main side effect of verapamil
ankle swelling
SOB symptoms
- DYSPNOEA
- PAROXYSMAL NOCTURNAL DYSPNOEA
- ORTHOPNOEA
a sensation of shortness of breath that awakens the patient, often after 1 or 2 hours of sleep, and is usually relieved in the upright position.
Orthopnea is a medical term to describe shortness of breath that occurs while lying flat and is relieved by sitting or standing
heart failure pharmacoglogical interventions
ACEI and CCB
HF - dont do
restrict salt intake and fluid
no smoking and alcohol
X ray changes that may be seen in a patient with COPD
- BARREL CHEST
- FLATTENED HEMIDIAPHRAGM(s)
- CARDIOMEGALY OR SMALLER LOOKING HEART
COPD first line meds
SALBUTAMOL (1), A SHORT ACTING BETA-2 AGONIST (1) TAKEN AS AN INHALER INTRANASALLY
COPD measuring scale
MRC DYSPNOEA SCALE
COPD complications
IECOPD, BRONCHIECTASIS, COR PULMONALE, LUNG CANCER
Name 2 causes of an AKI of
Prerenal origin
Intrarenal origin
Postrenal origin
- Anaemia, Hypovolemia; shock, heart failure, drugs (NSAIDs)
- Interstitial nephritis, tubular nephritis, glomerulonephritis, nephrotoxins
- Obstructions: renal stones, indwelling catheters, BPH
asterixis causes
Asterixis is a clinical sign that describes the inability to maintain sustained posture with subsequent brief, shock-like, involuntary movements.
- Chronic CO2 retention
- hepatic encephalopathy/liver failure
RHABDOMYOLYSIS
most common cause of primary hyperparathyroidism
PARATHYROID ADENOMA
name 4 causes for a raised serum calcium.
- CKD
- MYELOMA
- MALIGNANCY/BONE METASTASES
- VITAMIN D DEFICIENCY
- DEHYDRATION
- DRUGS (E.G. THIAZIDE DIURETICS, LITHIUM)
- SARCOIDOSIS
- NEOPLASTIC SYNDROMES (SQUAMOUS CELL LUNG
CA)
symptoms of hypercalcaemia
- kidney stones
- WEAK BONES
- PSYCHEDELIC MOANS/ DEPRESSIVE Sx
- ABDOMINAL GROANS/CONSTIPATION
- decreased muscle tone.
hypercalcaemia ecg
short QT interval
Name and explain 3 signs you may elicit when taking the patient’s history and on examination
- LHERMITTE PHENOMENON (neck flexion = electric shock)
- UHTHOFF’S PHENOMENON (burning
after heat exposure e.g. shower) - OPTIC NEURITIS (painful red eye + sensitive to red)
- INTERNUCLEAR OPHTHALMOPLEGIA (impaired lateral gaze)
- UMN SIGNS (hyperreflexia/Babinski +ve/hypertonia)
What cell is targeted in the pathological process?
OLIGODENDROCYTES
This patient describes widespread pain due to his symptoms. Which neurological tract is responsible for carrying pain afferent fibres to the CNS?
spinothalamic
List 2 Biologics that may be used to prevent further attacks of MS
BETA INTERFERON and MONOCLONAL Abx
What diagnostic criteria is used to make a MS diagnosis, and what does it constitute?
- MCDONALD CRITERIA
- requiring 2 OR MORE ATTACKS
- DISSEMINATED IN TIME AND SPACE
