can only be diagnosed if psoriasis is present (F) also if fhx of psoriasis ref K&C

Question 26

1. 
   F
   
2. 
   T
   
3. 
   T
   
4. 
   F
   
5. 
   T
   

A Fib has absent x descent/a wave in JVP

Pulsus alternans occurs in LVF

Pulsus paradoxus is found in pericardial effusion, constrictive pericarditis and asthma.

Plauteau pulse is found in aortic stenosis.

Question 27

1. 
   T
   
2. 
   T
   
3. 
   F?
   
4. 
   F
   
5. 
   T
   

Plasmapharesis can be used as treatment in hyperviscosity syndrome due to myeloma, waldenstroms macroglobulinaemia, polycythaemia, leukaemia.

Plasmapheresis is a process in which the fluid part of the blood, called plasma, is removed from blood cells by a device known as a cell separator. The separator works either by spinning the blood at high speed to separate the cells from the fluid or by passing the blood through a membrane with pores so small that only the fluid part of the blood can pass through. The cells are returned to the person undergoing treatment, while the plasma, which contains the antibodies, is discarded and replaced with other fluids. Medication to keep the blood from clotting (an anticoagulant) is given through a vein during the procedure. Today, plasmapheresis is widely accepted for the treatment of myasthenia gravis, Lambert-Eaton syndrome, Guillain-Barré syndrome and chronic demyelinating polyneuropathy. Its effectiveness in other conditions, such as multiple sclerosis, polymyositis and dermatomyositis, is not as well established.

An important use of plasmapheresis is in the therapy of autoimmune disorders, where the rapid removal of disease causing autoantibodies from the circulation is required in addition to slower medical therapy.Other uses are the removal of blood proteins where these are overly abundant and cause hyperviscosity syndrome.

Examples of diseases that can be treated with plasmapheresis:

• 
  Guillain-Barré syndrome
  
• 
  Chronic inflammatory demyelinating polyneuropathy
  
• 
  Goodpasture's syndrome
  
• 
  Hyperviscosity syndromes:
  
  • 
    Cryoglobulinemia
    
  • 
    Paraproteinemia
    
  • 
    Waldenström macroglobulinemia
    
• 
  Myasthenia gravis
  
• 
  Thrombotic thrombocytopenic purpura (TTP)
  
• 
  Wegener's granulomatosis
  
• 
  Lambert-Eaton Syndrome
  

Plasmapheresis is a plasma donation not platelets