what does NIV stand for ?
non invasive ventilation. fits as a mask over the nose or the nose and mouth with straps for the forehead and round the jaw to hold it snugly on the face. almost a ‘bane’ mask.
what is metronidazole and how does it work?
an antibiotic used in the treatment of anaerobic bacteria and also protozoa eg C. diff. (gram positive anaerobe), Bacteroides fragillis (gram negative colon anaerobe), amoebic dysentry and giardiasis.
anaerobes reduce metronidazole to make a nitroso free radical that binds and damages their DNA. aerobic bacteria cannot do this and thus are unaffected.
important side effects and interactions of metronidazole
1 - GI upset (nausea and vomiting like many antibiotics),
2 - immediate and delayed hypersensitivity reactions.
3 - if given at high doses or for prolonged periods it can cause peripheral and optic neuropathy, siezures and encephalopathy.
4 - it is metabolised by hepatic cytochrome P450 (beware in liver disease, warfarin and with cyt P450 inducers such as phenytoin and rifampicin. it also inhibits acetaldehyde dehydrogenase which clears acetaldehyde so alcohol should not be drunk or: flushing, headache, nausea, vomiting.)
what is tazocin
a combination of piperacillin ( a penicillin like antibiotic) and tazobactam ( a beta-lactamase inhibitor). given IV and is very broad spectrum. inhibits bacterial cell wall peptidoglycan cross link formation. used against gram positive and gram negative bacterial as well as pseudomonas aeruginosa.
what is a CTPA
a CT of the pulmonary arteries, introduced in the 1990s to replace ventilation/perfusion scanning. first line for evaulation of a suspected pulmonary embolism. an IV contrast is used.
what does MMSE stand for and when is it done
MMSE = mini mental state exaination. used for anyone over the age of 75. less than 25 points suggests dementia.
what is fluoxetine
an SSRI also known as prozac
what is linezolid
an antibiotic used to treat serious infections by gram positive bacteria that are resistant to other antibiotics eg MRSA. it is a oxazolidinone antibiotic that inhibits protein synthesis. it occupies the A site of the ribosome to prevent translation.
what is saccular bronchiectasis
bronchiectasis resulting in dilated bronchi of saccular or irregular shape.
what is azithromycin
a macrolide antibiotic derived from erythromycin. binds the 50s subunit of the bacterial ribosome to inhibit mRNA translation.
what is spironolactone
a potassium sparing diuretic that antagonises the action of aldosterone ( a mineralocorticoid).
normal blood glucose levels
about 4-6 mM, but can reach a little higher eg 7.5 temporarily after a meal.
what is the cockroft-gault equation
an equation regularly used to estimate GFR from the serum creatinine, age and weight, but was developed as a method of predicting creatinine clearance.
what is vancomycin
a glycopeptide antibiotic effective mostly against gram positive bascteria. inhibits peptidoglycan synthesis by preventing the addition of new units to the peptidoglycan.
what is a sarcoma
a malignant cancer of mesenchymal origin such as cancellous bone, cartilage, fat, muscle or vascular. eg osteosarcoma, rhabdosarcoma, liposarcoma.
what is a compound fracture
an open fracture where the skin wound communicates with the fracture and thus it is exposed to infection.
what questions should you be asking to gauge the severity of a patient’s asthma
1 - activities of daily living - use of inhaler, orthopnoea, PND
2 - exercise tolerance - distance and stairs
3 - hospitalisation history - ITU and ventilated?
CURB-65 score?
1 - confusion
2 - BUN over 19mg/dl (over 7mmol/L)
3 - resp rate greater than or equal to 30
4 - systolic BP less than 90mmHg, diastolic less than or equal to 60mmHg.
5 - age over or equal to 65
0 points = 0.6% 30 day mortality, outpatient
1 point = 2.7%, outpatient.
2 points = 6.8%, inpatient or outpatient with close followup.
3 points = severe risk 14%, inpatient, possible ITU
4 points = 27.8%, inpatient, possible ITU
5 points = 27.8%, inpatient, possible ITU.
what is coamoxiclav
amoxicillin (penicillin antibiotic) and clavulanic acid (beta-lactamase inhibitor)
what is clarithromycin
a macrolide antibiotic
what does held under section 2 mean for a patient?
The mental health act (1983, amended 2007) sets out the situations where a person may be compulsorily admitted to hospital for assessement and treatment. section 2 is one of the most commonly used sections that allows for a person to be admitted to hospital for assessement and the person may be given treatment with their consent. detention under this section can be for up to 28 days and cannot be extended.
section 3 by contrast allows the individual to be admitted to hospital for treatment and is detained for an initial 6 months which can then be reviewed and extended if need be.
