Cytochrome P450 Inducers & Inhibitors

Common ototoxic medications

"FAV Q&A"

Furosemide (and other loop diuretics) Aminoglycosides Vancomycin Quinine Aspirin

Management of acute MI

Reduce anginal pain

Morphine (+ anti-emetic)

Oxygen

Nitrate

Initiate reperfusion

Anti-platelet (aspirin, clopidogrel)

Thrombolytic (rtPA)

Primary angioplasty (PTCA)

Anticoagulant (heparin)

Protect myocardium

Beta-blocker

ACE inhibitor

Secondary prevention

Aspirin

Lipid-lowering (statin)

Lifestyle

Helpful mnemonic foe MI treatment.

The renin-angiotensin system that helps regulate the constriction of blood vessels and blood pressure.

Hypokalaemia ECG changes

U have no pot and you have no T but you have a long PR and a long QT

Low potassium causes:

U waves (small deflection immediately after T wave)

Flattened/inverted T waves

Prolonged PR interval

Apparent prolonged QT interval (due to fusion of T and U waves)

Also:

Increased P wave amplitude

Widespread ST depression

Carpal bones mnemonic

So Long Till Pinky, Here Comes The Thumb

Scaphoid

Lunate

Triquetrum

Pisiform

Hamate

Capitate

Trapezoid

Trapezium

(going anti-clockwise in this diagram)

Causes of drug-induced lupus

SHIP

Sulfasalazine & Sulfonamide Hydralazine Isoniazid Procainamide & Phenytoin

This is by no means a definitive list (they are many!) but these are some of the most common causes.

Haemosiderin staining

"Haemosiderin staining" describes orange/red/brown skin hyperpigmentation caused by haemosiderin (an iron-containing pigment found in blood) leaking into the skin.

Causes:

Chronic venous insufficiency (in lower legs)

Skin inflammation

Trauma e.g. wound, fracture, surgery

Pigmented purpuric dermatoses

Haemochromatosis

Haemosiderin staining may be exacerbated by anticoagulant use as this increases extravasation (leakage) of red blood cells into the skin.

See an example here.

I don’t know what stage of the semester you’re at right now but let someone in exam period (me) give you some advice on revision: Start early. Early as in NOW. Start now to not end up like me 

Causes of Acute Pancreatitis

In the UK and US, the main causes are gallstones and alcohol.

Use the mnemonic 'I GET SMASHED':

Idiopathic

Gallstones

Ethanol

Trauma

Steroids

Mumps / Malignancy

Autoimmune

Scorpion stings

Hypercalcaemia / Hypertriglyceridaemia / Hypothermia

ERCP

Drugs (including azathioprine, mesalazine, bendroflumethiazide, furosemide, steroids, sodium valproate)

Distribution of calcium in the body

Bone calcium (99%)

Ca^2+ and PO4^3+ form hydroxyapatite

Plasma calcium

Diffusible pool

~50% of plasma calcium is free/unbound ionic Ca2+ (physiologically important form)

~10% of plasma calcium is complexed with small molecular weight compounds (citrate, phosphate)

Non-diffusible pool

~40% of plasma calcium is bound to calcium-binding proteins and plasma proteins (albumin)

The body utilises plasma albumin-bound calcium as a circulating reserve