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

    • β^o 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