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