Flashcards in Review posters 05/05/2016 Deck (60):
Autosomal dominant inherited disorder
Defect on the MFS1 gene for fibrillin.
Diagnosis based on family linkage and mutations found.
Tall, thin (usually man) with long arms, legs and fingers.
High arched palette, retinal detachment/lens dislocation.
Cardiac implications of Marfans
Often have abdominal aortic aneurysms. Lots of patients also have arrhythmias. Also mitral valve regurgitation along with mitral valve stenosis.
Management of Marfans.
Beta blocker- stops further dilatation of the aorta
ACE inhibitor. In marfans TNF beta is upregulated. ACE inhibitors stop this.
Lifestyle advice- avoid prolonged strenuous exercise such as cross country running.
Dilatation monitored until greater than 5.5cm in diameter- then it is surgically removed.
The common cold (acute coryza)
Most commonly caused by rhinovirus.
Symptoms of coryza
Watery nasal discharge
Or blocked nose
How is the common cold spread?
Inflammation of the pharynx
Symptoms of pharyngitis
Oropharynx and soft palette are redenned.
Tonsils are inflamed and swollen.
Treatment of pharyngitis
What most commonly causes pharyngitis?
Inflammation of the epiglottis- blocks trachea
Symptoms of epiglottitis
Increasing difficulty breathing- acute air flow obstruction
Epiglottis is large and inflamed
What do you do with a case of epiglottitis?
Leave the mouth alone- no examination, no looking- any of these may make it more inflamed worsening the obstruction.
CALL AN AMBULANCE- medical emergency.
Could be influenza A or B
Which influenza strain is responsible for possible worldwide pandemics?
Symptoms of influenza infection
Followed by a severe headache, dry cough and sore throat. Possibly accompanied with diarrhoea.
What is the incubation period for influenza?
Inflammation of the sinus's
Symptoms of sinusitis
Blocked nose (due to the channels from the sinuses being blocked by inflammation
Painful headache that may spread to the cheeks, eyes and forehead.
Treatment of sinusitis
Usually self limiting- however may need assistance with antibiotics.
Contagious bacterial infection.
How is diptheria spread?
By direct contact, contact with an infected surroundings or touching something that the infected individual has touched.
Symptoms of diptheria
Grey/black coating at the back of the mouth
Antibiotics and antitoxins.
Two types, seasonal or persistent (perrenial)
Itchy soft palate
Watery nasal discharge
Most commonly to dust mites that live in the house. Could also be to household pets saliva.
Name the three types of persistent rhinitis.
Allergic, non-allergic eosinophilia, vasomotor rhinitis
No extrinsic cause.
eosinophillic granulocytes present in nasal discharge
Occurs when come into contact with cold air, smoke etc. Due to a nervous response.
Treatment of rhinitis
Sodium cromoglycate (anti-inflammatory)
Avoidance of irritant
Progressive airway obstruction
Most likely to be in right main bronchus.
Treatment of influenza A/B
Paracetamol and bed rest
The term pneumocoinosis refers to which occupational lung disorders?
Coal workers lung
The term hypersensitivity pneumonitis encompasses which occupational lung disorders?
Bird fanciers lung
Cheese workers lung
Coal workers lung
Two types- simple pneumocoinosis or progressive massive fibrosis
Dust particles from coal get into the lung. The more exposure to these duct particles, the more likely you are to develop pneumocoinosis.
Catagories of simple pneumocoinosis
1) small round nodular opacities relatively few in number
2) Small round nodular opacities in numerous quantities however lung markings still visible
3) Small round nodular opacities numerous in quantity- lung markings not visible,
Progressive massive fibrosis
Develops from simple pneumocoinosis.
Round masses are developed several centimetres in diameter.
Sometimes have necrotic centres
What would a lung function test of someone with progressive massive fibrosis show?
Restrictive and obstructive properties.
Symptoms of progressive massive fibrosis
Sputum may be black.
Silica fibres inside the lung
Particularly toxic to alveolar macrophages
Increased risk of TB
Signs of silicosis
Eggshell calcification around the hilar regions
Inhalation of asbestos fibres
These deposit in the tissues in the lung.
White blood cells then take up the particles- causing inflammation.
Types of asbestos
Crysotile- white (least fibrinogenic) (90%)
Croicodolite- blue (most fibrinogenic) (6%)
Relationship between asbestos and smoking
Cancer of the mesothelial cells (cells of the pleura that secrete the intrapleural fluid)
Related to asbestos exposure
Symptoms of mesothelioma
Chest wall pain
Exposure to cotton wool dust
"Monday sickness"- worse when you've had a break from it and gets better throughout the week.
Egg shell calcification
Inhalation of beryllium (copper alloy)
Clinical picture similar to sarcoidosis
Risk factors for PE
Thrombophilia (increased tendency of blood to clot)
What is a PE
DVT from legs have enlodged in the pulmonary circulation- causing blockage.
Symptoms of PE
Pleuritic chest pain
Shortness of breath (acute in onset)
Signs of PE
Investigations and their findings of PE
V/Q mismatch- shows where obstruction is
CT pulmonary angiogram- could do the same
Chest X-ray- normal
Leg- ultrasound may show atherosclerotic plaque
Treatment of PE
Low molecular weight heparin