Good morning and welcome to your Friday dose of Your Daily Meds.
Bonus Review: What is the chemoreceptor trigger zone (CTZ)?
Answer: The CTZ is located in the area postrema - in the lateral walls of the 4th ventricle. It is outside the blood brain barrier. Various substances can stimulate the CTZ, which has inputs into the vomiting centre, resulting in vomiting.
Public Healthiness:
Which of the following is an example of primary prevention?
* Immunisation program
* Breast cancer screening
* Performance of a Papanicolau (Pap) smear
* Regular hearing tests for workers in high noise environments
* Pulmonary rehabilitation program
Have a think.
Scroll for the chat.
Kiddies Case:
A three-week-old infant comes to the Emergency Department with his parents.
They report that their child has been vomiting and losing weight.
They also think there has been a yellowing of their baby’s skin.
The infant is afebrile and haemodynamically stable.
Which of the following is the most likely diagnosis?
* Galactosaemia
* Hepatitis
* Gilbert’s syndrome
* Cholecystitis
* Neonatal haemochromatosis
Have a think.
More scroll for more chat.
The Preventer:
This question tests knowledge of primary, secondary and tertiary prevention methods.
Primary prevention methods are those aiming to limit the incidence of disease and disability in the community. This is achieved by reducing or eliminating the factors that would impair health and function, and promoting factors that are protective. The objective of primary intervention is to prevent the occurrence of disease. Examples of primary prevention include immunisation programs, such as tetanus prophylaxis, and programs to discourage the uptake of smoking.
Secondary prevention aims to prevent progression of disease, with examples including breast cancer screening, Pap smear tests, and screening for hearing loss in high-noise environments.
Tertiary prevention aims to reduce the effects of established disease, with examples including pulmonary rehabilitation and self-management programs for those with chronic illness.
Yellow Baby:
Galactosaemia, or galactose-1-phosphate uridyltransferase (GALT) deficiency, is an autosomal recessive disorder characterised by impaired conversion of galactose-1-phosphate and uridine diphosphate (UDP) glucose to UDP galactose and glucose-1-phosphate. Almost all infants on lactose-containing diets, such as milk formulas, will manifest poor weight gain.
Normally, galactosaemia is detected in new-born screening tests. It commonly presents with poor growth, jaundice, vomiting, lethargy and, in some cases, cataracts.
Hepatitis and cholecystitis are unlikely given the infant is afebrile, and the young age.
Gilbert’s syndrome is a mild disorder of bilirubin metabolism in which there is decreased activity of the glucuronosyltransferase enzyme. Jaundice often manifests in times of illness. Typically, no treatment is required for Gilbert’s syndrome, and it is unlikely to cause vomiting and poor weight gain.
Neonatal haemochromatosis is a disorder characterised by severe liver disease and deposition of iron in extrahepatic sites. It is commonly associated with oligohydramnios, splenomegaly, oliguria and jaundice in the few days after birth.
Bonus: What happens during a cough?
Answer in Monday’s dose.
Closing:
Thank you for taking your Meds and we will see you Monday for your MANE dose. As always, please contact us with any questions, concerns, tips or suggestions. Have a great day!
Luke.
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