MEDICINE Flashcards

Question

What is beta thalassemia

Answer 1

disorders characterised by a reduced production rate of either alpha or beta chains thalassemia major, thalassemia intermedia, and thalassemia minor. Disproportionate microcytic anaemia - think beta-thalassaemia trait Hypersplenomegaly and gallstones. mostly found in thalassemia major and intermedia patients. beta thalassemia major usually present within the first two years of life with severe anaemia, poor growth, and skeletal abnormalities during infancy.

Answer 2

Enzymes that metabolise stuff Inducers increase activity leading to increased clearance of certain drugs Inhibitors decrease clearance of drugs

Answer 3

CRAP GPs - because crap GPs induce rage ;) Carbamazepine, Rifampicin, Alcohol (chronic), Phenytoin, Griseofulvin, Phenobarbitone, Sulphonylureas (also St. John's Wort and smoking)

Answer 4

SICKFACES.COM - I remember the alcoholic binge part because a hangover = sick face! Sodium valproate, Isoniazid, Cimetidine, Ketoconazole, Fluconazole, Alcohol (binge), Chloramphenicol, Erythromycin, Sulphonamides, Ciprofloxacin, Omeprazole, Metronidazole

Answer 5

Plasma paracetamol concentration above graph there is a staggered overdose patients who present 8-24 hours after ingestion of an acute overdose of more than 150 mg/kg of paracetamol even if the plasma-paracetamol concentration is not yet available patients who present > 24 hours if they are clearly jaundiced or have hepatic tenderness, their ALT is above the upper limit of normal

Answer 6

if no neurological involvement 1 mg of IM hydroxocobalamin 3 times each week for 2 weeks, then once every 3 months if a patient is also deficient in folic acid then it is important to treat the B12 deficiency first to avoid precipitating subacute combined degeneration of the cord

Answer 7

macrocytic anaemia sore tongue and mouth neurological symptoms the dorsal column is usually affected first (joint position, vibration) prior to distal paraesthesia neuropsychiatric symptoms: e.g. mood disturbances

Answer 8

transferrin saturation > 55% in men or > 50% in women raised ferritin (e.g. > 500 ug/l) and iron low TIBC

Answer 9

Prodromal phase; flu-like symptoms, gastrointestinal symptoms (such as anorexia, nausea, vomiting, and abdominal right upper quadrant discomfort), and occasionally headache, cough, pharyngitis, constipation, diarrhoea, itch, and urticaria. Usually, there are no specific signs on examination. Icteric phase; jaundice, pale stools, and dark urine (if there is cholestasis), pruritus, fatigue, anorexia, nausea, and vomiting — symptoms often improve once jaundice occurs. Hepatomegaly, splenomegaly, lymphadenopathy, and hepatic tenderness are often present on examination. Convalescent phase; includes malaise and hepatic tenderness

Answer 10

hard/craggy mass longer history of abnormal liver function blood tests as this cancer occurs most commonly in patients with chronic liver disease.

Answer 11

1 Greater than 90 ml/min, with some sign of kidney damage on other tests (if all the kidney tests* are normal, there is no CKD) 2 60-90 ml/min with some sign of kidney damage (if kidney tests* are normal, there is no CKD) 3a 45-59 ml/min, a moderate reduction in kidney function 3b 30-44 ml/min, a moderate reduction in kidney function 4 15-29 ml/min, a severe reduction in kidney function 5 Less than 15 ml/min, established kidney failure - dialysis or a kidney transplant may be needed

Answer 12

phase 1 (lasts 3-6 weeks): hyperthyroidism, painful goitre, raised ESR phase 2 (1-3 weeks): euthyroid phase 3 (weeks - months): hypothyroidism phase 4: thyroid structure and function goes back to normal

Answer 13

thyroid scintigraphy: globally reduced uptake of iodine-131

Answer 14

eye signs (30% of patients) exophthalmos ophthalmoplegia pretibial myxoedema thyroid acropachy, a triad of: digital clubbing soft tissue swelling of the hands and feet periosteal new bone formation

Answer 15

TSH receptor stimulating antibodies (90%) anti-thyroid peroxidase antibodies (75%)

Answer 16

Non tender

Answer 17

SABA/SAMA -> non steroid responsive add LABA+LAMA -> steroid responsive LABA + ICS Triple therapy if remains unresponsive LABA+ LAMA+ ICS

Answer 18

Pleural fluid protein / Serum protein >0.5 Pleural fluid LDH / Serum LDH >0.6 Pleural fluid LDH > 2/3 * Serum LDH upper limit of normal

Answer 19

Patients >= 17 years patients should be asked if their symptoms are better on days away from work/during holidays. If so, patients should be referred to a specialist as possible occupational asthma all patients should have spirometry with a bronchodilator reversibility (BDR) test all patients should have a FeNO test Children 5-16 years all children should have spirometry with a bronchodilator reversibility (BDR) test a FeNO test should be requested if there is normal spirometry or obstructive spirometry with a negative bronchodilator reversibility (BDR) test Patients < 5 years - diagnosis should be made on clinical judgement

Answer 20

IV 20% lipid emulsion

MEDICINE Flashcards

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