14/4/22 Flashcards
(44 cards)
Describe the method used to take blood glucose
- Check expiry date
- Insert strip into machine
- Wash patient hand
- Use lancet to take drop of blood
- PUT IN SHARPS BIN - - Push from proximal to distal
- Have machine vertical and get drop of blood
- Wipe with alcohol wipe and gauze
- Read the reading
What drug may be used in stress urinary incontience patients that don’t want surgery
Duloxetine
How many synapses in a reflex?
1
How can you tell the difference between anterior and posterior roots (beyond just location)?
Posterior root has a lump in it called the ganglion - made up of cell bodies
Once the roots join together they become the spinal nerve - then they split into what?
Anterior and posterior rami
The anterior and posterior roots are responsible for carrying axons responsible for what kind of thing?
Anterior - motor
Posterior - sensory
Where is there localisation in Weber’s test?
Best in normal ear - sensironeural
Best in abnormal ear - conduction
Where is bone marrow biopsied from?
Posterior iliac crest - adults
Tibia - kids
What’s the nice way to remember what ages are affected by different leukemias?
ALL CeLLmates have CoMmon AMbitions
ALL - <5 and >45
CLL - >55
CML - >65
AML ->75
What are leukemias?
Increase in the number of non-functioning WBC
In chronic - slow
In acute - fast process
What investigations would you like to do if you suspect leukemia?
What would make you suspect it?
In chronic typically asymptomatic ~
- huge hepatosplenomegaly
- bone marrow failure - infections, anaemia, bleedings
- painless lymphadenopathy
Acute
- similar but can cause painful lympadenopathy
- bone/joint pain
Full blood count
Blood film
Bone marrow aspirate
Chromosomal analysis (check for Philadelipha’s chromosome)
What blood result would you expect to see in CLL?
What age normally?
Same questions for CML
High levels of WCC (due to huge increase in lymphoblasts)
> 55
High levels of mature granulocytes
> 65
What kind of pain may patients present with in leukemia?
Why?
~ in acute - painful lymph nodes
Upper abdo pain due to hepatsplenomegaly
What lymphadenopathy gets extermely painful when drinking alcohol?
What do you see on biopsy of this?
Hodgkin’s lymphoma
Reed-sternberg cells
What do B symptoms suggest with regard to prognosis?
Presence of B symptoms suggests a worse prognosis
What is used as prophylaxis of tumour lysis syndrome?
In what situations does it occur?
Allopurinol
After chemotherapy - tumours breaking down and releasing potassium - leads to hyperkalaemia
What kind of leukemia is associated with warm autoimmune hameolytic anaemia?
CLL
LL = licking lollies in the sun = warm
Describe the presentation of a patient who has a condition as a result of her JAK2 mutation.
What should she be warned she is at high risk of developing?
Polycythaemia vera = JAK2 mutation
At high risk of STROKE
Present
- plethoric facies (red puffy face - similar to Cushing’s)
- Headaches
- dizziness
- tirednes
Other than generalised purpura what other clinical finding may you see in DIC?
- Remember can be seen in septic patients -
Haematuria
What is found in Fresh Frozen plasma?
Clotting factors
What is the first line management of DIC
FFP
What effect does DIC have on platelets?
Reduces them
What needs to have happened to diagnose tumour lysis syndrome?
- Increased serum creatine
- cardiac arrythmia or sudden death
- seizure
What drug should be used in sickle cell anaemia to reduce disease severity?
Aplastic crisis and sequestrion crisis can present in v similiar ways - how do you tell the difference? What are they?
Hydroxycarbamide
Can both cause worsening of anaemia
- Aplastic crisis is bone marrow suppresion due to parovirus infection and leads to anameia, low reticulocytes
- Sequestrion crisis is when due to sickling blood is pooling in the organs which leads to reduced blood in vasculature -> anaemia BUT HIGH RETICULOCYTES due to body trying to combat the anameia
