test via import csv (deck area) Flashcards
Acute Bronchitis - Aetiology
Viral
Acute Bronchitis - Key findings
loose rattly cough + sputumpost-tussive glut/vomitwellpost URTINO creps/wheeze
Acute Bronchitis - Managment
Supportive
Acute Bronchitis - Prognosis
Self-limiting
Anaemia - Aetiology
Deficiencies (iron, B12, folate)ThalassaemiamalignancySecondary (of chronic disease)
Anaemia - Epidemiology
Menstruating girls and womenPregnant/PPYoung children
Anaphylaxis - Key findings
Sudden and rapid progressionABC problems +- skin and mucosal changesurticaria, pruritus, flushingVasodilation -> warm extremtities, low BPCapillary leak -> hypovolaemia, oedemaBronchospasmGI symptoms
Anaemia - Key findings
Low HgPallor. fatigue, dyspnoea, anorexia, headache, bowel disturbance
Anaemia - Investigations
FBCBlood filmFerritinReticulocyte count
Anxiety disorder - Key findings
Excessive worry about everyday issues disproportionate to risk3 or more of: restless/nervous, easily fatigued, poor concentration. irritability, muscle tension, sleep disturbance>6msignificant distress or impairment
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Anaemia - Managment
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Anaphylaxis - Aetiology
Type I hypersensitivityFood, drugs, venom
Anaphylaxis - Investigations
Tryptase blood sample (ASAP = 1-2 h after)
Anaphylaxis - Managment
AdrenalineChlorphenamineHydrocortisoneNebulised salbutamolADMIT
Anaphylaxis - Prognosis
ResolutionDeath due to resp failure or cardio collapse
Anxiety disorder - Aetiology
Biopsychosocial factors???
Anxiety disorder - Epidemiology
Most common psych disorder1-7% prevalence in EuropeF>M35-55 yo
Anxiety disorder - Investigations
GAD-7 questionnaire
Anxiety disorder - Complications
Impaired functioningComorbidities (depression, substance misuse or dependance)SuicideIncreased use of healthcare
Anxiety disorder - Prognosis
Chronic fluctuatingLow rates of remission
Anxiety disorder - Managment
Step approach (if marked impairment - 3.)1. Communicate and educate, monitor2. Individual non-facilitated self-help, individual guided self-help, psychoeducational groups (all CBT based)3. Hight-intensity psych intervention (CBT, 12-15w 1 h), SSRI (sertraline, paroxetine, escitalopram), SNRI (duloxetine, venlafaxine) - monitor weekly for first month for suicide4. Referral
Atrial Fibrillation - Aetiology
Unknown
Atrial Fibrillation - Epidemiology
2.5% in EnglandM>F
Atrial Fibrillation - Key findings
Supraventricular tachyarrhythmiaHR 160-180Irregularly irregular pulseParoxysmal/persistant/permanentBreathless, palpitations, chest discomfort, syncope, dizziness
Atrial Fibrillation - Investigations
12-lead ECG (normal/ambulatory)EchoCXRBloodsCHA2DS2-VASCc
Atrial Fibrillation - Complications
StrokeHeart failure
Atrial Fibrillation - Managment
If CHADSVASC 2 or more - DOAC (Apixaban, dabigatran, edoxaban and rivaroxaban)If CI - vit K antagonist (warfarin)Beta blockerRate-limiting calcium channel (verapamil)
Asthma - Aetiology
Unknown
Asthma - Epidemiology
12 % of UKChildren (M>F)M=F in adulthoodCould be occupational
Asthma - Key findings
SOBWheezeCoughChest tightness Episodic, diurnal, triggers
Asthma - Investigations
Hx FeNOSpirometry PEFRBronchodilator reversibility
Asthma - Management (Adults)
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Asthma - Management (Children)
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Asthma - Complications
Acute exacerbation
Asthma - Acute exacerbation management (adults)
Admit if life threatening or near fatal or severe persistent after initial treatment (according to PAAP)OxygenBeta agonists (Salbutamol) + steroids (Prednisolone, 40-50 mg for at least 5 days)Nebulised Ipratropium bromide (severe or life-threatening asthma or those with a poor initial response)IV Magnesium SulfateIV Aminophylline
Asthma - Acute exacerbation (children)
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Asthma - Acute exacerbation managment (children)
