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