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CSB336 Medical and Surgical Tree of Knowledge - Coggle Diagram
CSB336 Medical and Surgical Tree of Knowledge
Haemostasis and Metabolic
Hormone balance
aldosterone
cortisol
hypothalamus
Osmosis
osmotic pressure
physiological changes to achieve homeostasis
acid-base balance
acidosis
metabolic
casues
types
high anion gap
keto
lactic
renal
toxic
normal anion gap
GI
renal bicarb loss
impaired renal excretion of acids
respiratory
define
<7.35 pH and paCo2 >45mmHg
mechanism
hypercarbia -> increased carbonic acid -> drop in pH -> kidneys conserve bicarbonate to compensate
causes
hypercabia
respiratory muscles
respiratory centre
lung disease
airway obstruction
chest trauma
clinical signs
management
define
increased H+ ions
alkylosis
respiratory
define
clinical signs
management
metabolic
causes
excessive antacids
diuretics
exessive vomitting
prolonged gastric suctioning
Endocrine and Autoimmune
DKA
HHNS
non-ketotic, usually in elderly suffering from sepsis or AMI, initial presentation
very high glucose, but enough insulin to prevent ketosis
high mortality, long prodrome
Functions of pancreas
Endocrine and Exocrine organs
endocrine (ductless, straight into blood/lymphatic stream)
pituitary/thymus
thyroid/parathyroid
adrenal/pineal
thyroid
affects BMR and oxygen consumption
heart, GIT, reproductive, integumentary function
glycogenesis
growth of skeleton
Functions of thyroid
hyperthyroidism
Grave's disease
exopthalmos
thyroid storm - overactive metabolism
hypothyroidism
Hashimoto's
myxodema, goitre
adrenal
cortex
corticosteroids, alcosterone, glucocorticoids, gonadocortioids
Cushing syndrome
Addison's disease
management
1 more item...
medulla
adrenaline, noradrenaline, catecholamines
pituitary
exocrine (ducted)
muscous, sweat, oil, saliva glands
bile duct
both - hypothalamus, pancreas, testes/ovaries
hypothalamus
makes ADH and stores it in posterior pituitary
pancreas
glucagon, insulin (beta)
Neurological influences on hormones
Glycolysis and Glycogenolysis
Hypoglycaemia
pathophys
management
drugs
glucagon
10% glucose
oral glucose if conscious
Feedback mechanisms
positive
clotting cascade
oxytocin
negative
Renal, Genitourinary and Reproductive
Rhabdomyolysis
impact on kidneys
accumulates in tubules of kidneys
causes
overexertion
crush
heat
Life-changing Genitourinary emergencies
renal colic and calculi
signs and symptoms
UTI
Preganancy
Anatomy and physiology
kidney
glomerular filtration
RAAS
AKI
prerenal
intrarenal
postrenal
Hepatic, GI and Abdomen
Pain management
abdo exam
4 quadrants
9 regions
4 elements
clinical signs
Kerr's
McBurney's
Rovsing
Obturator
Acute surgical abdomen
signs and symptoms
sudden onset of pain less than 24hrs
guarding
sepsis
haemodynamic compromise
management
Ulcerative colitis
define
chronic inflammation of large intestine
toxic colitis
medical emergency - leads to localised ileus and periotonitis
Appendicitis
signs
Rovising - contralteral pain when palpated
McBurney's - rebound tenderness
Obturator - internal rotation of leg causes pain
Diffuse, non-specific abdo pain
ruptured spleen
Kerr's sign - radiate to tip of left shoulder
Haematology
Composition of blood
RBC (45%)
production
properties
Anaemia
pathophysiology
causes
types
Fe deficient
haemolytic
sickle cell
thalasaemia
define
jaundice
polycythaemia
WBC (1%)
production
types
abundance
in order - NEVER LET MONKEYS EAT BANANAS
neutrophils
lymphocytes
monocytes and macrophages
eosinophils
basophils
leukemia
types
myeloid
multiple
acute
chronic
lymphoid
define
mangagement
prehospital problems
infection - neutrophils
anaemia - RBCs
bleeding - platelets
neutropenia
plasma (55%)
