• Rhinitis

    by  • 18/05/2013

    Rhinitis Definition Present if sneezing attacks, nasal discharge or blockage occur for more than an hour on most days for:  A limited period of the year = Seasonal rhinitis (‘Hayfever’): allergic, 2-20% incidence, most common in teens, p/c: nasal irritation, sneezing, rhinorrhoea, itching eyes/soft palate.  Throughout the whole year = Perennial rhinitis:...

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    Respiratory Failure

    by  • 16/05/2013

    Respiratory Failure: PaO2 <8kPa (60mmHg).. and.. PaCO2 <6kPa (low) = Type 1 RF o Seen in: o Hypoventilation (arterial-alveloar PO2 difference >2.5kPa) o PAO2 = PIO2 – PACO2/R o Starts as Type 1 RF, but over time maintain low O2, but start to retain CO2 – progress to Type 2 RF. o Diffusion impairment...

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    Respiratory Overview

    by  • 15/05/2013

    Respiratory function tests Test Use Peak Expiratory Flow Rate – ranges: o Male 440-670L/min o Female 300-460L/min   Monitoring changes in airflow limitation in asthma (diurnal change) – COPD fixed obstruction. Spirometry: FEV, FVC, FEV1/FVC Assessment of airflow limitation (constrictive/restrictive). The gold standard. Flow-volume curves Assessment of flow at lower lung volumes. Detection of...

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    Metabolic and Alcoholic Liver Disease

    by  • 14/05/2013 • 0 Comments

    Alcoholic liver disease: o Relationship between chronic liver disease and alcohol use is complex o Excess alcohol = chronic liver disease o However personal susceptibility varies and alcohol-related pathology is increasingly seen in individuals who drink minimal amounts of alcohol (=non-alcoholic steatohepatitis = NASH) o Of all the people who drink excess alcohol –...

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    Hepatitis

    by  • 13/05/2013 • 0 Comments

    Viral Hepatitis Hep A virus (HAV): o Common cause of transient hep, no long term carriage, often occurs in epidemics o Faeco-oral transmission o After 5/52 infection = IgM peaks and IgG continues to rise o 50% are subclinical (=have IgG to HAV without jaundice) o Jaundice: most common presentation in an acute hep....

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    Acute and Chronic Liver Disease

    by  • 11/05/2013 • 0 Comments

    Acute hepatitis:  Non-specific term for acute, self-limiting liver inflammation  p/c: jaundice, nausea, anorexia, RUQ pain, fever, fatigue, orange urine, occasional substantial intrahepatic cholestasis (=white stools)  Causes: o Common = viral hepatitis A/B, EBV, drug reactions (=paracetamol) o Uncommon = autoimmune hepatitis o Rare = Wilson’s disease, toxins  Ix: o LFTs:...

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    Silicosis

    by  • 11/05/2013

    Silicosis  P/c: SOB, cough, fever, cyanosis, pulmonary oedema, pneumonia, +TB (=’silicotuberculosis’), RF=CP+RHF. May have CTD (SLE, scleroderma) etc.  Uncommon RLD  May be seen in stonemasons, sand-blasters, pottery and ceramic workers.  Caused by the inhalation of SILICA (occupational hazard of sandblasting)  Dust is highly fibrogenic.  CXR = distinctive thin...

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    Pancreatitis

    by  • 10/05/2013 • 0 Comments

    Acute pancreatitis:  Acute destructive inflammation of pancreas  Incidence 40-500/mil (varying with rate of alcohol consumption and incidence of GS)  Incidence is increasing and mortality is falling  p/c: jaundice (if deep = GS/cholangitis), cyanosis, ARDS (T1 RF), metabolic problems (hypo-/hyperglycaemia, hypocalcaemia), acute renal failure, Grey-Turner sign (=bruising in flanks), DIC and...

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    Biliary Disease

    by  • 09/05/2013 • 0 Comments

     Gallstone disease: ‘female, fat, fertile and forty!’  Stones occur in 7% of men and 15% of women aged 18-65yo  Prevalence is underestimated because 90% are asymptomatic  Pathophysiology: gallstones form due to precipitation of cholesterol crystals in supersaturated bile. Increase in size by 2.5mm/y  Clinical features: o Asymptomatic = GS...

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    Coeliac Disease- Malabsorption

    by  • 07/05/2013 • 0 Comments

     Most common cause of malabs in the west  Common, 1/150 (in Ireland), 1/300 (England), peak incidence 20-40yo  Due to allergic reaction to the gliaden fraction of wheat germ. Initially causes an increase in intraepithelial lymphocytes in the small intestinal epitheliumprogresses to flattening of intestinal villi (villous atrophy), strong HLA (human leukocyte...

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