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Year 4 - 5 Qs A Day > 10/6 > Flashcards

10/6 Flashcards

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1
Q

Amiodarone dosage

A

300mg

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2
Q

What always ALWAYS ALWAYS needs to come in with depression Qs

A

SUICIDE RISK

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3
Q

The name of the vitamin injection for alcoholics

A

Parbinex

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4
Q

Hyperaldosteronism is the most common cause of secondary HTN

How do you invx the difference between primary and secondary and what can cause both

How do you manage both

A

Primary (increased aldosterone but reduced renin)
- single adenoma (Conn’s syndrome)
1. bilateral adrenal hyperplasia - MOST COMMON
- cancer

Secondary (reduced BP to the kidneys = increased renin = increased aldosterone)
- renal artery stenosis
- compression of renal arteries by mass

Invx
- renin:aldosterone ratio
-> just aldosterone high = primary
-> both high = secondary

Imaging
1. CT abdo if normal ->
2. Adrenal venous sampling (distinguish between Conns and bilateral hyperplasia)

Manage
Primary = resection of tumour, if bilateral = spironalcatone

Secondary = renal artery angioplasty

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5
Q

When does the HbA1c target move from 48 to 53

A

If on more than one med or if one of the meds has an increased risk of hypo

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6
Q

What meds are used in alcohol abstinence that:
- deterrent med -> makes you violently sick if u drink on it
- anti-craving medication

A
  1. Disulfiram (D = deterrant)
  2. Acamprosate (AC = anticraving)
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7
Q

LAMBAST meds again

A

Lithium
Aspirin
Methotrexate
Benzos
Amiodarone
Sulfonamides (-zole)
Tetracyclines

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8
Q

How long must have depressive symptoms before it can be classed as a depressive episode?

A

2 weeks

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9
Q

Core symptoms of depression relate to mild, moderate and severe

A

MEE

Mood - low mood
Energy - low energy
Excitement - none anymore

2/3 core + others = mild
3/3 + others = moderate
3/3 core + severe others (often with agitation/ can have psychosis) = severe

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10
Q

Pain on supination/pronation with golfers/tennis elbow

A

Golf = closed game = palm shut = pronation

Tennis = open game for all = palm open = supination

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11
Q

How many doses of IM adrenaline can be given before needing IV?

A

2 doses

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12
Q

What can trigger a migraine

A

CHOCOLATE

Chocolate
Hangovers
Organsms
Caffeine/cheese
Oral contraceptives
Lie-in
Alcohol
Travel
Exercise

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13
Q

When do surgeries require prophylactic abx?

A
  • If perforating a viscus e.g. appendectomy
  • already contaimanted surgery

Single dose IV antibiotic on anaesthesia

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14
Q

Exercise-induced desaturation in HIV?

A

Pneumocystis jiroveci pneumonia

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15
Q

Most common cause of endocarditis <2months post prosthetic valve replamcent

A

Staph epidermis - NOT THE CASE AFTER 2 MONTHS

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16
Q

What blood bottles for each thing in ABCDE

A

Purple - FBC, HbA1c
Pink - clotting and group and save
Yellow - U+Es, LFTs, troponin, amylase
Grey - lactate and glucose (grey of clouds in cloudy with a chance of meatballs = raining sugary milk - lactate and glucose)
Blue = d-dimer and coag (cold blue = cold coag and dimer)

17
Q

What colours are wide bore cannulas?

A

Orange and grey

18
Q

What are each of the following meds:
- salbutamol
- salmeterol
- beclothemasone
- budenoside
- ipatropium
- tiotropium

A
  1. SABA
  2. LABA
  3. ICS
  4. ICS
  5. SAMA
  6. LAMA

I stop for a TIA = I = short, TIA = long

19
Q

Overview of COPD management

A

Conservative
- stop smoking
- flu and pneumoccal vaccinations
- nutritional support
- pulmonary rehab

Drugs
1. SAMA/SABA
If asthmatic features -> 2. ICS + LABA (use SABA/SAMA as req)
No asthma -> 2. LABA + LAMA (use SABA PRN)

