16/6 Flashcards
Give ddx for breast lump
Breast cancer
Fibroadenoma
Breast cyst
Fibrocystic changes
Ductal ectasia
Surgery for endometrial cancer
Hysterectomy with bilateral oo-ophectomy
What cancers does the COCP put you at increased risk of?
Breast and cervical - the ones they screen for
What things are important to ask about when invx causes of palps
- Caffiene and alcohol
- Hyperthyroid - tremor, heat intolerance, agitated, weight loss, diarrhoea
What meds to start in intermittent claudication?
Atorvastatin
Clopidogrel
(+ maybe HTN and diabetes meds)
Investigation and management for angina
ECG
Cardio exam
Bloods for everything inc. TFTs
- CTA
Aspirin and statin
Beta-blocker - bisoporol or CCB - verampil
Risk factors for endometrial and cervical ca
Endometrial
- obesity
- nulliparty
- early menarche
- late menopause
- oestrogen-only HRT
Cervical
- COCP
- HPV
- Smoking
- multiple sexual partners
What can cause post-coital bleeding
Cervical
- cervical ectropion
- cervical ca
- cervical polps
PID
STIs
Atrophic vaginitis
Questions to ask in gynae
Gynae
- smears UTD?
- any abnormal findings
- periods ok? - regular? - how long? - painful/very heavy?
- anything you have seen gynae for in the past?
- any recent or lifelong STIs
Obs
- ever been pregnant before?
- any TOP or miscarriages?
- what were the births and pregnancies like?
- did you breastfeed?
Contraception
- on any contracpetion atm?
- any side effects from that?
Graft rejection - when hyper, acute and chronic
Hyper - within minutes
Acute - <6 months
Chronic >6months
How is felcainide taken?
Carry it with you and take when you feel symptoms coming on
for young pts with paraoxysmoal AF
What causes steatorrhoea?
Fat malabsorption
- Pancreatic problem - not releasing the enzyme
- GI malabsorption
- Biliary tract problem - blockage etc
Palps invx and management
Bedside
- cardio exam
- ECG
Bloods
- FBC, U+Es, LFTs, TFTs
Imaging
Special tests
- Holter monitoring (wearable ECG for 24hrs - will be fitted at the hospital - keep a diary alongside it)
Management
- dependant on cause
Paroxysmal AF = felcanide (pill in pocket) if CHADVAS - give DOAC
Episodic SVT = valsalva maneouver (popping ears technique)
- B-blockers can reduce episodes
- ablation
What meds can cause gynaecomastia?
Spironlactone
Ketoconazole
Finasteride
Digoxin
Cannabis
Cimetidine
Oestrogens
Anabolic steroids
Go over CHA2DS2VAS again
Congestive HF
HTN
Age >75 = 2
Diabetes
Stroke/TIA/Thromboembolism
Vascular disease
Age 65-74
Sex
