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Year 3 - GP Block > 18&19 - Cardiorespiratory Medicine > Flashcards

18&19 - Cardiorespiratory Medicine Flashcards

1
Q

Five smoking risks to the mother?

A
  1. Maternal DVT
  2. Pre-eclampsia
  3. Pre-term birth
    Premature membrane rupture
  4. Ectopic/Praevia
  5. Miscarriage
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2
Q

What are three methods of smoking cessation?

A
  1. NHS Stop Smoking
  2. Pharmaceuticals (NRT)
  3. E-Cigarettes
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3
Q

Smoking Cessation - Pharmaceuticals

A

Smoking cessation

1. Nicotine replacement
	Transdermal
	Lozenge
	Gum
	Inhaled
	Nasal
  1. Bupropion hydrochloride (150-300mg)

Or

Varenicline (500mcg-1mg)
	Attenuates withdrawal symptoms
  1. Clonidine (0.1-0.4mg) and nortriptyline (25-100mg)
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4
Q

Smoking cessation follow-up

A

Smoking cessation follow-up

  1. 2/52 of NRT
  2. 4/52 of Bupropion (antidepressant)/Vareniclone
3. Adherence
	 CO level
	ADRs
	Withdrawal
	How’s it going?
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5
Q

E cigarettes

  1. Evidence
  2. ADRs
  3. Relative danger
A

E-cigarettes

  1. Growing evidence
  2. No CO
    No Tar
  3. Less harmful
    Than liquid
    Than vapour
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6
Q

Asthma reversibility test?

A
  1. Spirometry
  2. Salbutamol (2x200mgc)
    Large volume spacer
  3. 20-30 minutes
  4. Repeat spirometry
    FEV1/FVC
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7
Q

What are different SABA inhalers?

A

Salbutamol

  1. MDI
    Ventolin 100mcg
    Salamol 100mcg
    Airomir 100mcg
  2. DPI
    Ventolin 200mg

Terbutaline
Bricanyl 500mcg

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8
Q

What are different ICS inhalers?

A

ICS

Belclometasone
Clenil modulite 50mcg
QVAR 50 Autohaler 50mcg

Fluticasone
Flixotide propionate 50mcg

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9
Q

ICS/LABA

A
  1. Seretide 250/25
    Fluticasone with salmeterol
  2. Symbicort 200/10
    Budesonide with formoterol
  3. Fostair (100/6)
    Beclometasone with formoterol
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10
Q

LABA Inhalers

A
  1. Salmeterol
    Serevent 25mcg
    Neovent 25mcg
  2. Formoterol
    Formoterol Easyhaler 12mcg
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11
Q

LAMA Inhaler

A

LAMA

  1. Spiriva
    (Tiotropium)
  2. Incruse
    (Umeclinidium)
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12
Q

HFPEF

- Chronic Mx

A

Chronic HFPEF Mx

Conservative

  1. Diet + exercise
  2. Smoking and alcohol

Medical
- BP, DM, Lipids

  1. ACEi/ARB
    - Ramipril
    - Lorsartan
  2. Furosemide/bumetanide
    - Spironolactone/metolazone
  3. BBlocker
    - Bisoprlol
    - Metoprolol
    - Carvedilol
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13
Q

HFPEF

- Acute Mx

A

Acute HFPEF Mx

  1. Dieuretic
    - Furosemide/bumetanide
    - Spironolactone
  2. Oxygen
  3. ACEi/ARB
  4. Nesiritide

Hypertensive emergency
5. IV GTN/nitroprusside

AF

  1. Beta blocker/CCB/Digoxin
  2. Anticoagulate
  3. ?Amiodarone
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14
Q

COPD

- GOLD Stages

A

Global initiative for chronic Obstructive Lung Disease

1 Early

  • FEV-1: > 80%
  • SoB walking fast

2 Moderate

  • FEV-1: 50-79%
  • SoB on level ground

3 Severe

  • FEV-1: 30-49%
  • SoB to leave house

4 Very severe

  • FEV-1: <30%
  • SoB at rest
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15
Q

COPD

- GOLD Groups

A

GOLD Groups

Group A

  • Low risk
  • Fewer symptoms

Group B

  • Low risk
  • More symptoms

Group C

  • High risk
  • Fewer symptoms

Group D

  • High risk
  • More symptoms
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16
Q

COPD

- Acute Management

A

Acute COPD Mx

Gold A

  1. SABA/SAMA
    - Salb/ipra
  2. LABA/LAMA
    - Salm/tiot

Gold B

  1. LABA/LAMA
  2. SAMA/SABA
  3. Pulmonary rehab

Gold C

  1. LAMA
  2. SABA
  3. Pulmonary rehab

Gold D

  1. LAMA or LABA/LAMA or LABA/ICS
  2. SABA
  3. Pulmonary rehab
17
Q

COPD

- Ongoing management

A

Ongoing COPD Mx

  1. Long-acting combination
    - LABA/LAMA
    - LABA/LAMA/ICS
  2. SABA PRN
  3. Oxygen/Ventilation
  4. Mucolytic
  5. Theophylline
  6. Bronchoscopy
  7. Surgery
  8. Palliation
18
Q

COPD

- Persistent exacerbation

A

Persistent COPD

  1. Roflumilast
    - PDE4 Inhibitor
  2. Azithromycin
    - Macrolide
  3. Erdosteine
    - Mucolytic
  4. Theophylline
    - Non-selective PDEi
  5. Bronchoscopy
  6. Surgery
  7. Palliation
19
Q

DM

- Five Drug Classes

A

DM Drugs

  1. Metformin
    - Biguanide
    - Decreased gluconeogenesis
    - Increased cellular uptake
  2. Sitagliptin
    - DPP-4i
    - Reduced GLP breakdown
  3. Exenatide
    - GLP1
    - Increased insulin secretion
  4. Gliclazide
    - SU
    - Bind to K+(ATP)
    - Increased insulin secretion
  5. Empa/Dapa
    - SGLT-2 i
    - Reduced renal absorption
20
Q

DM

- HbA1c levels

A

HbA1c

<6.0 Target
- 42%

6-6.5 Pre-diabetic
- 48%

> 6.5 Diabetic
48%

21
Q

DM

- Random plasma glucose

A

Random plasma glucose

<11.1
- Not diabetes

> 11.1
- Diabetes

22
Q

Hyperosmolar Hyperglycemic State

- Definition

A

HHS

  1. Very high blood glucose
  2. Common in concomitant illness
23
Q

Insulin resistance syndrome

- Definition

A

Insulin resistance syndrome
- Metabolic syndrome

  1. Obesity
  2. HTN
  3. Hyperlipidaemia
  4. DM T2

Year 3 - GP Block (13 decks)

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