AMC EXAMS AUSTRALIA ,AUSTRALIAN MEDICAL EXAMS,MCQS,CLINICALS.

The therapeutic indications for bronchoscopy include: removal of secretions and mucus plugs: often used in ITU pneumonic lobar collapse allergic bronchopulmonary aspergillosis removal of foreign bodies stent insertion in benign airways disease: for example in relapsing polychondritis

Diagnostic role of flexible bronchoscopy lung cancer: the type and operability of lung tumours can be assessed pneumonia: good for identifying infecting organism interstitial lung disease: permits histoloy and analysis of bronchoalveolar lavage causes of haemoptysis, cough and recurrent pneumonia

bronchodilators Bronchodilation is a phenomenon of sympathetic stimulation. Thus drugs which attempt to achieve it include: 1.sympathomimetics salbutamol } beta-2 adrenoceptor terbutaline } agonists fenoterol } rimiterol } salmeterol } adrenaline isoprenaline 2.antimuscarinics Anticholinergics are drugs which antagonise cholinergic receptors. 3.xanthinesTypes of sympathomimetic include: Xanthines are compounds which inhibit phosphodiesterase and thus are able to produce bronchodilatation. theophylline aminophylline caffeine, theophylline and tannin

Lymphoedema after axillary dissection and/or radiotherapy. It can arise at any time, even many years after treatment. ● Cardiovascular toxicity after radiotherapy, and increased cardiovascular risk after premature menopause. Treat with appropriate medical and risk-reduction strategies. ● Congestive heart failure associated with anthracyclines and trastuzumab. Monitor (mandatory with trastuzumab) and manage medically if present. ● DVT, stroke (tamoxifen). Treat as usual if present. ● Hot flushes after premature menopause, tamoxifen or aromatase inhibitors (less so). SSRIs, SNRIs and gabapentin may be useful. Alternatives such as black cohosh have also been suggested. ● Vaginal dryness and dyspareunia. Non-hormonal moisturisers and lubricants; use local oestrogen with caution as there may be systemic absorption. ● Loss of libido resulting from altered body image, radiotherapy, chemotherapy, depression or dyspareunia. Counselling may be helpful, as well as appropriate medical treatment. ●...

Relative risk Advanced age >10 Genes, family history, personal history BRCA1/2 mutation 5-10 Breast cancer in first-degree relative 2 Previous atypical hyperplasia 4-5 Previous breast cancer >4 Breastfeeding for 12 months 0.96 One birth 0.93 Two births 0.84 Menstrual/reproductive history Menarche before 11 years 3 Menopause after 54 years 2 First child after 30 1.2-1.4 First child after age 40 3 Current use of HRT 1.3-1.6 Current use of oral contraceptive 1.2 Other Living in a developed country (?oestrogen exposure) 5 High breast density on mammogram (?oestrogen exposure) >5 Abnormal exposure to ionising radiation 3 ‘Lifestyle’ High socioeconomic status 2 High postmenopausal BMI 2 High premenopausal BMI One alcoholic drink daily 1.07 Lancet 2005; 265: 1727-1741. Cancer 2004; 101:353-62.

GOOD DAY 1.Zoster immunoglobulin (ZIG) should be offered to pregnant, varicella-seronegative women with significant exposure to varicella-zoster virus (VZV) (chickenpox) infection. 2.Oral aciclovir prophylaxis should be considered for susceptible pregnant women exposed to VZV who did not receive ZIG or have risk factors for severe disease. 3.Intravenous aciclovir should be given to pregnant women who develop complicated varicella at any stage of pregnancy. 4.Counselling on the risk of congenital varicella syndrome is recommended for pregnant women who develop chickenpox. 5.ZIG should be given to a baby whose mother develops chickenpox up to 7 days before delivery or up to 28 days after delivery. 6.Intravenous aciclovir should be given to babies presenting unwell with chickenpox, whether or not they received ZIG. 7.Breastfeeding of babies infected with or exposed to VZV is encouraged. 8.A mother with chickenpox or zoster does not need to be isolated from her own baby. 9.If siblings at h...