Your Daily Meds - 1 December, 2022
Good afternoon and welcome to your Thursday dose of Your Daily Meds.
Bonus Review: The normal cardiac output for a young subject at rest is about 5 litres per minute. To what value can the cardiac output increase in an athlete under strenuous exertion?
Answer: The CO can increase up to about 25-30 litres per minute. The majority of this extra flow is going to the skeletal muscles.
Query:
Which of the following correctly describes the normal venous drainage of the adrenal glands?
Left via the left renal vein; right via the inferior vena cava
Left via the left phrenic vein; right via the inferior vena cava
Right via the right renal vein; left via the left renal vein
Right via the right renal vein; left via the inferior vena cava
Right via the right gonadal vein; left via the inferior vena cava
Have a think.
Scroll for the chat.
Question:
Secondary amenorrhoea is most likely to originate from which of the following sites?
Hypothalamic-pituitary
Ovary
Endometrium
Lower genital tract
Iatrogenic cause
Have a think.
Scroll for the chat.
Anatomical:
Righto, so - left adrenal gland via the left renal vein; right via the inferior vena cava.
See the image below for the normal venous drainage of the adrenal glands:
Cessated:
Secondary amenorrhoea involves the cessation of menstruation for 6 or more months in those with previously regular periods. This is contrasted to primary amenorrhoea, the failure to commence menstruation.
Normal menstrual function requires a functional hypothalamic-pituitary-ovarian axis, functional uterine endometrium and normal lower genital tract. Secondary amenorrhoea can be considered based on the level at which the pathology occurs. Central causes (hypothalamic-pituitary dysfunction) are more likely to have low levels of follicle-stimulating hormone (FSH) or luteinising hormone (LH) being released from the hypothalamus. Peripheral causes, as with dysfunction of the ovaries or endometrium, are more likely to have high levels of FSH and LH.
The origin of secondary amenorrhoea is hypothalamic-pituitary in approximately 85% of cases.
Bonus: What would happen to the cardiac output in a young healthy person if you gave them a whack of Atropine to increase their heart rate from 60 to 120 beats per minute?
Answer in tomorrow’s dose.
News: I made a little Ward Call Course for you all. It maps out an Evening Ward Call shift and covers a bunch of common tasks that you may need to do, like:
Deteriorating Patients
Heparin Infusions
Fluid Orders
Electrolyte Replacement
Difficult patients - Discharge Against Medical Advice, Ryan’s Rule
End of Life etc
You can find the course page here:
It’s free and always will be. Let me know what you think.
Remember, you are free to rip these questions and answers and use them for your own flashcards, study and question banks.
As always, please contact me with any questions, concerns, tips or suggestions. Have a great day!
Luke.