsof presentation
Name 2 clinical scenarios when vsd murmur is absent
Chf is due to Lt R shunt with increased flow to lungs. This usually becomes apparent ( except when small) when pulmonary resistance drops. This high resistance also means that vsd murmur may be absent at birth or within first week
Can present in 1st year of life even 1st 2 to 3months as compared to ASD when most even at 3 to 5years at repair may be asymptomatic.
VSD murmur : 1 - 6wjs, 6wks - 4month. 6weeks!
VSD is closed at 18 to 24months even if can close to avoid developing Intra vascular pressures and pulm hpt.
May be associated with FTT and recurrent respiratory infections
In TOF and Eisenmenger high pulmonary hypertension leads to absence of murmur. In Eisenmenger may even have honeymoon period of no shunt
Also close if chf, cardiomegaly, chronic resp, FTT, endocarditis, prevention of Inc pulm pressures,
WHICH COMMON SYNDROMES MAY HAVE VSD
-The 3 trisomies Tri 13,18,21
-Maternal DM (also septal hypertrophy, D - transposition)
-Maternal alcohol (also pulminary Stenosis)
What are the causes of Liver failure in Babies?
What are the causes of conjugated hyperbilirubinemia in newborns & infants
What are the differentials if Conjugated & Unconjugated hyperbilirubinemia
How Useful is Pulse oximetry in screening CHDx in newborns
Only 75% of critical congenital heart dx are screened
Most non cyanotic like VSD, ASD, PDA will be normal
What are the likely causes of a CHD presenting with heart failure at
Birth
In the First Week
In the first month
BIRTH
Absent pulmonary valve and severe tricuspid insufficiency ( as in ebstein)
Arterio Venous fistula
HLHS
1 Week
TGA with VSD
Critical AS and PS
Preterm with PDA
Arterio Venous fistula
HLHS
1 Month to 6 WEEKS
Large VSD, Large PDA, AV Canal
Coarctation of Aorta
Critical AS
INR CALCULATION
ESR VS CRP
PARACETAMOL POISONING
-Rumack mathew: how is it used
-Emergency treatment
-Classification
SERUM IgG
- what are some causes of elevation
- Can be elevated in Chronic Hepatitis esp cirhossis as well as AIH
-Other causes of raised IgG
Multiple myeloma
HiV
Tb
Other Autoimmune conditions
Sarcoidosis
OPNSD DOPPLER USG
-When to do
-Interpretation
-Clinical Implication
SCDX THERAPIES
-HUT
-glutamine if above 5yrs esp if not doing well on only HUT( 2x daily)
- Crunzalizumab ( >16yrs), alone if previous 2 didn’t work, monthly
- Volezotor
- Stem cell
- Gene therapy
- Ask at the clinic if had last menses, guys should not impregnate
- Must be off 3months before pregnancy, Males 3 - 9months
ASTHMA
-Gina Guidelines
Gold standard is lowest dose that prevents symptoms
Adults - lowest is budesenide + formetrol
Most patients at clinic will be step 3 & 4
Only refer if have to refer above step 3 for 6 - 11
Below 6yrs: choose appropriate