production
composition
nutrients
hormones
electrolytes
water
proteins
platelets
thrombocytopenia
Coagulation disorders
haemophilia
treatment
DIC
Blood types
donors and recipients
negative can only receive negative
O can give to everybody
A can only give to A or AB, same with B
haematochromatosis
lymphoma
types
hodgkins
non-hodgkins
Rheumatology and Musculoskeletal
Rheumatic fever
define
inflammation of heart, vessels and joints after Strep.A infection, mainly affects children and teens
Osteoporosis
define
weakening of bones
mechanism
old age, post-menopausal women (decreased oestrogen)
management
drugs
calcium supplements
HRT
Rheumatoid arthritis
define
chronic inflammation of joints
management
drugs
NSAIDs
corticosteroids
DMARDS
methotrexate
Non-traumatic back pain
causes
Sciatica
Disk herniation
Spinal Stenosis
Ankylosing spondylitis
Scoliosis
Kyphosis
Lordosis
Gout and Pseudogout
Corda Equinae
Lupus
types
systemic lupus erythematosus (SLE)
discoid
mechanism
mostly in females
elevated autoimmune response that's not suppresible
clinical signs
butterfly rash on face
phtosensitivity
inflammation in heart, mouth and joints
management
long term
anti-inflammatories
avoid emotional and physical stress
Toxicology
approach
toxidrome recognition
main toxidromes
sympathomimetic
opioid
management
drugs
naloxone
D - drug paraphernalis
airway and breathing, ensure good o2 before naloxone
other presentations - seizures, PO, hypothermia, compartment syndrome
CNS depression
hypoventilation/tension
pinpoint pupils (miosis)
N/V
serotonin
causes
SSRI
SNRI
anticholinergic
causes
TCAs
Mechanism
Muscarinic
cholinergic
Mechanism
Nicotinic
Muscarinic
other
benzos
carbon monoxide
oral analgesics
salicylates
paracetamol
NSAIDS
iron
hypoglycaemics
cardiovascular
beta blocker
Ca2+ channel blocker
digitalis
management
drug
digibind
corrosives
herbicides
paraquat
glycophosphates
hydrocarbon
cyanide
recreational
stimulants
classical
novel
depressants
classical
novel
GHB
hallucinogenics
classical
novel
stabilisation
decontamination
antidote
supportive care
Anaphylaxis and Toxinology
Anaphylaxis
management
drugs
adrenaline
glucagon
refractory anapylaxis
clinical signs
Envenomation
spider
funnelweb
signs
phase 1 - chlinergic and adrenergic crisis
phase 2 - refractory hypotension, apnoea cardiac arrest
redback
snake
brown
paralysis tick
blue ringed octopus
signs
painless
numbness
respiratory paralysis
jellyfish
box
drugs
antivenom
magnesium
irukandji
drugs
vinegar - inactivates nematocysts
methoxy/morphine/icepacks
mgSo4 CCP only
blue bottle
hot water or ice packs
toxidrome
bullrout fish
hot water or ice
Anaphylactoid
when to PIB?
all snakes
funnel web
blue ringed octopus
cone shell
bee and wasp in allergic
Sepsis, Infectious and Communicable diseases
Malaria
define
mosquito parasite
Septic shock
clinical signs
causes
Hepatitis
define
liver infection
types
A, B, C
Meningitis
Meningococal septicaemia
management
drugs
ceftriaxone
adult
paed
indication
only non-blanching rash
clinical signs
sepsis
define
life threatening organ dysfunction caused by dysregulated host response to infection
management
drugs
paracetamol
adrenaline (high risk) CCP only
IV fluids
O2
prenotification if mroe than two vital signs
septic shock
hypotension despite fluid resus
criteria
high risk
BP - 90
HR - 130
RR - 25
ALOC
O2 - need o2 to maintain above 92%
skin - mottled
chemo
anuria - last 18hrs
moderate risk
qSOFA (quick sepsis organ failure assessment)
H - hypotension
A - ALOC
T - tachyponoea
Palliative Care
Goals
pain relief
death is normal
don't speed up or slow down
pscyhological and spiritual support
family support
Communication
Infection in oncology patients