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13.02.08 AMU notes

Drugs in COPD
  • Anticholinergic inhaler
    • Ipratropium (Atrovent)
    • Tiotropium (Spiriva)
  • Beta-agonist inhaler
    • Salmeterol (Serevent)
    • Formoterol (Foradil)
  • Inhaled corticosteroid (gargle after use)
    • Beclomethasone (Qvar)
    • Fluitcasone (Flovent)
    • Ciclesonide (Alvesco)
    • Flunisolide (Aerobid)
    • Mometasone (Asmanex)
    • Triamcinolone (Azmacort)
    • Budesonide (Pulmincort)
  • Combination: Budesonide/formoterol = Symbicort

Miller Fisher syndrome
  • Rare variant of GBS
    • Accounts for approximately 5% of GBS cases
  • Manifests as a descending paralysis, proceeding in the reverse order of the more common form of GBS
  • Usually affects the eye muscles first
  • Presents with a classic triad:
    • Ophthalmoplegia
    • Ataxia
    • Areflexia
  • The ataxia predominantly affects the gait and trunk, with the limbs relatively spared
  • Anti-GQ1b antibodies are present in 90% of cases


Bartholin's cyst

  • Formed when a Bartholin's gland is blocked
    • Tubes which lead from the glands to the vulva
  • May develop to a Bartholin's abscess
  • If the infection is severe or repeated, a marsupialization may be required to stop further recurrences


Headache: Indications for a scan/investigation

  • Any one of:
    • Age >40
    • Witnessed LOC
    • Neck pain or stiffness
    • Onset with exertion
    • Arrived by ambulance
    • Vomiting
    • HTN
      • SBP >160
      • DBP >100
  • Document all these if negative


SAH

  • CT sensitivity
    • 95% in day 1
      • Esp. if within 6 hours
    • 50% day 7
  • Xanthochromia on LP sensitivity
    • 98% 12 hours - 2 weeks
    • 40% at 4 weeks
  • Sentinel headache
    • Only in <5% of cases



Notes
  • LRTI is often used as a synonym for pneumonia
    • But can also be applied to e.g. bronchitis, lung abscess
  • Useful renal books:
    • Pocket tutor of renal medicine
    • Brenner: Textbook of nephrology
  • UGIB => Rockall score


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