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13.03.20 Notes

Weber classification


  • B = At the level of the tibiofibular syndesmosis
  • A = Below
  • C = Above


Prochlorperazine (Stemetil)

  • Dopamine (D2) receptor antagonist
  • Highly potent typical antipsychotic (but rarely used)
    • 10-20x more potent than chlorpromazine
  • Prominent antiemetic/antivertiginoic activity
    • Most often used for the (short-time) treatment of nausea and vomiting and vertigo


Joint pain timing

  • OA
    • Joints probably become stiffer and harder to move over time
    • Morning stiffness lasting for 30 minutes or less
    • Feel better with gentle use (warming up) but worse with heavy use
  • RA
    • Morning stiffness, which lasts more than 1 hour
    • Feel worse following prolonged inactivity


Thalassaemia major 

  • Mutations
    • βo or β thalassemia major: No formation of β chains at all (can't make any RBCs)
    • β+ or β thalassemia intermedia: Allow some β chain formation to occur
  • Management
    • Blood transfusions every 3 weeks
    • Treatment for the resulting iron overload (check ferritin regularly)
      • Oral iron chelators (Deferiprone)
      • SC injection/infusion (Deferoxamin)
  • Complications
    • Kitchen manager rheum guy
      • Iron inflammation of joints
        • MCP, IP, knee, ankle
        • Early morning stiffness but no pain!
        • Check MRI, arthroscopy, biopsy, aspiration to confirm iron
    • Risk of cancer if ferritin consistently high
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