Which one of the following is equivalent to the pre-test probability?
Correct Answer C:
The prevalence is the proportion of a population that have the condition at a point in time whilst the incidence is the rate at which new cases occur in a population during a specified time period.
Pre and Post test odds and probability:
Pre-test probability:
Post-test probability:
Pre-test odds:
Post-test odds:
What is the main action of atrial natriuretic peptide?
Atrial natriuretic peptide is a powerful vasodilator.
Atrial natriuretic peptide:
Basics:
Actions:
A 28-year-old female undergoes a renal transplant for focal segmental glomerulosclerosis. Within hours of the operation the patient becomes unwell with features consistent with severe systemic inflammatory response syndrome. The patient is immediately taken back to theatre and the transplanted kidney is removed.
What type of immunoglobulins are responsible for the graft rejection?
Hyperacute graft rejection is due to pre-existent antibodies to HLA antigens and is therefore IgG mediated.
Renal transplant: HLA typing and graft failure:
The human leucocyte antigen (HLA) system is the name given to the major histocompatibility complex (MHC) in humans. It is coded for on chromosome 6.
Some basic points on the HLA system:
Graft survival:
Post-op problems:
Hyperacute acute rejection (minutes to hours):
Acute graft failure (< 6 months):
Causes of chronic graft failure (> 6 months):
You review a 24-year-old woman with a history of asthma in the Emergency Department. She has been admitted with acute shortness of breath associated with tongue tingling and an urticarial rash after eating a meal containing shellfish. Her symptoms settle with nebulized salbutamol and intravenous hydrocortisone.
What is the most useful test to establish whether this episode was due to anaphylaxis?
Correct Answer A:
Anaphylaxis - serum tryptase levels rise following an acute episode.
Serum tryptase levels may remain elevated for up to 12 hours following an acute episode of anaphylaxis.
Anaphylaxis:
Anaphylaxis may be defined as a severe, life-threatening, generalized or systemic hypersensitivity reaction. Anaphylaxis is one of the few times when you would not have time to look up the dose of a medication. The Resuscitation Council guidelines on anaphylaxis have recently been updated.
Adrenaline is by far the most important drug in anaphylaxis and should be given as soon as possible.
The recommended doses for adrenaline, hydrocortisone and Chlorphenamine are as follows:
Adrenaline can be repeated every 5 minutes if necessary. The best site for IM injection is the anterolateral aspect of the middle third of the thigh.
Common identified causes of anaphylaxis:
Which one of the following conditions is usually inherited in a X-linked dominant fashion?
Correct Answer E:
Alport's syndrome is inherited in a X-linked dominant fashion in around 85% of cases.
X-linked dominant:
The following conditions are inherited in a X-linked dominant fashion*:
*Pseudohypoparathyroidism was previously classified as an X-linked dominant condition but has now been shown to be inherited in an autosomal dominant fashion in the majority of cases
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