• Archive for June, 2013


    by  • 22/06/2013 • Rheumatology

     Impaired mineralization of skeleton in childhood.   3 congenital causes:  Hypophoshatemic rickets (X-linked)  Congenital 1a-hydroxylase deficiency  Congenital vitamin D resistance.   P/c: Causes bone pain, deformities, muscle weakness and growth retardation as well as the increased fracture risk. Tx:    The treatment and prevention of rickets is known as...

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    by  • 21/06/2013 • Rheumatology

     Is the impaired mineralization (deposition of hydroxyapatite) of bone in the mature skeleton. Due to inadequate phosphate and or calcium in the extracellular fluid, or a circulating inhibitor of mineralization   Cause:  Vitamin D deficiency.  Abnormal vitamin D metabolism – liver/renal disease or drugs such as anticonvulsants, hypophosphatemia.  Inhibitors of...

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    by  • 20/06/2013 • Rheumatology

    General principles of fractures  Fracture is a loss of continuity of the substance of the bone due to physical force. Covers severely comminuted, hairline crack (can cause a periosteal reaction 2 weeks later) and micro fracture.  Dislocation is a complete loss of contact between articulating surfaces of a joint  Subluxation of...

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    Medical Emergencies and Essential Management

    by  • 18/06/2013 • Medical Emergencies and Essential Management

    Medical Emergencies and Essential Management:  Anaphylaxis  Shock (secondary to large GI bleed)  Pulmonary Embolus  Cardiac arrest  Myocardial Infarction  Paracetamol OD  Opiate OD  Benzodiazepine OD  Beta-blocker OD  Iron OD  Organophosphate Insecticide OD  Warfarin OD  Wide-complex tachycardia  Narrow-complex tachycardia  Asthma ‘Attack’...

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    Behcets Disease

    by  • 18/06/2013 • Rheumatology

     Multi-organ disease, unknown cause – infective?  Men, arthritis, ocular symptoms (pain in eyes, reduced vision, floaters, iritis, ulceration of mouth and genitals, colitis, meningoencephalitis.  Mx: refer to GUM and ophthal, high dose prednisolone or colchicine, topical steroids for ulcers. 

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    by  • 17/06/2013 • Respiratory

    PLEURISY:  Definition: Inflammation of the pleura  p/c: sharp inspiratory pleuritic (‘catching’) chest pain, dyspnoea, cough, fever, chills, weight loss, sore throat.  Causes: viral, pneumonia, TB, SLE, LC, CF, sarcoidosis, PE, idiopathic.  O/E: CXR, CT, USS, MRI, FBC, ABG, thoracocentesis (identify pathogen)  Tx: aspirate fluid, analgesics, anti-inflammatories, also useful =...

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    Adult Acute Respiratory Distress Syndrome (ARDS)

    by  • 16/06/2013 • Respiratory

    Adult acute respiratory distress syndrome (ARDS) Definition Serious reaction to various forms of injuries to the lung = RLD Epidemiology  10/100,000/y  Mortality rate = 30% – 85%.   Presenting complaint ARDS can occur within 24 to 48 hours of an injury or attack of acute illness. In such a case the patient...

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    Ankylosing Spondylitis

    by  • 15/06/2013 • Rheumatology

     1:2000, male, 95% HLA-B27 +ve  p/c: morning back pain/stiffness, progressive spinal fusion (ankylosis) = reduced spinal movement, kyphosis, SI joint fusion, neck hyperextension, and neck rotation, reduced chest expansion, hip/knee arthritis, enthesopathies, iritis, Crohn’s/UC (=IBD), heart disease, OP, psoriaform rashes.  Ix: FBC (anaemia), ESR high, RhF –ve. Xray: widened SIJ and...

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    Restrictive Lung Disease

    by  • 14/06/2013 • Respiratory

    Restrictive Lung Disease Definition are a category of extrapulmonary, pleural, or parenchymal respiratory diseases that restrict lung expansion resulting in a decreased lung volume (reduced TLV), reduced RV, an increased work of breathing, and inadequate ventilation and/or oxygenation. Diagnostic tools/investigations o FEV1 reduced o FVC reduced (TLC <80% and reduced RV) o Therefore –...

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    by  • 13/06/2013 • Respiratory

    Pneumonia Definition  is an inflammatory condition of the lung  It is often characterized as including inflammation of the parenchyma of the lung (alveoli) and abnormal alveolar filling with fluid (consolidation and exudation)   Can be acute / chronic Acute pneumonias  Classic pneumococcal bronchopneumonias (such as Streptococcus pneumoniae)  Atypical pneumonias (such...

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