Progress 5 (Page 61-74)

mbch4kz2's version from 2016-05-08 14:06


Question Answer
What tests should pleural fluid from aspiration be sent for?pH, protein, LDH, cytology, microbiology
What does Light's criteria distinguish between?The difference between a transudate and exudate. Exudate- Protein >30g/L Transudate- <30g?L
Pleural infection; when should a chest tube be placed?If fluid is purulent or turbid/cloudy a chest tube should be placed. If fluid is <7.2 pH in patients with suspect pleural infection a chest tube should be placed
What would low glucose in pleural fluid suggest?Rheumatoid arthritis, TB
What does a raised amylase in pleural fluid suggest?Pancreatitis, oesophageal perforation
What does heavy blood staining in pleural fluid suggest?Mesothelioma, PE and TB
What does a translocation in the philadelphia chromosome present with?t(9;22)- Present in >95% of patients with chronic myeloid leukaemia. Causes excess tyrosine kinase activity
What translocation is seen in Burkitt's lymphoma t(8;14)
What normal variants may be seen in athlete's ECGs due to increased vagal tone?Sinus bradycardia, 1st degree AV block, Wenckeback (2nd degree AV block- Mobitz type 1), junctional escape rhythm
What ECG changes would you see in acute MI?1. Hyperacute T waves (1st sign) 2. ST elevation 3. Inverted T waves within 1st 24 hours 4. Pathological Q waves (after several days to months- persists indefinitely)
What are the key indications for non-invasive ventilation?1. COPD with respiratory acidosis (pH 7.25-7.35) 2. Type II respiratory failure 3. Cardiogenic pulmonary oedema (unresponsive to CPAP) 4. Weaning from tracheal intubation
What artery supplies the anteroseptal heart and where in ECG would ST elevation be evident?Left anterior descending (V1-4)
What artery supplies the inferior heart and where in ECG would ST elevation be evident?Right coronary (II, III, aVF)
What artery supplies the anterolateral hearth and where would ST elevation be evident on ECG?LAD or left circumflex (V4-6, I, aVL)
What artery supplies the lateral heart and where on the ECG would ST elevation be evident?Left circumflex (I, aVL +/- V5-6)
What artery supplies the posterior heart and where on the ECG would ST elevation be evident?Left circumflex and right coronary. Tall R waves, V1-2
What is the management of NSTEMI1. Aspirin (300mg) 2. Nitrates 3. Antithrombin treatment- Fondaparinux 4. Clopidogrel (300mg) 5. IV glycoprotein (Eptifibatide/Tirofiban) 6. Coronary angiography
What is the mechanism of action of aspirin?Antiplatelet (inhibits production of thromboxane A2)
What is the mechanism of clopidogrel?Inhibits ADP binding to platelet receptor
What is the mechanism of enoxaparin?Activates antithrombin III which potentiates the inhibition of coagulation factors Xa
What is the mechanism of bivalirudin?Reversible direct thrombin inhibitor

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