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Mobitz type I second degree AV block (Wenkebach block).
- - not usually require treatment
- - Inferior myocardial infarctions conduction abnormalities.
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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.
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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.
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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.
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Drugs that commonly cause increased urate levels and gout include
-aspirin, diuretics, cyclosporine and levodopa.
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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
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A lactic acidosis is defined as a
-pH of < 7.35 - lactate of > 5 mmol/L
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Type A lactic acidosis is due to
- tissue hypoxia.
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Type B lactic acidosis is due to
- non-hypoxic processes affecting the production and elimination of lactate.
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The mortality associated with lactic acidosis despite full supportive treatment remains at
-60-90%.
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The majority of filtered potassium is reabsorbed in the
proximal renal tubule.
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NSAIDs inhibit aldosterone
hyperkalaemia.
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Bartter's syndrome
- - inherited defectascending limb of the loop of Henle.
- - hypokalaemic alkalosis + normal to low blood pressure.
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Rotavirus is responsible for
50% of admissions for severe diarrhoea in infants and children.
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Cryptosporidia are protozoa with acid fast walls. They are resistant to
chlorine treatment and conventional filtering methods.
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Coli strain 0157 causes
enterohaemorrhagic diarrhoea Hemolytic uraemic syndrome (renal failure, haemolytic anaemia and thrombocytopenia).
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Ossification of the patellar occurs between
3 and 6 years of age.
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During expiration
->the size of the thorax is reduced ->more blood from the pulmonary veins ->left atrium. ->filling of the left atrium is increased.
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Causes of nephrogenic diabetes insipidus include:
- Inherited disorders of tubular ADH receptor Hypercalcaemia
- Hypokalaemia
- Renal disease
- Drugs e.g. lithium and demeclocycline
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Glucagon acts
via cyclic AMP
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Prolactin acts via
receptor tyrosine kinases
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Causes cranial diabetes insipidus
- Sarcoidosis
- Histiocytosis X
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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.
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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.
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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.
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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).
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Pulmonary embolism can cause an exudate or a transudate. Of effusions present in P.E.
80% are exudates and 20% transudates.
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Meig's syndrome is a
benign ovarian tumour ascites + pleural effusion.
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During inspiration
->increased venous return to -> atrium due to reduced intra-pleural pressure-> filling of the right atrium is increased.
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Regarding salicylate poisoning:
- with mild toxicity
- >125 mg/kg
- moderate toxicity
- >250 mg/kg
- severe and potentially fatal toxicity
- >500 mg/kg with.
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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
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Haematemesis is an uncommon feature of salicylate poisoning.
Common features include:
- Nausea and vomiting
- Tinnitus
- Lethargy
- Dizziness
- Restlessness
- Sweating
- Bounding pulses
- Warm extremities
- Hyperventilation
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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)
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The null hypothesis states that
no statistical significance exists in a set of given observations.
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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
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