Random fun facts Flashcards
(33 cards)
What are the populations where asymptomatic bacteruria should be tested?
- pregnancy
- urological procedures where mucosal bleeding anticipated
- recent transplant recipients
Describe the process of b12 metabolism
- B12 binds to haptocorrin (aka transcobalamin 1) in the stomach to protect it from acid
- in the duodenum binds to intrinsic factor, absorbed in the terminal ileum
- transported with transcobalamin 2 to peripheral tissues, but 90% is bound to haptocorrin and can’t be taken up by cells
What is the dose of IM adrenaline for anaphylaxis
0.5mg in 1:1000
What allele is protective in diabetes?
DR2
True or false - I should be worried about mesothelial cells in a pericardial effusion
False - can be found in benign and malignant conditions
Capnocytophaga canimorsus is a fastidious, slow-growing, Gram-negative bacteria. Where is it found and which immunosupressed patient group are at high risk?
It is a commensal bacterium in the normal gingival microbiota of canine and feline species, but can cause illness in humans.
*due to the fact there is delayed phagocytic production
Explain why charcoal may be useful in the posioned patient
Interruption of enterohepatic recirculation
●Facilitation of transluminal diffusion from the body into the bowel lumen (“gut dialysis”), followed by excretion
●Reduced absorption of extended or delayed release formulations
When would use of charocal be ideal with regards to time?
Indications — AC is most likely to benefit patients when administered while toxin remains in the stomach. Traditionally, this period is thought to be within one hour of poison ingestion, but the potential for benefit when administered later cannot be excluded [1,4].
What are the two AEDs in overdose charcoal can help with?
carbemazepine
phenytoin
Whole bowel irrigation uses polyethylene glycol to induce formation of liquid stools. List a special situation where it would be indicated
Indications — WBΙ is not routinely recommended, but it may be helpful in the following settings [3]:
●Potentially toxic ingestions of sustained-release or enteric coated pill formulations
●Significant ingestions of toxins not adsorbed by activated ϲhаrсoаl (eg, iron tablets, lead-containing foreign bodies)
●Ingestion of illicit drug packets (see “Internal concealment of drugs of abuse (body packing)”)
What is the drug of choice for portal hypertension and why?
Options for prophylaxis with a nonselective beta blocker include carvedilol, nadolol, and propranolol. Саrveԁilоl is a nonselective beta blocker that also has mild anti-alpha 1 adrenergic activity. In addition to reducing portal venous inflow through nonselective beta blockade, the anti-alpha 1 adrenergic activity lowers hepatic vascular tone and hepatic resistance. This results in greater reduction in portal pressure [32].
What is the basic issue in Pagets disease?
bone resorption exceeds bone growth -> haphazard and large bones
Give me a one sentence description of osteogenesis imperfecta
Osteogenesis imperfecta (OI) is an inherited (genetic) bone disorder that is present at birth. It is also known as brittle bone disease. A child born with OI may have soft bones that break (fracture) easily, bones that are not formed normally, and other problems.
Why does a right sided hypoglossal lesion deviate to the right side?
unoppsed action from the contralacteral sign;
LMN lesion
What are the HLA proteins associated with coeliac disease?
HLA dominant DQ2 or DQ8 genes.
In coeliac disease, what are antibodies produced against and what cytokine is upregulated?
- tissue transglutaminase
- you get upregulation of IL-15
What skin condition is associated with coeliac disease?
dermatitis hepatoformis
List 3 extraintestinal manifestations of coeliac disease?
Extraintestinal symptoms are common and may include:
1/ Anemia due to defective absorption of vitamin B12, folate or iron
2/ Coagulopathy due to impaired absorption of vitamin K
3/ Osteoporosis
4/ Neurological symptoms like muscle weakness, paresthesias, seizures and ataxia
Describe the process of work up for coeliac disease
Diagnostic workup usually starts with serological tests. - - The two antibodies measured are anti-tissue transglutaminase antibodies (by enzyme-linked immunosorbent assay or ELISA measured numerically) and anti-endomysial antibodies that are usually reported as negative, weakly positive or positive.
- Traditionally, the next step and the gold standard for the diagnosis is duodenal mucosal biopsy; in celiac disease, this shows villous atrophy. It is important that these tests be performed while the patient is on a regular, gluten-containing diet
What autoimmune conditions is coeliac disease associated with? What cancer is it associated with?
- T1DM
- thyroid problems
- associated with lymphomas*
Which globin gene is affected in sickle cell disease?
beta chain
What is dumping syndrome and what is it associated with?
Early Dumping Syndrome
This occurs within the first hour after ingesting a meal (usually within 10 to 30 minutes) and is attributed to the rapid introduction of nutrients into the small bowel, causing an osmotically driven fluid movement into the small bowel lumen. This will typically present with diarrhea, dizziness, flushing, and possibly hypotension. First-line treatment is with a low carbohydrate, high protein/fiber diet taken in small/frequent meals. If one has persistent symptoms, then octreotide can be used. This is typically a self-limiting disease and subsides in 12 to 18 months following surgery.
Late Dumping Syndrome
This occurs between 1 to 3 hours after a meal and is a hypoglycemic response to hyperinsulinemia. This will present as tremors, diaphoresis, palpitations, and altered mental status. The first step in treatment is as above with diet modification and octreotide. If the effects of hypoglycemia are debilitating, then surgical intervention may be required. Accepted methods include bypass reversal to normal anatomy, surgeries to increase gastric reservoir, and conversion to sleeve gastrectomy.[13]
What Vitamin deficiency is the post serious post a Roux-En Y bypass?
Thiamine deficiency is one of the most serious vitamin deficiencies after an RYGB. It is a water-soluble vitamin that is primarily absorbed in the jejunum. Only small amounts of thiamine are stored in the body, and a continuous exogenous supply is needed to maintain adequate levels.
What can be given with isonizid to prevent peripheral neuropathy?
Taking supplemental pyridoxine concurrently with isoniazid can prevent pyridoxine deficiency and therefore prevent isoniazid-induced neuropathy.
