13th November Flashcards
What should be used first line for sedation of an agitated patient?
Chlorpromazine
What is the management of Alzheimers disease?
1st line- acetylcholinesterase inhibitors such as donepezil, galantamine and rivastigmine
2nd line- NMDA receptor antagonist, memantine
When is memantine used in Alzheimers disease?
Moderate Alzheimers who are intolerant/contraindicated to have 1st line
Add on drug for moderate-severe disease
Monotherapy in severe disease
When is donepezil contraindicated?
In bradycardia
What is the medical management of miscarriage?
Mifepristone- weakens attachment to endometrial wall, softens cervix and causes uterine contractions
48 hours later- misoprostol, furthers contractions and expels uterine products
What is the management of incomplete miscarriage?
Single dose of misoprostol
How is termination of pregnancy done medically?
Mifepristone followed by vaginal administration of misoprostol
What are causes of nasal septal perforation?
Granulomatosis with polyangiitis
Cocaine Use
Nose Picking
Decongestants
What is Granulomatosis with Polyangiitis?
Autoimmune vasculitis affecting resp tract and kidneys
What are features of granulomatous with polyangiitis?
Epistaxis
Sinusitis
Nasal Crusting
Dyspnoea
Haemoptysis
Rapidly progressing glomerulonephritis
Vasculitic rash
Eye involvement
What is Atelectasis?
Collapse of part or all of the lung
What is a risk factor for atelectasis?
Anaesthesia
Prolonged bed rest with minimal position changes
Shallow breathing
Underlying lung disease
What are features of mycoplasma pneumoniae?
Flu like symptoms initially
Then dry cough
What are complications of mycoplasma pneumoniae?
Cold agglutins (IgM)- lead to haemolytic anaemia or thrombocytopenia
Erythema multiforme/nodosum
Guillain Barre Syndrome
Bullous myringitis- painful vesicles on tympanic membrane
Pericarditis
Hepatitis
Pancreatitis
What is the management of mycoplasma pneumoniae?
Doxycycline or macrolide e.g. erythromycin
What is Goodpastures disease?
Autoimmune disorder causing damage to kidneys and lungs
What are symptoms of goodpastures
Haematuria
Haemoptysis
Pain on urination
Dyspnoea
Pale skin
Fatigue
Proteinuria
What antibodies are detected in Goodpastures?
Anti-glomerular basement membrane antibodies
What is the management of goodpastures?
Immunosuppression and plasmapheresis
what is refeeding syndrome?
Combination of electrolyte balances brought on by sudden introduction of nuttrition
What electrolyte imbalances are seen in refeeding syndrome?
Hypomagnesia
Hypokalaemia
Hypophosphataemia
What findings are found with Thalassaemia major?
Hypochromic, microcytic anaemia
Target cells
What laxative should be used in a aptient with an ileostomy for constipation?
Magnesium SulfateW
What is the management of an arterial ulcer?
If no signs of infection or necrosis then hydrocolloid dressing
What is Peutz Jegher syndrome?
Autosomal dominant condition
Leads to numerous polyps in GI tract
What are features of PJS?
Pigmented lesions on lips, oral mucosa, face, palms and soles
Hamartomatous polyps in GI tract (often small bowel)
- can lead to SBO commonly due to intussuception
What are risk factors for PPH?
Previous PPH
Porlonged labour
Polyhydraminos
Multiple pregnancy
Antepartum haemorrhage
PET
Placenta previa
Macrosomia
Em C section
What are signs of congenital heart failure in babies?
Postnatal:
Heart murmur
Cyanosis
Poor feeding
Shortness of breath
Sweating
Hepatomegaly