(can’t have SAMA and LAMA together as exacerbates side effects)

  1. If affecting daily life/ >1/2 exacerbations/yr = LABA + LAMA + ICS

(If asthmatic and affecting daily life but not 1/2 exacerbations per year - just do a 3 month trial of triple)

Surgery
- select pts get lung volume reduction surgery

20
Q

Drug management of asthma

A
  1. SABA
  2. ICS + SABA
  3. LABA OR MART
  4. Increase ICS dose or montelukast
  5. Specialist referral
21
Q

Signs of a life-threatening asthma attack

A

A CHEST

Arrthmyia/altered GCS

Cynaosis/normal CO2
Hypoxia/ <92%/ hypotension
Exhuastion
Silent chest
Threatening PEF <33%

22
Q

What antibiotic is used to reduce COPD exacerbations?

A

Azithromycin

23
Q

Go over asceptic - how to ask after each bit in a psych hx

A

A - will be covered by looking
- age
- clothing
- weight
- hygiene
- anything brought with them
- obvious scarring
- obvious stigmmata of disease
- maintaining eye contact
- body language
- distractable?
- build rapport
- facial expressions

S - rate and rhythm - assessed by just answering Q
- quantity -> poverty of speech and excessive speech
- tone -> monotonous or tremulous
- volume -> quiet and loud
- fluency -> stammering/stuttering, slurred, stilted

E - mood = exact words, affect = how they respond = “How are you feeling”
-> appropraite/incongurancey = mood matches affect
-> blunted/heighted
-> range (fixed, restricted or labile)
ASK ABOUT SUICIDE AND SELF/HARM TO OTHERS

P - hallucinations = visual/somatic/olfactory or auditory
auditory = 2nd/3rd person, thought echo (hear their own thoughts spoken/repeated out loud), command hallucinations
“do you ever see, hear, smell, feel or taste things that are not really there?”
what do these voices tell you? do they ever tell you to do certain things?
- if it’s a constant stream of chat = running commentary on their life

  • do you feel like you’ve changed or that you don’t recognise the person you currently are” = derealisation (world around them is not true reality) and depersonalistion (aren’t you true self anymore)

T -Thoughts
- go over specific thought terms
what’s been on your mind recently?, do you ever feel that people are you to harm you?, do you have any beliefs that aren’t shared by others you know? do you ever feel that specific events in the world relate to you somehow?”
- insertion = “do you ever feel like people are putting thoughts in your head”
- withdrawal - “people are taking ideas out your head”
- broadcasting - “others can hear your thoughts”

I - what do you think the cause of the problem is?
- what would you do if you went home now?

Cognition
where are you, what day is it, who bought you here and what is your name and DOB”

REMEMBER RISK ASSESSMENT - self harm and risk to others, substance misuse, taking care of physical needs e.g. meds

24
Q

SOCRATES for dementia/delirium

A

S - what are you forgetting - faces, names, words
O - when first start? when been getting more concerning? any partcicular trigger - infection, trauma, grief
C - personality changed?
R - affecting daily life - carers?, driving, ADLs
A - systemic enquiry - movement disorders + mood/psych assess
T - how is the memory loss changing over time?
E - any times or places that it is worse or more evident
S - safety = police, driving, wandering, cooking, finances

25
Q

What do the following terms mean (all under thought in MSE):
- delusions
- overvalued ideas
- thought blocking
- perseveration
- word salad
- ideas of reference

A

Delusions = fixed firm belief that cannot be rationalised with pt
Overvaled = solitary, abnormal belief not delusional or obsessional but occupying their life e.g. overweight in anorexia
Thought blocking = stopping mid-sentence and not being able to return to the point
Perseveration = repeating of an answer e.g. repeatting their name as the answer for all questions after being asked their name
Word salad = random words strung together with no link
Ideas of reference = think there are signs that are referring to them e.g. telly speaking to them etc.

26
Q

What is thought split into?

A

Form
Content
Possession

27
Q

Pt experienced auditory hallucinations 3hrs ago - go in the MSE?

A

NO but does go in your hx

28
Q
A

Year 4 - 5 Qs A Day (122 decks)

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