Miscellaneous Flashcards
(36 cards)
Certifying death
Pupils fixed and dilated
No breath sounds on auscultation - 3 minutes
Central pulse palpable - 1 minute
No heart sounds on auscultation in 1 minutes
When to refer to a coroner
In hospital for
When can you fill out a death certificate
you must have seen the patient 14 days before death (/after)
Provided care in the last illness before death
Registered medical practitioner
Knowledge and belief of the cause of death
Stoma complications
Early: high output stoma (dehydration, hypokalaemia), retraction, bowel obstruction, ischaemia of stoma
Late: parasternal hernia, prolapse, fistulae, psychological, skin dermatitis
Causes of hepatomegaly
V Budd-chiari, RVF I Glandular fever, hepatitis viruses, liver abscess T A Sarcoidosis. Amyloidosis M Alcoholic liver disease, haemochromatosis, NASH I TB drugs N Liver mets, HCC, leukaemia, lymphoma D C Riedels lobe
Dupuytrens causes
Liver disease Antiepileptics Diabetes Genetic (Peyronies, ledderhose, garrods)
Dupuytrens treatment options
Non surgical - conservative, splintage and physio, collagenase
Minimally invasive - percutaneous needle fasciotomy
Surgical - partial fasciectomy, dermofasciectomy
Carpal tunnal syndrome causes
Idiopathic Pregnancy Obesity Endocrine - diabetes, hypothyroid, acromegaly Local extrinsic pressure
Management of carpal tune syndrome
Conservative:
- wait, splint, steroids, NSAIDs
Surgery
CYP2D6 deficiency
inability to convert codeine to morphine (so no analgesic effect)
5-10% of population
Fluid normal requirements
20-30ml/kg/day
Fluid resus
500ml bolus 15 mins crystalloid
How long to infuse blood products for
RBCs 2-3 hours
FFP 30 mins
Platelets 30 mins
Scabies
Permethrin 5%
Don’t use steroids
Erythema nodosum
Type IV hypersensitivity - inflammation of subcutaneous fat
Causes: group A strep, TB, pregnancy, malignancy, sarcoidosis, IBD, Chlamydia, leprosy
Discrete tender nodules on shins
Erythema multiform
Acute self limiting inflammatory condition
Herpes simplex
Steven-Johnson - mucocutaneous, necrosis with 2 or more mucosal sites involved
Similar to toxic epidermal necrosis
Erythroderma
= exfoliative dermatitis
>90% of skin
Causes: lymphoma, drugs, idiopathic, previous skin disease
Leads to inflamed, oedematous, scaly skin. Can have lymphadenopathy and malaise
Management: treat cause, emollients and wet wraps. topical steroids
Eczema herpeticum
Kaposis varicelliform eruption
Serious complication of atopic eczema
- herpes simplex
Give antivirals
Staphylococcal scalded skin syndrome
Production of circulating epidermolytic toxin from phage group II
Benpen resistant staph
Treatment: ABs, analgesia
Recovery: 5-7 days
Tinea
Corporis - trunk/limbs Cruris - groin/natal cleft Pedis - athletes foot Manuum - hand Cupitus - scalp Unguium - nail Incognitio - inappropriate treatment with systemic steroids
Bullous pemphigoid
autoantibodies against antigens between the epidermis and dermis - causing a sub epidermal split in the skin
Commonly affects the elderly
Pemphigus vulgaris
Blistering skin disorder, commonly affects middle aged
Autoantibodies against antigens within the epidermis - causing intraepidermal split in the skin
Leriche syndrome
Triad of:
- claudication
- atrophy of legs
- impotence (Paralysis of L1)
Test for glandular fever
Mono spot/Paul bunnel test
