Vascular/ENT Flashcards
What are the 6Ps in limb ischaemia?
Pain Pulseless Pallor Perishingly cold Paraesthesia Paralysis
When do we need to act surgically on an AAA?
When >5.5cm.
Give x3 causes of microcytosis
Fe2+ deficiency Thalassaemia Anaemia of chronic disease (ACD) Lead poisoning Acute blood loss
Give x2 causes of macrocytosis
Folate/ B12 deficiency
Aplastic anaemia
‘aplastic’ = failure to
Does pernicious anaemia show micro/normo or macrocytosis?
Macrocytosis; B12 deficiency.
What is the sign on blood film seen in Pernicious anaemia?
Hypersegmented neutrophils.
What does ‘mixed picture’ mean?
For example, Fe2+ deficiency AND B12 deficiency.
Low MCV
Normal RDW
How will the MCV be in Anaemia of Chronic Disease?
Low MCV.
How will the MCV be in Chronic Disease?
Normal MCV.
How will the MCV contrast between ‘Anaemia of Chronic Disease’ and Chronic disease?
ACD = low MCV
Chronic disease = normal MCV.
Normal MCV, Normal RDW. What is the diagnosis?
Chronic disease.
Give an example where we will see normocytic anaemia.
Chronic disease.
What is the general rule regarding pre-operative patients and blood transfusion?
Patients without cardiovascular disease do not need to be transfused unless the Hb is <80g/L.
When giving a transfusion to an anaemia patient, what should be requested?
Packed red blood cells (not fresh frozen plasma!).
What is a positive Rinne’s test?
Air conduction > bone conduction
This is either normal or sensorineural hearing loss.
What will Rinne’s test look like in conductive hearing loss?
Rinne’s test will be negative.
Bone conduction > Air conduction.
In a normal patient, should air or bone conduction be greater?
Air conduction should be greater. This will be a positive Rinne’s test.
What is Cholesteatoma?
Collection of cells in the ear. ‘Foul smelling discharge’.
Which bacteria causes Otitis media?
Viral URTI
Bacteria - Streptococcus pneumoniae.
What is the commonest cause of childhood deafness?
Otitis Media effusion ‘Glue ear’.
What is the main way we treat Otitis media with effusion?
Grommets/ surgery.
NOT ANTIBIOTICS.
What is Bell’s palsy?
LMN facial palsy.
How do Bell’s palsy patients present?
Unilateral facial weakness, droop
Facial, neck, ear numbness
Hyperacusis (heightened sensitivity to loud sounds).
DOES NOT SPARE FOREHEAD; LMN.
Name two appropriate investigations for Bell’s palsy.
EMG - Local axonal conduction block.
