Pathology 3 Flashcards
(43 cards)
Drug for ventricular tachycardia
Amiodarone and lidocaine
Drug for Wolf Parkinson White syndrome
Propranolol
Drug for atrial fibrillation
Metoprolol or amiodarone or digoxin
Drug for ventricular fibrillation
Amiodarone
Drug for atrial flutter
Verapamil hydrochloride
Drug to reverse torsades des pointes
Magnesium
Osteoarthritis
Gradual onset joint pain, worse at end of day and with movement. Short periods of stiffness less than 30 mins in the morning.
Can affect distal phalanges and is often on load bearing joints. Swelling can be both hard and soft. Crepitus can be heard.
Characterised on imaging with thinning joint space, osteophytes, subchondral cysts, subchondral sclerosis.
Rheumatoid arthritis
Connective tissue disease affecting joints within a synovium. Classically a symmetrical polyarthralgia with wide distribution and can particularly affect the hands.
Tender swollen joints. Smaller joints more likely to be affected.
RF and anti ccp can help to diagnose but some are seronegative.
Methotrexate, leflunomide or sulfasalazine
Pseudogout
Acute or chronic deposition of calcium pyrophosphate instead of uric acid crystals. Tends to affect ankles, wrists, knees and shoulders.
Treating RHA
DMARDs methotrexate, sulfasalazine, hydroxychloroquine, leflunomide. Bio DMARDs rituximab, etanercept, adainmumab anti TNFs.
Ankylosis spondylitis
Arthritis of spine joints, occasionally pelvis, hips correct shoulder involvement. May get eye or bowel issues eg anterior uveitis.
It’s a seronegative spondyloarthropathy without RF antibodies.
Treatment includes NSAIDs and DMARDs eg sulfasalazine or TNF inhibitors.
Symptoms include dull back pain that radiates down and wakes people up.
Progressive with loss of spinal mobility and chest expansion with often weight loss, fever, fatigue.
Prepubertal knee and ankle swelling. Will show high crp and esr.
Detectable via HLA B27
Osteoporosis
Progressive skeletal disorder characterised by low bone mass and micro architectural deterioration leading to increased bone fragility. Diagnosis from DEXA or fragility fractures.
If begin consolidating without achieving peak bone density will drop to osteopenia and osteoporosis faster.
Secondary causes include hyperthyroidism, hyperparathyroidism, RHA, IBD, Coeliacs, Cushing.
Drug treatments are anti resorption or stimulate bone.
Biphosphonates eg alendronate, risedronate, longer term iv zolendronate or ibondronate,
Anabolic teriparatide sc injection. Extreme treatment
SORM raloxifene for spine.
Denosumab sc per 6m if intol of biphosphonates, 2 yrs max
Values for diabetes in glycated glycohaemoglobin A1c test
Prediabetes is 5.7-6.4 and diabetes is 6.5 or more.
Systemic lupus erythematous
Most common in middle aged women. Triggered by factors like UV light, ebv, smoking, oestrogen.
Symptoms include fatigue, fever, uv sensitivity, butterfly rash, discoid rash, cognitive impairment, headaches, seizures, peripheral neuropathy, interstitial fibrosis leading to possible pleural effusion, pericarditis, htn, lupus nephritis, anaemia and leukopenia. Polyarthralgia.
Responds to esr, evc, crp, albumin and creatinine.
Treatment includes vitamin D, calcium, cholesterol management, myelophenalate or azathiopurine to halt B cell proliferation.
SLE increases risk of Hodgkin lymphoma.
Poly myalgia rheumatic a
Inflammatory condition of severe bilateral pain and morning stiffness over 45 mins of the shoulder, neck and pelvic girdle.
Bilateral upper arm tenderness. Struggle to raise arms to head at waking hours. May have flu symptoms.
Managed with methotrexate or steroid prednisolone.
Fibromyalgia
Chronic pain disorder, mostly in women between 20-50+. Believed peripheral and central hyper excitability at spinal or brain stem level resulting in altered pain perception.
