Day 2 Flashcards
(16 cards)
What is diverticulosis? What is diverticular disease? What is diverticulitis?
Presence of an outpouching of the gut wall.
Symptomatic - ABDO pain (left sided colic relieved with defecation) and altered bowel habits, nausea and flatulence
Features above plus pyrexia
What is BNP?
Brain natriuretic peptide
SENSITIVE (SNOUT) for heart failure.
Can be raised in renal failure.
What is short bowel? What are the causes? What are the risks?
Anatomically <250cm in an adult although better defined functionally.
Common result of substantial resection of small bowel but can be congenital.
D + V and lead to electrolyte or vitamins deficiencies.
What is an echo? What are the types? What are the uses?
Non-invasive technique that uses sound waves to form pictures of the heart.
TTE - transducer places on outside of chest
TOE - transducer is put down your throat and into your oesophagus
Uses
1) quantifies global LV function via measuring end diastolic volume. Will also show HYPOKINESIA, ANEURYSM, MURAL THROMBUS or LVH
2) Valvular disease
3) CHD
4) endocarditis
5) pericardial effusion
Difference between T1 and T2 MRIs?
T1 - provide good anatomical detail. Fat is bright, fluid is dark.
T2 - best detection of most lesions because they contain oedema and fluids. “Water is white in T2” (WW2)
When is CT better than MRI? Role of contrast in CT?
Acute stroke, haemorrhage and fractures. Headache suggestive of SAH.
Easier to do in ill or anaesthetised patients.
Contrast will provide clearer margins.
Advantages of MRI over CT? Advantages of CT over MRI?
MRI has
- higher detail
- less radiation than ct
CT has
- good for bone
- good for pts with metallic clips or surgical clips, pacemakers
- good for claustrophobic, cheaper, quicker
What is non-convulsive status epilepticus?
Sx
- confusion
- impaired cognition/memory
- odd behaviour
- dream derealization
- LC: aggression, psychosis, abnormalities of eye movement,
Can occur as a prolonged post-ictal state or ischemic brain injury.
Ix - EEG: rhythmical discharges (prolonged 3 per second wave forms)
MRI: focal oedema
Rx: lorazepam first line then valproate IV
What is an EEG? Limitations?
Electroencephalogram measures electrical activity of the brain and it’s wave forms.
Limitations: Only measures activity for a short time.
What is ataxia? What is apraxia?
Inability is the loss of co-ordination of muscles due to muscle weakness. “Muscles give way”
Inability to perform purposeful movement despite having the physical capacity and desire to do so.
What is the anatomy of the cerebellum and what is their clinical relationship?
Midline cerebellum
- motor execution, eye movements, vestibular function, balance/lower extremity coordination
- gait ataxia, imbalance, Truncal ataxia, dysmetria, ocular findings, vertigo
Cerebellar hemispheres
- motor planning and co-ordination
- Dysdiadochokinesis, dysmetria, limb ataxia, intention tremor and staccato speech
How do you differentiate ataxia causes?
Acute (minutes to hours)
- ischemia
- haemorrhage
- iatrogenic: antiepileptic drugs, chemo, toxins
- infectious: meningoenxephalitis
Subacute (days to weeks)
- atypical infectious: CJD
- autoimmune: MS
- malignancy
- vitamin deficiency
- systemic disorders
- neuro degenerative: MSA and PSP
Chronic
- Wilson’s
- hereditary
What type of INFARCT would cause ataxia?
Lesion of the superior cerebellar artery, anterior inferior cerebellar artery or the posterior inferior cerebellar artery.
The PICA comes of vertebral
The SCA and AICA comes of the basilar
Causes of hypoalbuminemia?
Albumin is synthesized in the liver. Liver failure
Nephrotic syndrome
Chronic malnutrition
Protein losing enteropathy
Will cause oedema through a decrease in oncotic pressure.
Cerebellar examination features?
Broad based gait.
Unilateral deviation to side of lesion if affecting one hemisphere.
Heel to toe -> exaggerates cerebellar vermis (Truncal ataxia)
Rombergs ->
Vision
Dorsal column
Vestibular system
Speech -> staccato speech
Nystagmus
What is the role of the cerebellum?
Receives input from sensory systems and integrates it into fine tune motor movements.
