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3b/4 > Imm/metabolic med > Flashcards

Imm/metabolic med Flashcards

1
Q

in tx of anaphylaxis, how often can you repeat doses of adrenaline?

A

5 mins

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2
Q

Oral allergy syndrome is strongly linked with??

A

history of allergic rhinitis and seasonal pollen allergy

would present as allergy to certain foods

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3
Q

6 months - 6 years adrenaline dose for anaphylaxis =

A

150 mcg (0.15ml 1 in 1,000)

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4
Q

Anaphylaxis: A child aged 6-11 years should be administered adrenaline at a dose of?

A

300mcg (0.3ml), repeated every 5 minutes if necessary

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5
Q

A man presents with an area of dermatitis on his left wrist. He thinks he may be allergic to nickel. Which one of the following is the best test to investigate this possibility?

A

skin patch test

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6
Q

Patients who have had emergency treatment for anaphylaxis should be observed for??

A

6-12h from onset of sx

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7
Q

You are teaching a man about how to use an EpiPen (adrenline auto-injector). What is the most appropriate advice about where to inject the pen?

A

anterolateral aspect of middle third of thigh

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8
Q

13+ years old: adrenaline dose?

A

500mcg` (0.5ml)

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9
Q

After a suspected anaphylactic reaction in adults and young people aged 16 years or older, timed blood samples for mast cell tryptase should be taken as follows:

A

As soon as possible after emergency treatment has started

A second sample ideally within 1-2 hours ( but no later than 4 hours ) from the onset of symptoms

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10
Q

dose chlorphenamine?

A

10mg

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11
Q

What is the most suitable test to investigate possible food allergy?

A

skin prick testing

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12
Q

severe hyponatraemia (< 120 mmol/L) mx?

A

hypertonic saline 3%

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13
Q

SIADH - drug causes:

A

carbamazepine, sulfonylureas, SSRIs, TCAs

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14
Q

hyponatremia with low serum osmolality and concentrated urine (urinary sodium >40 mEq/L) with high urine osmolality (>100 mOsm/kg) levels

A

SIADH

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15
Q

LFT raised in pregnancy?

A

ALP

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16
Q

siadh tx?

A

fluid restriction

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17
Q

what can cause euvolaemic hyponatraemia?

A

hypothyroidism

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18
Q

mutated in familial hypercholesterolaemia??

A

LDL receptor

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19
Q

broad QRS, tall tented T =

A

hyperkalaemia

also sinusoidal pattern, with very wide QRS complexes, bizarre deep T-waves in V1 and V2 and peaked T-waves in V4 and V5

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20
Q

statin and should be started as primary prevention against cardiovascular disease. Atorvastatin primary and secondary doses?

A

primary prevention - 20mg

secondary - 80mg

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21
Q

Acute pancreatitis may cause?

A

hypocalcaemia

22
Q

Raised ALP in the presence of normal LFT’s should raise suspicion of

A

malignancy - bone ca/mets

23
Q

hypocalcaeamia ecg?

A

prolonged QT

rare: AF, torsades de pointes

24
Q

Hypercholesterolaemia rather than hypertriglyceridaemia:

A

nephrotic syndrome
cholestasis,
hypothyroidism

25
Q

drugs can cause hypokalaemia?

A

thiazide

acetazolamide

26
Q

first line tx in severe hypercalcaemia?

A

IVI

27
Q

Rapid correction of hyponatraemia can cause?

A

osmotic demyelination syndrome

28
Q

SIADH and cerebral salt wasting are differentiated by?

A

fluid status (euvolaemic in siadh, hypovolaemic in cerebral salt wasting)

29
Q

tendon xanthomata and cholesterol levels meet the diagnostic criteria for

A

familial hypercholesterolaemia

30
Q

what is the most serious electrolyte abnormality that can complicate acute kidney injury.?

A

hyperkalaemia

31
Q

single most useful test in determining the cause of hypocalcaemia??

A

PTH

32
Q

Hypernatraemic dehydration in children is associated with jittery movements, increased muscle tone, hyperreflexia, convulsions, drowsiness or coma - mx?

A

replace slowly to reduce the chances of cerebral oedema - NS 0.9%

33
Q

Bleeding gums

vitamin?

A

C

34
Q

Diarrhoea, confusion and eczematous skin

vitamin?

A

Niacin (B3) - pellagra

35
Q

osteomalacia viatmin>

A

D

36
Q

34M ED 1/7 hx intermittent, severe colicky left flank pain, radiates to the groin. PMH includes recurrent renal stones and Sjogren’s syndrome. No FHx. His blood tests show the following: K 2.1. CT KUB) identifies a small left ureteric stone. An ECG is also performed, which shows U waves and flat T waves. underlying dx?

A

renal tubular acidosis

causes hypokalaemia

37
Q

causes hypokalaemia
complications include osteomalacia
_____?

A

Type 2 RTA

Fanconi syndrome

38
Q

causes hypokalaemia
complications include nephrocalcinosis and renal stones
causes include idiopathic, rheumatoid arthritis, SLE, Sjogren’s, amphotericin B toxicity, analgesic nephropathy
???

A

Type 1 RTA

39
Q

RTA ABG?

A

hyperchloraemic metabolic acidosis (normal anion gap)

40
Q

urea is raised disproportionately to the creatinine. dx?

A

dehydration

41
Q

carpopedal spasm caused by

inflating the blood-pressure cuff to a level above the systolic blood pressure in patients with hypocalcaemia????????

A

trousseau’s sign

42
Q

seen in hypocalcemia; tapping over the facial nerve causes twitching of the facial muscles.
sign?

A

chvostek’s sign

43
Q

A 24-year-old man is involved in a road traffic accident. His right leg is trapped for 6 hours whilst he is moved. On examination his foot is insensate and a dorsalis pedis pulse is only weakly felt. Which of the biochemical abnormalities listed below is most likely to be present?

A

hyperkalaemia

compartment syndrome

44
Q

Hypophosphataemia can be caused by?

A

DKA

consider parenteral phosphate replacement therapy alongside insulin tx

45
Q

heparin causes which electrolyte abnormality?

A

hyperkalaemia

46
Q

The maximum rate of IV potassium infusion that can be conducted without monitoring is>

A

10mmol/h

47
Q

Treatment of asymptomatic hyperuricaemia in an attempt to prevent gout?

A

none

48
Q

longer term hypercalcaemia advice?

A

stay hydrated

49
Q

Causes of raised alkaline phosphatase (ALP)

A

liver: cholestasis, hepatitis, fatty liver, neoplasia
Paget’s
osteomalacia
bone metastases
hyperparathyroidism
renal failure
physiological: pregnancy, growing children, healing fractures

50
Q

Respiratory alkalosis can result in hypocalcaemia -

A

if normal phostphate levels

normal ALP

51
Q

perioral paresthesia and a prolonged QT interval?

A

hypocalcaemia

3b/4 (19 decks)

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