MRCP Part 1 | study guide | latest update
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Terms in this set (589)
Pregnancy and Thyroid Hormone Pregnancy increases the amount of TBG (thyroid
binding globulin) so increases the total thyroxin
levels but not free thyroxine
Hyperthyroid in pregnancy Untreated - fetal loss, premature labour, maternal
heart failure
Graves disease most common
HCG can activate TSH receptors - transient
gestational hyperthyroid - these fall in trimester 2 &
3
treatment - propylthiouracil in first trimester
this can cause hepatic injury
carbimazole in 2nd trimester once lower risk of
congenital abnormalities
Monitoring - free thyroxine levels should be kept
upper third normal so to avoid fetal hypothyroid
- thyrotrophin receptor stimulating antibodies
should be checked weeks 30-36
DO NOT - block and replace or use radioiodine.
,Hypothyroid in pregnancy Thyroxine replacement is safe in pregnancy and
breastfeeding
TSH measured each trimester and 6-8 weeks post
partum
Women often require an increased dose - up to
50% by weeks 4-6
untreated - developmental abnormalities,
miscarriage, still birth, low birth weight, pre-
eclampsia, anaemia
Gentamicin Aminoglycoside antibioitic
Given IV or topically
Ototoxic - irreversible due to auditory or vestibular
nerve damage
Nephrotoxic - causes tubular necrosis,
accumulates in renal failure requiring increased
monitoring, furosemide increases this risk
CI - Myasthenia Gravis
Dosed via height and weight and renal function.
Peak and trough levels monitored with dose
adjustments based on trough levels
CSF: Protein levels normal = 0.2-0.4 g/L
Causes of raised CSF protein
GBS
Froin's syndrome - a spinal canal blockage
characterised by xanthochromia, raised protein and
CSF hypercoagulability
TB, bacterial or fungal meningitis
viral encephalitis
,Vigabatrin Irreversibly inhibits GABA transaminase-->increased
GABA levels in synapse
Uses = tx infantile spasms (Viga"Baby"trin)
Or used as adjunct therapy for adults with
refractory complex partial seizures
SE = visual field constriction and even visual loss in
40% of patients- visual fields must be checked
every 6 months as visual loss can be irreversible
Tricuspid regurgitation Signs: pansystolic murmer, parasternal heave, giant
V waves, pulsatile hepatomegaly
causes: IVDU endocarditis, rheumatic heart disease,
right ventricle infarction, pulmonary hypertension,
carcinoid syndrome, epsteins anamoly (rare heart
defect that causes tricuspid regurg)
, Corticosteroid side effects COME IN PIGG
Cushings
opthalmic - glaucoma, catterachts
M - musculoskeletal - OP, proximal myopathy,
avascular necrosis
Endocrine- hyperglycaemia, weight gain, hirsuitism,
high lipids
Immunosupression
Neutrophilia
Psychiatric - mania, psychosis, insomnia, depression
Intracranial hypertension
Gastric - pancreatitis, ulcers,
Growth suppression in kids
Acne - Systemic glucocorticoids can cause drug-
induced acne. This is characterised as
monomorphic papular rash without comedones or
cysts. This does not respond to acne treatment but
improves on drug discontinuation
Therapeutic Steroids Fludocortisone - mostly mineralocorticoid
hydrocortisone - some glucocorticoid, some
mineralocoticoid
Dexamethsone - high glucocorticoid
Save
Terms in this set (589)
Pregnancy and Thyroid Hormone Pregnancy increases the amount of TBG (thyroid
binding globulin) so increases the total thyroxin
levels but not free thyroxine
Hyperthyroid in pregnancy Untreated - fetal loss, premature labour, maternal
heart failure
Graves disease most common
HCG can activate TSH receptors - transient
gestational hyperthyroid - these fall in trimester 2 &
3
treatment - propylthiouracil in first trimester
this can cause hepatic injury
carbimazole in 2nd trimester once lower risk of
congenital abnormalities
Monitoring - free thyroxine levels should be kept
upper third normal so to avoid fetal hypothyroid
- thyrotrophin receptor stimulating antibodies
should be checked weeks 30-36
DO NOT - block and replace or use radioiodine.
,Hypothyroid in pregnancy Thyroxine replacement is safe in pregnancy and
breastfeeding
TSH measured each trimester and 6-8 weeks post
partum
Women often require an increased dose - up to
50% by weeks 4-6
untreated - developmental abnormalities,
miscarriage, still birth, low birth weight, pre-
eclampsia, anaemia
Gentamicin Aminoglycoside antibioitic
Given IV or topically
Ototoxic - irreversible due to auditory or vestibular
nerve damage
Nephrotoxic - causes tubular necrosis,
accumulates in renal failure requiring increased
monitoring, furosemide increases this risk
CI - Myasthenia Gravis
Dosed via height and weight and renal function.
Peak and trough levels monitored with dose
adjustments based on trough levels
CSF: Protein levels normal = 0.2-0.4 g/L
Causes of raised CSF protein
GBS
Froin's syndrome - a spinal canal blockage
characterised by xanthochromia, raised protein and
CSF hypercoagulability
TB, bacterial or fungal meningitis
viral encephalitis
,Vigabatrin Irreversibly inhibits GABA transaminase-->increased
GABA levels in synapse
Uses = tx infantile spasms (Viga"Baby"trin)
Or used as adjunct therapy for adults with
refractory complex partial seizures
SE = visual field constriction and even visual loss in
40% of patients- visual fields must be checked
every 6 months as visual loss can be irreversible
Tricuspid regurgitation Signs: pansystolic murmer, parasternal heave, giant
V waves, pulsatile hepatomegaly
causes: IVDU endocarditis, rheumatic heart disease,
right ventricle infarction, pulmonary hypertension,
carcinoid syndrome, epsteins anamoly (rare heart
defect that causes tricuspid regurg)
, Corticosteroid side effects COME IN PIGG
Cushings
opthalmic - glaucoma, catterachts
M - musculoskeletal - OP, proximal myopathy,
avascular necrosis
Endocrine- hyperglycaemia, weight gain, hirsuitism,
high lipids
Immunosupression
Neutrophilia
Psychiatric - mania, psychosis, insomnia, depression
Intracranial hypertension
Gastric - pancreatitis, ulcers,
Growth suppression in kids
Acne - Systemic glucocorticoids can cause drug-
induced acne. This is characterised as
monomorphic papular rash without comedones or
cysts. This does not respond to acne treatment but
improves on drug discontinuation
Therapeutic Steroids Fludocortisone - mostly mineralocorticoid
hydrocortisone - some glucocorticoid, some
mineralocoticoid
Dexamethsone - high glucocorticoid
