3b lectures

Question 1

What is a peer worker?

Answer 1

AKA expert by experience

Patient that has / has had the illness that can provide support to someone newly diagnosed

Question 2

What is the commonest cause of maternal death within the 1st year post-partum?

Answer 2

Suicide

Question 3

What are the 5 main categories of psychotropic medications?

Answer 3

Antipsychotics 
Antidepressants
Anti-anxiety agents 
Stimulants 
Mood stabilisers

Question 4

What are the stages of PDSA cycle?

Answer 4

Plan, Do, Study, Act

Question 5

Name a tyrosine kinase inhibitor, a condition for which it is prescribed and its MOA?

Answer 5

Nintedanib 
Pulmonary Fibrosis 
Inhibits VEGFR (vascular endothelial growth factor)

*TKIs end in -nib

Question 6

What are the 2 broad categories of bronchodilators and how do they work?

Answer 6

Adrenergic receptor agonists (SNS)= binding to B2 adrenoceptors causes bronchodilation
Anti-cholinergics (PNS)= blocking muscarinic receptors prevents Ach binding which normally causes bronchoconstriction

Question 7

Give an example of a SABA, LABA, Ultra-long BA?

Answer 7

Salbutamol
Salmeterol
Indacterol (once daily)

Question 8

Give an example of an anti-cholinergic?

Answer 8

Ipratropium bromide

Question 9

Give 3 side effects of long term inhaled corticosteroid use?

Answer 9

reduced bone density
adrenal suppression
cataracts/glaucoma

Question 10

For which respiratory condition is pirfenidone prescribed? MOA?

Answer 10

IPF

Anti-fibrotic drug that reduced fibroblast proliferation and collagen production

Question 11

What is the calculation for ideal body weight for men and women?

Answer 11

Men= (0.9 x Height)- 88
Female= (0.9 x Height)-92

*height measure in cm

Question 12

What is the calculation for total blood volume in adults, children, neonates?

Answer 12

Adults= 70mls/kg 
Children= 80mls/kg
Neonates= 90mls/kg

Question 13

Describe Normal Saline and explain why you should not resuscitate someone on normal saline for a prolonged period of time

Answer 13

Solution of Na+ (154) and Cl- (154)- normal for both is 140

Long term resuscitation on normal saline results in hypernatraemia and hyperchloraemic acidosis

Question 14

What is different between normal saline and hartmanns solution?

Answer 14

Hartmann’s is a balanced salt solution - it has other electrolytes in it which normal saline does not e.g K+ and Ca2+

Question 15

If you gave a patient IV 5% glucose fluids which electrolyte derangement might you expect to see and why?

Answer 15

Hypokalaemia - glucose is co-transported into cells with potassium so if you give glucose you get hypokalaemia

Question 16

What are the daily requirements /kg of: 
Water 
Na+ 
K+
Energy

Answer 16

Water= 30mls/kg 
Na+ = 1-2mmol/kg 
K+ = 1mmol/kg
Energy= 30kcal/kg

Question 17

What is the calculation for average urine output?

Answer 17

0.5-1ml/kg/hr

Question 18

What is meant by the presentation ‘somnolescence’?

Answer 18

Drowsiness / sleepiness

Question 19

Buccal mucosal hyperpigmentation is pathopneumonic of which endocrine condition?

Answer 19

Addison’s disease (addrenal insufficiency)

Question 20

Mx of CA-related hypercalcaemia?

Answer 20

IV fluids, IV/oral bisphosphonates, refer to oncology

Question 21

Secondary HTN causes?

Answer 21

Renal artery stenosis, PKD
Cushing’s, Acromegaly
Conn’s, Phaeochromocytoma
Aortic coarctation

Question 22

Mx of phaeochromocytoma?

Answer 22

Alpha blockage with phenoxybenzamine

Then beta blockers

Question 23

Give an example of a testosterone that is administered? route? frequency? monitoring?

Answer 23

Sustanon IM every 4 weeks

Monitor for BPH / Prostate CA- PSA and DRE

Question 24

Describe TFTs of throid storm?

Answer 24

High T4, Low TSH

Question 25

What is the management of thyroid storm?

Answer 25

IV fluids, Oral propylthiouracil, IV hydrocortisone,
Cardiac monitoring + pulse oximetry
Urgent endocrine referral

Question 26

What can precipitate a thyroid storm?

Answer 26

thyroid surgery, infection, MI, DJA, radioactive iodine

Question 27

What electrolyte abnormality can occur if a patient with DI is given too much desmopressin as tx?

Answer 27

Hyponatraemia

Question 28

Give an endocrine ‘condition of under-secretion’ and an appropriate endocrine test to go with it?

Answer 28

Under-secretion- adrenal insufficiency

Short synacthen test

Question 29

Give an endocrine ‘condition of over-secretion’ and an appropriate endocrine test to go with it?

Answer 29

Over-secretion= Cushing’s disease

Dexamethasone suppression test