Medicine Notes Medicine and Surgery Notes
Theses are my latest set of notes for my first year as a clinical medic, complementing the 3rd year curriculum perfectly. Each topic is briefly but thoroughly covered with clear headings and colour co-ordination.
The notes use a great mix of words and diagrams in an eye-pleasing layout making revision easier for you with plenty of space to annotate.
Each system is clearly marked and most of the core diseases are covered and broken down into prevalence, aetiology, clinical features, managemen...
The following is a more accessible plain text extract of the PDF sample above, taken from our Medicine and Surgery Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:
Chronic bronchitis – cough & sputum production on most days for 3 months of 2 successive years
Emphysema – histologically enlarged air spaces, distal to terminal bronchioles with destruction of alveolar walls
COPD or Asthma, not both
10-20% of over-40s
PINK PUFFER
Increased alveolar ventilation
Normal PaO2
Low PaCO2
Breathless but not cyanosed
Type 1 respiratory failure
BLUE BLOATER
Reduced alveolar ventilation
Low PaO2
High PaCO2
Cyanosed but not breathless
May develop Cor Pulmonale
Clinical features
Complications
Acute exacerbations
Infection
Polycythaemia
Respiratory failure
Cor pulmonale
Pneumothorax
Lung carcinoma
Investigations
Lung function tests
FEV1:FVC is reduced
CXR is often normal
CT
Hb level can be raised due to hypoxaemia
ABG
Hypoxaemia
Hypercapnia
Sputum for exacerbations
Strep. Pneumonia
H. influenza
ECG
ECHO
Abnormal, permanently dilated airways
Inflamed, thickened, irreversible damage
Aetiology
Congenital
Cystic fibrosis
Young’s syndrome
Primary ciliary dyskinesia
Kartagener’s syndrome
Post-infection
Measles
Pertussis
Bronchiolitis
Pneumonia
TB
HIV
Other
Bronchial tumour
Allergic bronchopulmonary aspergiollosis
RA
UC
Investigations
CXR
Dilated bronchi
CT
Sputum culture
Sinus X-ray
Serum immunoglobulins
Sweat electrolytes
Mucociliary clearance
Treatment
Postural drainage
Twice daily
Chest physio
ABX
Bronchodilators
Salbutamol
Corticosteroids
Prednisolone
Surgery
Localised disease to control haemoptysis
Caused by mutations of the CF transmembrane conductance regulator gene
Investigations
Sweat test: high sodium sweat concentration
Genetics: screen for mutations
Faecal elastase: pancreatic dysfunction
Inflammation of the substance of the lungs
Usually caused by bacteria
Investigations
CXR
Infecting agent | Frequency as cause | Clinical circumstance |
---|---|---|
Streptococcus pneumoniae | 35-80% | CAP in usually fit patients |
Mycoplasma pneumoniae | 2-14% | CAP in usually fit patients |
Influenza A virus | 10-15% | CAP in usually fit patients |
Haemophilus influenzae | 5-6% | Pre-existing lung disease |
Chlamydia pneumoniae | 4-13% | CAP |
Chlamydia psittaci | 4-13% | Contact with birds |
Staphylococcus aureus | 3-14% | Children, IV drug users, assoc with flu |
Legionella pneumophila | 2-15% | Institutional outbreaks, sporadic, endemic |
Coxiella burnetii | 1% | Abattoir and animal hide workers |
Pseudomonas aeruginosa | 4-9% | Cystic fibrosis |
Enteric Gram-negatuve bacilli | 6-12% | |
TB | 1-5% |
Raised WCC, ESR & CRP
Management
ABX
CAP – amoxicillin/co-amoxiclav/clarithromycin
HAP – IV aminoglycoside + antipseudomonal penicillin
Oxygen
IV fluids
Analgesia
Multisystem granulomatous disorder of unknown cause
20-40yrs women>men
Clinical features
50% present with respiratory Sx and abnormalities are found on a CXR
Investigations
CXR
FBC, normocytic anaemia, raised ESR & CRP
Serum calcium, raised
Transbronchial biopsy
Serum ACE, raised in untreated patients
Lung function
Treatment
If the disease does not spontaneously improve after 6 months, 30mg prednisolone for 6 weeks is needed, reducing to 15mg for 6-12 months
1.3 million deaths annually
3rd most common cause in the UK after heart disease & pneumonia
Male: female 3:1
Significant association with smoking and occupational factors (asbestos, arsenic, chromium, oil etc)
No abnormal physical signs
Pleural effusion or lobar collapse possible
Direct spread
Pleura & ribs
Pancoast’s tumour – pulmonary apex
Can induce Horner’s syndrome...
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Theses are my latest set of notes for my first year as a clinical medic, complementing the 3rd year curriculum perfectly. Each topic is briefly but thoroughly covered with clear headings and colour co-ordination.
The notes use a great mix of words and diagrams in an eye-pleasing layout making revision easier for you with plenty of space to annotate.
Each system is clearly marked and most of the core diseases are covered and broken down into prevalence, aetiology, clinical features, managemen...
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