OxygenSABAIpratropium bromide (every 20-30 mins)Oral prednisoloneNebulised magnesium sulfate if severe2nd lineIV SalbutamolIV Aminophylline if severeIV Magnesium sulfate
Eczema - Aetiology
Skin barrier dysfunction??? FilaggrinEnvironmental factors or allergens
Eczema - Epidemiology
Children 20%Adults 10%
Eczema - Key findings
Dry, pruritic skin, and is typically an episodic disease of flaresChronic inflammatoryPersonal and familial atopic hx
Eczema - Investigations
HxExam rash
Eczema - Management
EmollientsTopical CorticosteroidsAntihistaminesOral corticosteroids
Eczema - Complictaions
Eczema herpaticum (admit)Infected eczema (weeping, pustules, crusts, fever and malaise)
Bronchiolitis - Aetiology
Viral
Bronchiolitis - Epidemiology
Peak at 3 - 6 m<1 yo (up to 2yo)
Bronchiolitis - Key findings
Symptom peak at 5dResolution within 3wCoryzal prodromePersistent cough + tachypnoea/chest recession + wheeze/cracklesYoung infants (<6 we) may only have apnoea
Bronchiolitis - Differentials
Pneumonia if high fever and/or persistently focal cracklesViral induced wheeze (older, no crackles, recurrent episodes, atopic hx)
Bronchiolitis - Investigations
Oxygen satsTempResp exam
Bronchiolitis - Managment
Reassure + conservativeAdmit to hospital if apnoea, sats <90% (<92% if under 6w), inadequate fluids, persistent sever reps distress, risk factorsOxygenCPAPNG tube
Bronchiolitis - Complications
Acute resp distress syndromeBronchiolitis obliterans Congestive HF
Heart failure - Aetiology
Coronary artery diseaseMIIschaemiaHypertension Cardiomyopathy Arrhythmias Valvar and congenital heart diseaseAlcohol and drugsPericardial diseaseHigh output
Heart failure - Epidemiology
Age
Heart failure - Key findings
SOBFatigue Swollen ankles and legsLightheaded mess and faintingCoughWheezeBloatingAppetite lossWeight gain/lossConfusionFast HRPalpitations
Heart Failure - Investigations
N-terminal pro-B-type natriuretic peptide >400ng/L diagnostic (if >2000ng/L refer urgently)EchoECGCXRBloodsUrinalysis Peak flow/spirometry
Heart failure - Managment
Lifestyle adviceTreat underlying causeIf reduced ejection fraction - ACEi + beta blocker, Ivabradine, Savibitril valsartan, DigoxinAll HF types - diuretics, calcium channel blockers, amiodarone, anticoagulant, vaccinations
Heart failure - Complications
Arrhythmias DepressionCachexia AnaemiaCKDAKISexual dysfunction Sudden cardiac death
Chronic kidney disease - Aetiology
DiabetesHypertension Glomerulonephritis
Chronic kidney disease - Epidemiology
Over 65sF>M
Chronic kidney disease - Key findings
FatigueTrouble concentratingPoor appetite Trouble sleeping
Chronic kidney disease - Investigations
U&EscreatinineeGFRUrine albumin-to-creatinine ratiourine dipstick for haematuriaCheck nutritional status, BMI, BP, and serum HbA1c and lipid profile (cardiovascular risk factors)renal US if indicated, (suspected urinary tract stones or obstruction, FHx of polycystic kidney disease and > 20 yo)
Chronic Kidney Disease - Managment
Underlying causesMonitor serum creatinine and eGFRManage hypertension urinary ACR of 70 mg/mmol or more - lisinopril or losartan irrespective of blood pressureatorvastatin 20 mgantiplateletsavoid nephrotoxic drugs
Chronic Kidney Disease - Complications
AKIHypertension and dyslipidaemiaCVDRenal anaemiaRenal mineral and bone disorderPeripheral neuropathy and myopathyMalnutritionMalignancyEnd stage renal disease
COPD - Aetiology
SmokingOccupationalAir pollutionAlpha1-antitrypsin deficiency
COPD - Epidemiology
1.2 million in UK>40 yoM=F
COPD - Key Findings
Breathlessness — persistent, progressive, and worse on exertionChronic/recurrent coughRegular sputum productionFrequent lower respiratory tract infectionsWheezeCyanosisRaised jugular venous pressure and/or peripheral oedema CachexiaHyperinflation of the chestUse of accessory muscles and/or pursed lip breathingWheeze and/or crackles on auscultation of the chest