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2013-11-29 18:43:18

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  1. Mobitz type I second degree AV block (Wenkebach block).
    • - not usually require treatment
    • - Inferior myocardial infarctions conduction abnormalities.
  2. Indications for the use of IV atropine in bradycardias are:
    • 1. Shock
    • 2. Syncope
    • 3. Myocardial ischaemia
    • 4. Heart failure
    • In addition to this extreme bradyardia with a rate less than 40 bpm is an indication for the use of IV atropine also.
  3. ECG changes may be normal during pregnancy:
    • -axis leftward
    • - Q waves normal finding in leads III and aVF.
    • -T wave flattening or inversion in the praecordial leads and in leads III and aVF
    • -increased frequency of ectopic beats during pregnancy.
  4. The APTT measures
    • -intrinsic and common coagulation pathways factors I, II, V, VIII, IX, X, XI and XII.
    • -1925 10-11-12- prolonged with heparin usage.
    • - not tend to become prolonged until end stage liver failure and will be normal in early liver failure.
  5. Drugs that commonly cause increased urate levels and gout include
    -aspirin, diuretics, cyclosporine and levodopa.
  6. Macrophages have a longer lifespan than
    • -neutrophils
    • -cytokines: TNF-alpha, interferon alpha, interferon beta, IL-1, IL-6, IL-10, IL-12 and IL-18.
    • -IL-1 production by monocytes and macrophages facilitates IL-2 production by T-lymphocytes
  7. A lactic acidosis is defined as a
    -pH of < 7.35 - lactate of > 5 mmol/L
  8. Type A lactic acidosis is due to
    - tissue hypoxia.
  9. Type B lactic acidosis is due to
    - non-hypoxic processes affecting the production and elimination of lactate.
  10. The mortality associated with lactic acidosis despite full supportive treatment remains at
  11. The majority of filtered potassium is reabsorbed in the
    proximal renal tubule.
  12. NSAIDs inhibit aldosterone
  13. Bartter's syndrome
    • - inherited defectascending limb of the loop of Henle.
    • - hypokalaemic alkalosis + normal to low blood pressure.
  14. Rotavirus is responsible for
    50% of admissions for severe diarrhoea in infants and children.
  15. Cryptosporidia are protozoa with acid fast walls. They are resistant to
    chlorine treatment and conventional filtering methods.
  16. Norwalk virus
    • RNA virus.
    • noRwalk
  17. Coli strain 0157 causes
    enterohaemorrhagic diarrhoea Hemolytic uraemic syndrome (renal failure, haemolytic anaemia and thrombocytopenia).
  18. Ossification of the patellar occurs between
    3 and 6 years of age.
  19. During expiration
    ->the size of the thorax is reduced ->more blood from the pulmonary veins ->left atrium. ->filling of the left atrium is increased.
  20. Causes of nephrogenic diabetes insipidus include:
    • Inherited disorders of tubular ADH receptor Hypercalcaemia
    • Hypokalaemia
    • Renal disease
    • Drugs e.g. lithium and demeclocycline
  21. Glucagon acts
    via cyclic AMP
  22. Prolactin acts via
    receptor tyrosine kinases
  23. Causes cranial diabetes insipidus
    • Sarcoidosis
    • Histiocytosis X
  24. 72 year old man + severe epistaxis on Warfarin for a prosthetic aortic valve+ Platelets 160, INR 8.4.
    • vitamin K he would require is 5mg IV.
    • It would be reasonable to give intravenous prothrombin complex concentrate (Beriplex or Octaplex).
    • Beriplex or prothrombin complex concentrate (PCC) factors II, VII, IX and X as well as protein C and protein S
    • If this was not available he could be given FFP 15 ml/kg.
  25. Regarding the diaphragm:
    • The greater and lesser splanchnic veins pierce the crura at the level of T12.
    • The left dome reaches the 5th rib in expiration.
    • The sympathetic chain passes behind the medial arcuate ligament lying on psoas major.
    • The azygous vein is transmitted through the diaphragm at the level of T12.
  26. Onchocerciasis (river blindness) is
    • caused by Onchocerca volvulus, a nematode
    • transmitted black fly of the Simulium genus.
    • South America and West Africa.
    • world's second leading infectious cause of blindness.
    • skin rashes, skin lesions, intense itching and skin hypo-pigmentation.
  27. The following are causes of transudates:
    left ventricular failure, cirrhosis, hypoalbuminaemia, hypothyroidism, nephrotic syndrome, mitral stenosis, pulmonary embolism, constrictive pericarditis and Meig's syndrome (a benign ovarian tumour).
  28. Pulmonary embolism can cause an exudate or a transudate. Of effusions present in P.E.
    80% are exudates and 20% transudates.
  29. Meig's syndrome is a
    benign ovarian tumour ascites + pleural effusion.
  30. During inspiration
    ->increased venous return to -> atrium due to reduced intra-pleural pressure-> filling of the right atrium is increased.
  31. Regarding salicylate poisoning:
    • with mild toxicity
    • >125 mg/kg
    • moderate toxicity
    • >250 mg/kg
    • severe and potentially fatal toxicity
    • >500 mg/kg with.
  32. Risk factors for death in severe poisoning include:
    • Age < 10 or > 70 years
    • CNS features
    • Metabolic acidosis
    • Hyperpyrexia
    • Late presentation
    • Pulmonary oedema
    • Salicylate concentration > 700 mg/L
  33. Haematemesis is an uncommon feature of salicylate poisoning.
    Common features include:
    • Nausea and vomiting
    • Tinnitus
    • Lethargy
    • Dizziness
    • Restlessness
    • Sweating
    • Bounding pulses
    • Warm extremities
    • Hyperventilation
  34. Type III hypersensitivity reactions are implicated in:
    • Serum sickness
    • Drug induced haemolytic anaemia
    • Post streptococcal glomerulonephritis
    • Rheumatoid arthritis
    • SLE
    • Polyarteritis nodosa
    • Arthur reaction

    (NEMO: aMo llamado Arturo, se puso SICK, despus de tomar DRUG , para POST STREP cogiendo una Glomerulonefritis quedando Reumtico y Esclerosadndo con la orina a un Policia Nodular)
  35. The null hypothesis states that
    no statistical significance exists in a set of given observations.
  36. A 95% confidence interval is calculated at
    • ->+/- 1.96 times the standard error of the mean.
    • ->useful when comparing data with another population.
    • ->used for both parametric and non-parametric data but the calculations used are different