21.0.24 Flashcards
(24 cards)
Features of cold AIHA:
Lymphoma is a risk factor, and mycoplasma and EBV
Raynauds phenomenon
Symptoms worse in cold
Macrocytic anaemia, macrocytosis due to reticulocytosis to compensate for haemolysis
IgM antibody
Leukaemia cause of warm AIHA?
CLL
Mechanisms of anaemia in CKD:
Reduced EPO production
Reduced iron absorption
Reduced rbc lifespan e.g. haemodialysis
Reduced erythropoiesis due to uraemic toxicity on bone marrow
What type of cells are seen on blood film in myelofibrosis?
Teardrop poikilocytes
What type of cells are associated with HS and immune-mediated haemolytic anaemias?
Spherocytes
What type of cells are associated with haemolytic anaemia?
Shistocytes
What conditions present with a positive direct Coomb’s test?
Acquired, immune causes:
AIHA
Mycoplasma infection
Transfusion reaction
HDN
Methyldopa
Penicillin
Mechanism of anaemia in HL:
AIHA, coombs positive
Hypersplenism
Bone marrow replacement by HL
Normocytic usually
Causes of warm vs cold AIHA:
Warm:
Idiopathic
SLE/AI disease
Lymhpoma
CLL
Methyldopa
Cold:
lymphoma
mycoplasma
EBV
Mnemonic for asthma treatment:
O SHIT ME
Oxygen
Salbutamol o2 nebs
Hydrocortisone IV/ Pred oral
Ipratropium bromide nebs
Theophylline - aminophylline infusion
Mag sulphate
Escalation e.g. intubation, ITU
3 investigations in MS:
MRI Brain and Spine with gadolinium contrast (disseminated in time and space and demyelination)
LP with oligoclonal bands
Visual evoked potentials (slowed conduction of nerve signals in the optic nerve)
Delirium definition:
Acute fluctuating altered level of consciousness with inattention and disorganised thinking.
Causes include PINCH ME:
Pain
Infection
Nutrition
Constipation
Hydration
Medication
Environment
Management of delirium:
Treat underlying cause
Orientate patient
Review medications
Ensure adequate fluid balance
Haloperidol / risperidone / benzos as last resort.
Most common organism in lactational mastitis / abscess?
Staph aureus
Investigation and management of a breast abscess:
US to visualise abscess and guide drainage procedure
Needle aspiration, for culture and drainage
Incision and drainage or needle aspiration under US
PO or IV abx depending on severity
When to treat carotid stenosis?
> 50% or >70%
Carotid endarterectomy
Most haemorrhoids can be managed conservatively. Outline 3 aspects of conservative management:
Lifestyle advice including increasing daily fibre and fluid intake, and weight loss.
Laxatives
Topical analgesia e.g. lignocaine gel (avoid oral opioids)
Surgical management of haemorrhoids by degree of severity:
1+2 = rubber band ligation
2+3 = haemorrhoidal artery ligation
3+4 = haemorroidectomy
Treatment of lactational mastitis:
- continue breastfeeding
- analgesia and warm compresses
- If symptoms don’t improve after 12-24 hours of effectve milkd removal treat with oral fluclox.
Other indications for abx are systemically unwell, nipple fissure present and culture indicates infection.
Continue feeding during abx.
Most common cause of serous or bloody nipple discharge:
Intraductal papilloma
Benign tumour of the ductal epithelium, creates a central mass.
Manage with lactiferous duct excision (microdochectomy)
What is involved in a Hartmann’s procedure?
Emergency laparotomy e.g. bowel obstruction or perf.
Complete resection of the recto-sigmoid colon.
End colostomy and closure of rectal stump.
Definition of syncope
a TLOC due to transient global cerebral hypoperfusion that is characterised by rapid onset, short duration and spontaneous complete recovery
Can be split into reflex, orthostatic intolerance and cardiac
5 frailty syndromes:
Instability
Intellectual impairment
Incontinence
Immobility
Iatrogenic
4 assessments of frailty:
Rockwoods Frailty Index
Rockwood Clinical Frailty scale
Timed up and go test
Walking speed
