miscellaneous Flashcards
(38 cards)
ECG signs of Hyperkalaemia
- loss of P waves
- widened QRS complexes
- tented T waves
- bradycardia
Normal PR interval on ECG?
120-200 ms
Normal QRS complex on ECG
<120ms
Causes of Chronic Pancreatitis
- EtOH
- autoimmune
- Steroids
- malnutrition
- hereditary
- Trauma or obstruction
- Recurrent acute pancreatitis
History of Chronic Pancreatitis
- severe pain radiating to the back
- relieved by sitting forward
- Weight loss
- Loss of exocrine function –> steatorrhea
- Loss of endocrine function –> diabetes
Investigations for Chronic Pancreatitis
NOT amylase (= acute pancreatitis) Check exocrine function: faecal elastase
Management of Chronic Pancreatitis
- Pain - analgesia (NSAIDs, opiates)
- Endocrine function - if diabetic give insulin
- Exocrine function - creon (enzymes)
- Give acid suppression: PPI: omeprazole to stop creon deactivation
- Coeliac nerve block
- Pregabalin
- Low fat diet for steatorrhoea (<20g fat a day)
Complications of Chronic Pancreatitis
- pancreatic pseudocyst
- splenic vein thrombosis
- obstruction (may need ERCP)
Prognosis of Chronic Pancreatitis
High risk of pancreatic Ca
Causes of low phosphate
- malabsorption: vit D
- Increased PTH (1° hyperparathyroidism)
- Insulin: drives phosphate into cells
- Refeeding syndrome (due to insulin secretion when give food)
What is part of a Liver Screen?
Alcohol Autoimmune: (AMA, ANA, LK;M) Drugs Viruses: Hep B, C, A a-fetoprotein if chronic liver disease USS to look for obstruction or dilatation Metabolic: - haemochromatosis (increased ferritin) - Wilson's: excess copper --> measure caeruloplasmin
Causes of pulmonary hypertension
Chronic lung disease: - COPD - fibrosis R heart: - mitral stenosis Congenital heart disease: - VSD etc. HIV --> causes idiopathic pulmonary hypertension Sarcoid Connective tissue disease: SLE
Henoch-Schönlein purpura
= small vessel vasculitis
Presents with purpura (non-blanching purple papules due to intradermal bleeding)
There may be glomerulonephritis, arthritis, and abdominal pain (+/- intussusception) which may mimic an acute abdomen.
Porphyrias
= heterogenous group of rare diseases caused by various errors of haem biosynthesis
Modifiable cardiovascular risk factors
Alcohol Blood pressure Cholesterol (and lipids) Diabetes/diet Exercise Smoking
Non-modifiable cardiovascular risk factors
Age/gender/family history Myocardial infarction Rheumatic fever Claudication Stroke/TIA
Respiratory causes of Clubbing
Lung Ca Mesothelioma Fibrosing Alveolitis Bronchiectasis Cystic Fibrosis Empyema
Causes of COPD
Smoking
Environmental pollutants
Alpha-1-AT deficiency
Occupational exposure (coal minors etc.)
X-ray findings of Heart failure
A - alveolar shadowing (Bat wing) B - Kerley B lines (interstitial oedema) C - Cardiomegaly D - upper lobe diversion E - pleural effusion
3 main drugs indicated in heart failure
Beta-blockers
ACE inhibitors
Spironolactone
Risk factors for jaundice
A - alcohol B - blood (transfusions, taoos, IVDU, needle stick) C - coitus D - drugs E - expeditions (travel history) F - family history
What is Courvoisier’s Law?
A palpable non-tender gallbladder in the presence of jaundice is unlikely to be caused by gallstones.
What are Kayser-Fleischer rings?
Caused by Wilson’s disease. Only visible with a slit light.
GI systems review
Mouth ulcers, dental problems Difficulty swallowing (dysphagia) Odynophagia Nausea & vomiting Haematemesis Indigestion Heartburn Abdominal pain CIBH Change in colour of stools
