11/6 Flashcards
Paediatric asthma pathways
How does this differ if child <5
- SABA
- V.low dose (100mcg) ICS
- LTRA
- STOP LTRA and + LABA
- SABA + low-dose MART (nothing else)
- SABA + mod-dose MART
- specialist
If <5yrs
SABA + 8wk trial of mod-dose ICS
Then step 3 - if that fails specialist advice
How hypoxic/acidoic do pts have to be to be eligible for LTOT
<7.3 for both - magic number 7+3=10
ALSO THE MAGIC NUMBER FOR LIVER TRANSPLANT IN PARACETMOL OD
How are kids diagnosed with asthma?
PEFR and brochodilator reversiblity
- if normal -> FeNO
Indications for starting steroids in sarcoidosis
PUNCH
Parenchymal lung disease (nodules)
Uveitis
Neurological involvement
Cardiac involvement
HyperCa
What antibiotic for legionella?
Clarithromycin - (imagine Ella as a mice)
What should follow all cases of pneumonia 6 weeks later?
CXR to assess clinical eolution q
What med is given to CF pts
Lumacaftor/ivacaftor = orkambi
What is included in S of asceptic
Tone
Volume
Quanitty
Fluency
Rate
What can you ABSOULTELY NOT forget in psych hx
RISK ASSESSMENT !!!! - ASK IN INSIGHT
What is the conservative management of COPD
COPD
Can you eat better?
Omit smoking
Pulmonary rehab
Drug - vaccinate
How do you obtain a wound swab?
Rotate the swab several times over the ulcer with enough pressure to illict fluid if approriate
What else needs to be asked in insight?
Taking risks esp in mania
What associated sx are importnat to ask in anxiety?
- Panic attacks
- Intrusive thoughts - ever had unpleasant thoughts that enter your head that you can’t get rid of?
- Obssesive behaviours - any routines or rituals that you do to help manage worries?
GAD
Go on then do it! jump! = intrusive thoughts
Attack = panic attacks
Do it again, do it again = obsessive behaviours
Define
- ruminating
- catastrophising
ruminating = constant thinking negative thoughts without solution
catastrophising = jump to worst possible conclusion
What is schizoaffective disorder?
Psychotic and affective (depression or mania)
Alcohol with paracetomol OD - good or bad?
Some studies have proven that acute alcohol intake is acc a protective factor!
Chronic on other hand is bad
Ring-enhancing lesions in the brain in HIV pt
Cerebral toxoplasmosis
Name a DPP4 inhibitor
-gliptin
How are diabetes drugs managed?
- Metformin - if struggling MR metformin. If cardiac risk + SU as well
- dual oral therapy
- insulin
LADA vs MODY
LADA - more like T1DM - have antibodies but onset typically after 30
MODY - more like T2DM but onset in teenage and young adults
What painkiller can cause serotonin syndrome
Tramadol
Go over paracetomol OD chart
How quick is acetlycysteine given?
Over 1 hour
What is the max dose of metformin?
500mg TDS
Vision colour changes caused by what drugs:
- blue vision
- yellow-green
Blue = sildenafil = viagra
Yellow-green = digoxin
When should albumin:creatine ratio be measured?
Early morning specimen
What is the preffered way to feed MND patients?
PEG
What is the cut-off for pregnancy-induced HTN?
20 weeks
Go over the L of GALS
Knee extension and flexion feeling the joint
Internal rotation of the hip
Knee effusion
Check the foot
Squeeze the MTP
Assess someones vision properly
Acuity
Colour vision
Acommodation and convergence - look at pen and wall
Shine light in eyes
H shape
Visual fields
