gen med Flashcards
(20 cards)
mx of myasthenic crisis
IV immunnoglobulins + plasmapheresis
what unusual medication can be added second line in reduced ejection fraction heart failure
SGLT-2 inhibitors - whether they’re diabetic or not !
standard second line is spironolactone but consider adding SGLT-2 too
how is management of aortic stenosis guided
symptomatic = valve replacement
asymptomatic, observe - replace if valvular gradient >40mmHg
aortic valve replacement surgery options
young, low/med operative risk = surgical AVR
high risk = transcathetere
kids = balloon valvuloplaty (maybe)
what type of MI can block the AV node? how would this present?
inferior MI !
bradyarrhythmias
criteria for starting ivabradine in chronic heart failure
sinus rhythm >75bpm
AND
left ventricular fraction <35%
(3rd line mx)
PE investigation if renal impairment
V/Q scan !!!!
contrast bad !!!!!!!
causes of S3 (third heart sound)
normal if <30yrs
heard in;
- left ventricular failure - dilated cardiomyopathy
- constrictive pericarditis (pericardial know)
- mitral regurg
S4 causes
aortic stenosis
HOCM - double apical impulse
hypertension
normal ECG variants in athletes
sinu brady
1st degree heart block
2nd degree - mobitz type 1 !! (Wenckebach phenomenon)
criteria for discharge post asthma attack
- stable on their discharge meds for 12-24hrs
- inhaler technique checked + recorded
- PEF >75% of best or predicted
commonest chemical cause for occupation asthma?
isocyanates
–> spray painting, foam moulding
ix = serial measurement of peac expiratory flow
empyema - pH, glucose and LDH levels
turbid effusion with;
- pH <7.2
- low glucose
- high LDH
management of GI autonomic neuropathy from diabetes
metoclopramide, domperidone or erythromycin
(prokinetic agents)
management of prmary hyperaldosteronsm
spironolactone
(hypertension + hypokalaemia)
primary hyperaldosteronism investigation
1st = plasma aldosterone/renin ratio
then - HR CT
if CT notaml - adrenal venous sampling (used to distinguish between unilateral adenoma + bilateral hyperplasia)
subclinical hypothyroidism
TSH >10 + thyroxine level normal
- offer levothyroxine if TSH >20 on 2 occasions 3 months apart
TSH 5.5-10;
- <65 + symptomatic - 6 month trial of levo
- older - watch + wait
- asymptomatic - obsever, repeat tests in 6 months
how to work out who would benefit from glucocorticoid mx in alcoholic liver disease
Maddreys discriminant function
- prothrombin time + bilirubin concentraiton
commonest cause of primary hyperparathyroidism
solitary adenoma !!!! (85%)
10% - hyperplasia
1% - carcinoma
definitive mx = total parathyroidectomy
mx of UC with systemic upset
admit + IV corticosteroids
