Third Flashcards

Question

drugs known to cause pleural effusion

Answer 1

nitrofurantoin, methotrexate, and amiodarone

Answer 2

aPTT and, if available, the thrombin time (TT) apt will be prolonged

Answer 3

high plasma renin - response to the low pressure sensed by the constricted renal artery

Answer 4

radial nerve palsy, or wrist drop, although many peripheral nerve palsies may be seen. proximal renal tubular failure, particularly with increased excretion of phosphate and glucose and acidification of the urine lead poisoning with a pronounced anaemia, often with dimorphic picture and reticulocytosis Basophilia with stippling is seen and bone marrow trephine may show ring sideroblasts. Abdominal pain, constipation, neuropsychiatric features

Answer 5

erythrocyte zinc protoporphyrin (ZPP) levels and delta aminolevulinic acid dehydratase (ALAD) coupled with skeletal analysis and blood lead levels are used to test for occupational lead poisoning

Answer 6

Ondansetron

Answer 7

Levomepromazine is correct. This is a broad-spectrum anti-emetic - a 'dirty drug' targeting many receptors

Answer 8

If this patient had mitral stenosis, weighed over 120kg

Answer 9

1st line: PRN GTN 2nd line: BB or CCB 3rd line (if no hypotension after 2nd line) ISMN/nicorandil 3rd line (if hypotension after 2nd line) RANOLAZINE in HR<70, IVABRADINE in HR >70 recommend the use of no more than 2 antianginals prior to consideration of reperfusion therapies patients with complex anatomy, triple vessel disease or proximal left mainstem disease report better long-term survival and freedom from MI is greater with CABG Nicorandil is only contraindicated in LV failure and cardiogenic shock Ranolazine - contra in severe kidney disease liver dysfunction, an absolute contraindication

Answer 10

her age (< 75 years), femoral neck/ hip bone mineral density > -2.5 lack of history of fragility fracture no Previous history of hip or vertebral fracture not Taking oral glucocorticoids ≥7.5mg prednisolone/day or equivalent Allpatients on bisphosphonate treatment for ≥10 years should be reviewed repeat DEXA scan is recommended after two years or in the event of fragility fracture Tx break after 3-5 years on bisphosoabte of low risk t score more than 2.5

Answer 11

MPO antibodies - churg pr3 positive Wegener's granulomatosis Microscopic polyangiitis is a small-vessel ANCA vasculitis. pANCA (against MPO) - positive in 50-75% cANCA (against PR3) - positive in 40%

Answer 12

High Renin+ Aldosterone= RAS Low Renin+ HIGH Aldosterone= conn syndrome Low Renin + low Aldosterone= Liddile syndrome high aldosterone, high renin, normotension, low K = bartter syndrome High renin and low aldosterone - gitleman syndrome

Answer 13

Furosemide C captopril derivative P penicillin & penicillamine derivatives S sulfasalazine

Answer 14

primary hiv apetite suppressant - fenfluramine connective tissue disease vasculitis secondary thromboembolic

Answer 15

significant enlargement of the ascending aorta severe regurgitation with symptoms asymptomatic patients with severe AR who have LV systolic dysfunction ejection fraction of less than 50%

Answer 16

EF < 60% 2. Left ventricular end systolic diameter > 40mm 3. New onset of AF or pulmonary hypertension 4. High likelihood of durable repair with low surgical risk and absence of risk factors

Answer 17

Symptoms of hypercalcaemia b. Osteoporosis and/or fragility fractures c. Renal stones or nephrocalcinosis 2. Age <50 years 3. Serum adjusted calcium of 2.85 mmol/L or above 4. Estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m²

Answer 18

intermittent pneumatic compression LMWH - has a high chance of covering to hemorrhagic stroke

Answer 19

immune thrombocytopenic purpura (ITP) and autoimmune haemolytic anaemia (AIHA). The body's immune system mistakenly targets and destroys platelets and red blood cells leading to symptoms of both thrombocytopenia such as easy bruising, petechiae, and bleeding, as well as symptoms of haemolytic anaemia like fatigue, pallor and jaundice. Diagnosis is typically based on the presence of these two conditions with a positive Direct Coombs Test (DCT) confirming AIHA

Answer 20

defective platelet aggregation due to a deficiency or dysfunction of the glycoprotein IIb/IIIa causing mucocutaneous bleeding such as epistaxis, menorrhagia or gum bleeding. confirmed by flow cytometry showing GPIIb/IIIa negativity or Platelet Aggregation Tests using ADP, collagen or adrenaline which show abnormal results while ristocetin-induced agglutination remains normal.

Answer 21

deficiency or dysfunction in the glycoprotein Ib-IX-V complex prolonged bleeding time despite having normal platelet count but larger than average size (macrothrombocytes). Diagnosis can be confirmed by flow cytometry showing GPIb/IX negativity Platelet Aggregation Test showing decreased agglutination with ristocetin.

Answer 22

haemolytic anaemia pancytopaenia may be present haemoglobinuria: classically dark-coloured urine in the morning (although has been shown to occur throughout the day) thrombosis e.g. Budd-Chiari syndrome aplastic anaemia may develop in some patients Diagnosis flow cytometry of blood to detect low levels of CD59 and CD55 tx blood product replacement anticoagulation eculizumab stem cell transplantation

Answer 23

Acute intermittent porphyria Acute intermittent porphyria (AIP) defect in porphobilinogen deaminase, abdominal: abdominal pain, vomiting neurological: motor neuropathy psychiatric: e.g. depression hypertension and tachycardia common classically urine turns deep red on standing Diagnosis raised urinary porphobilinogen (elevated between attacks and to a greater extent during acute attacks) assay of red cells for porphobilinogen deaminase raised serum levels of delta aminolaevulinic acid and porphobilinogen Management avoiding triggers acute attacks IV haematin/haem arginate IV glucose should be used if haematin/haem arginate is not immediately available

Answer 24

motor and sensory involvement

Answer 25

immune-mediated disorder, commonly associated with anti-GM1 antibodies multifocal areas of demyelination and motor block, with f waves and H-reflexes Anti-GM1b are antibodies typically present without sensory or bulbar involvement pure motor peripheral neuropathy respond well to intravenous immunoglobulin.

Answer 26

does not have nerve block , typically nerve conduction normal

Answer 27

von willebrand - prolonged bleeding time platelet aggregation is impaired in response to ristocetin