Ward round/clinics Flashcards
(27 cards)
what is Enlers danlos syndrome?
genetic condition affecting the connective tissue
why do HIV patients get diarrhoea?
infectious causes of diarrhoea in HIV are CMV infection, cryptosporidiosis, microsporidiosis and MAC infection
why is pain in Ulcerative colitis an alarm sign?
in UC usually only the mucosa is involved so if pain is present there is probably deeper nerve damage.
what are the causes of pain in Ulcerative Colitis?
toxic dilatation
microperforaton
opposite side foecal load
what pain relief can be used in a patient with ulcerative colitis?
paracetamol and morphine
what is the management of acute severe colitis?
- monitor and replace electrolytes
- FBC (with CRP)
- stop anticholinergics, antidiarrheals, NSAIDs, opioids
- LMWH prophylaxis
- IV corticosteroids
- infliximab infusion
what is the role of lactulose in encephalopathy?
- reduce nitrogen absorption
- stop nitrogen conversion to ammonia
- increases motility so stagnant bacteria can’t translocate over gut mucosa and less ammonia producing bacteria available.
- as ammonia causes encephalopathy lactuose can be used to prevent it
what are the 5 P’s of ischaemia?
pain pulseless parathesia paralysis perishingly cold
why should oral iron only be give once a day?
hepcidin produced in the liver as soon as iron enters the body and released to blood and regulates amount of iron absorbed. its activity peaks 6-8 hours after initial iron intake
what do blue areas on colonoscopy indicate?
liver/spleen (hepatic/splenic flexure)
what sedatives are given for colonoscopY?
medazalan
phenytoin
oxygen given via nasal cannula
what is seen in the small bowel on colonoscopy
villi
what do blue veins on colonoscopy suggest?
haemorrhoids
what ‘sign’ is seen at the appendix on colonoscopy
mercedes sign
what parts of the bowel are passed through on colonoscopy in order?
anus rectum sigmoid descending colon splenic flexure transverse colon hepatic flexure ascending colon cecum (appendix)
what would blood results show in a patient with iron deficiency anaemia?
- low Hb, Low MCH, low MCV, RCDW may be raised
- ferritin test, transferrrin test, serum iron decreased
- total iron binding capacity increased
what are the causes of microcytic anaemia?
iron deficiency due to
- bleeding
- malabsorption
- genetic
- malnutrition
- thalasemia
- SIT (sideroblastic, iron deficiency, thalasemia)
what are the causes of normocytic anaemia?
acute blood loss
haemolysis
renal failure
what are the causes of macrocytic anaemia?
folate, B12 deficiency
alcohol
what are the GI causes of anaemia??
blood loss coeliac alcohol B12 folate liver disease
when should you consider thalassemia/
young patient, iron deficiency, asian and otherwise well
what are the investigations in a patient with iron deficiency anaemia/
dipstick
Hb electrophoresis
pregnancy
coeliac
when should blood transfusion be considered in a patient with anaemia?
levels lower than 60/70
what do gastric cardia secrete?
mucus