Often presents alongside arthritis/osteoarthritis. Pain in multiple sites, shoulders and lower back, fatigue, sleep disturbance, morning stiffness, paraesthesia, feeling of swollen joint without swelling, headaches, anxiety and depression.
Flares when stressed, cold or humid.
Ehlser danlos hyper mobile form
Soft skin, hyperextending, striae, bilateral piezogenic papules of the heels. Multiple abdominal hernias. Prolapse, mitral prolapse, aortic root dissection, dislocations and pain.
Ehsler danlos classical
Autosomal dominant, skin stretching, atropic scarring, generally hyper mobile, skin splitting, soft, pseudotumours, hernias, sprains, subluxations, pain, bruising.
Types of Alopecia
Areata- autoimmune round patches missing in places like head, beard, eyebrows, eyelashes.
Androgenic is all over age related loss for men and all over thinning for women.
Scarring/cicatricial- conditions that destroy the follicle. If central, starts in the centre of the scalp and slowly spreads outwards.
Frontal fibrosing- type of scarring one where follicle is destroyed and replaced by scar tissue.
In lichen planopilaris - a scarring one with patches over the head.
Telogen effluvium- having a faster hair cell cycle that sheds more often.
Tractional is from physical tension on the hair.
Trichotillomania is obsessively pulling out hair.
vestibular neuronitis and labyrinthitis
Vestibular neuronitis is thought to be due to inflammation of the vestibular nerve and often occurs after a viral infection.
Labyrinthitis is a different diagnosis that involves inflammation of the labyrinth.
Hearing loss is a feature of labyrinthitis, but hearing is not affected in vestibular neuronitis.
Symptoms of vestibular neuronitis include spontaneous onset of vertigo, nausea, vomiting, and unsteadiness. Hearing loss and tinnitus are not present, and there are no focal neurological symptoms. Will often have nystagmus.
If symptoms are severe, short-term symptomatic drug treatment can be offered.
Buccal or intramuscular prochlorperazine or intramuscular cyclizine can be considered to rapidly relieve severe nausea or vomiting associated with vertigo.
A short course of oral prochlorperazine, cinnarizine, cyclizine, or promethazine teoclate can be considered to alleviate less severe nausea, vomiting, and vertigo.
Diaphragmatic breathing
Diaphragmatic breathing, or “belly breathing,” involves fully engaging the stomach, abdominal muscles, and diaphragm when breathing. This means actively pulling the diaphragm down with each inward breath. In this way, diaphragmatic breathing helps the lungs fill more efficiently. used in COPD.
Biot’s breathing
Biot respiratory pattern is characterized by regular deep respirations interspersed with periods of apnea. It is caused by damage to the pons due to stroke, trauma, or uncal herniation. As the insult to the pons progresses, the pattern becomes irregular. At this point, the pattern deteriorates to ataxic breathing.
It has rapid, shallow breathing. It differs from Cheyne-Stokes respiration in that it does not feature cycles of deep breathing, or gradual alternations in breathing patterns.
Hordeolum
A stye (hordeolum) is a tender red bump on the edge of the eyelid. It is an infection of a gland of the eyelid. The infection is most often caused by bacteria called staph (Staphylococcus aureus). The most common symptoms are redness and swelling of the eyelid. In most cases a stye will go away on its own.
Reactive arthritis
Reactive arthritis is a painful form of inflammatory arthritis (often at knees, ankle, heels, digits, lower back). It occurs in reaction to an infection by certain bacteria. Most often, these bacteria are in the genitals (Chlamydia trachomatis) or the bowel (Campylobacter, Salmonella, Shigella and Yersinia). Chlamydia most often transmits by sex. It often has no symptoms, but can cause a pus-like or watery discharge from the genitals. The bowel bacteria can cause diarrhoea. If you develop arthritis within one month of diarrhoea or a genital infection -may have reactive arthritis. Give NSAIDS, then DMARDs if not useful eg sulfasalazine or methotrexate.
