clinical examinations on someone with heart failure
- Basal crackles (bilateral)
- Peripheral oedema (bilateral)
- Dull percussion at the lung bases
- Raised jugular venous pressure (JVP)
- Hepatomegaly
- Gallop rhythm (S3 or S4 heart sounds)
- Tachypnoea
- Tachycardia
- Cyanosis Cold
- Pale
- Confusion/agitation
- Syncope/pre-syncope
- Narrow pulse pressure
classification system of heart failure
NYHA
1st line and gold standard of HF
NT Pro-BNP
ECG
what does an FEV1:FVC ratio < 0.7 indicate
this indicates an obstructive picture
high curb-65 score treatment
IV co-amoxiclav and clarithromycin
most common bacteria for community aquired pneumonia
S.Pneumoniae
anaphylaxis pathophysiology
- Trigger that stimulates IgE production (1 mark)
- IgE stimulates mast cells (1 mark)
- To release histamine(1 mark)
- Degranulation (1 mark)
- This causes a rapid onset of symptoms, with airway, breathing and/or circulation
compromise (1 mark)
blood test for anaphylaxis
mast cell trypase
differentials of breast lump
- Cancer
- Fibroadenoma
- Breast Implant
- Hamartoma
- Breast Cyst
- Breast Abscess
- Lipoma
- Intra-mammary lymph node
- Ductal papilloma
- Fat necrosis
COCP increases and decreases chance of what
Combined Oral Contraceptive Pill (COCP)
Increased risk of: breast/ cervical cancer
lowers risk of: ovarian/ endometrial
sensitivity
Sensitivity = Proportion of people with a disease that have a positive test result
specificity
Specificity = Proportion of people without the disease that have a negative test result
stroke acute treatment
300mg
mechanism action of clopidogrel
P2Y12 inhibitor
scoring system to identify stroke
CHADVASc
first line treatment of stroke
DOAC
atheroscleorisis process
- Endothelial Dysfunction. Injury to endothelial lining, caused by factors like
hypertension, smoking, high cholesterol. - Lipid Accumulation. LDL cholesterol penetrates damaged endothelium. Accumulates
in subendothelial space. - Foam Cell Formation. Monocytes transform into macrophages. Macrophages engulf
LDL, forming foam cells. - Inflammation and Smooth Muscle Activation. Inflammatory response attracts
immune cells. Smooth muscle cells proliferate and migrate. - Plaque Formation. Smooth muscle cells deposit collagen, forming fibrous cap.
Calcium deposits contribute to plaque hardening. - Plaque Rupture and Thrombosis. Fibrous cap weakens, leading to plaque rupture.
Thrombus formation causes artery occlusion and clinical manifestations.
name the likely causative organism in this scenario
Neisseria meningitidis
bacterial meningitis - lumbar puncture
low glucose
high protein
high neutrophil
primary care meningitis
IV or IM benzylpenicillin
The patient deteriorates further and develops a non-blanching purpuric rash
what complication of meningitis has occurred:
meningocal speticaemia
who to notify for bacterial meningitis
public health england
close contacts of meningitis medication
ciproflaxin
iatrogenics that can arise from treatment of DKA
hypoglycaemia and hypokalaemia
