4. Planning Management Flashcards
How do you manage fever?
Treat cause
Paracetamol
What kind of laxatives are the following…
Docusate
Isphagula husk
Lactulose
Senna+ Bisacodyl
Docusate: Stool softener
Isphagula husk: bulking agents
Lactulose: osmotic laxative
Senna+ Bisacodyl: stimulant
What laxatives should be avoided in acute abdomen?
Stimulants and osmotics
What laxatives are good for faecal impaction?
Docusate (stool softener)
What can you give for diarrhoea?
Exclude infective causes
Give loperamide 2mg OR codeine 30mg
How do you manage…
STEMI
NSTEMI
Acute LVF
How do you manage a tachy that is unstable?
How do you manage a tachy that is stable and broad?
How do you manage a tachy that is stable and narrow?
How do you manage anaphylaxis?
How do you manage an acute asthma exacerbation?
How do you manage a pneumothorax?
tension: emergency aspiration + chest drain
Secondary: aspiration + chest drain (if >2cm/SOB/>50 years)
How do you manage an acute pneumonia?
How do you manage an acute PE?
How do you manage an acute GI bleed
How do you manage bacterial meningitis?
How do you manage a seizure?
How do you manage a stroke?
How do you distinguish between DKA and HONK?
How do you manage both cases of hyperglycaemia?
DKA // HONK
Ketones present // absent
raised pH // osmolality over 340mmol/L (2(Na+K) + urea + glucose)
How to manage hypoglycaemia?
Oral intake: sugary drink or biscuit
No oral but IV: 100ml 20% glucose
No oral or IV: IM glucagon 1mg
How do you diagnose an AKI?
How do you manage an AKI?
When do you treat hypertension?
What are the target values?
If BP >150/95mmHg OR
If >135/85 + the following:
- Q-risk >10% or existing CV disease
- End organ damage
–> Under 80: 135/85 ABPM or 140/90mmHg
–> over 80: +10 to above systolic values
How do you treat HTN?
When is rhythm control given first in AF
If the AF is…
Reversible
Onset < 48 hours
Causing HF
Symptomatic on rate
Outline rhythm control in AF
Initial
<48 hours/unstable: Cardioversion
Pharmacological: flecainide/amiodarone
Electrical: Defibrillation
Long-term
1. B-blockers
2. Dronendarone if successful DC
3. Amiodarone if HF/LVD
Outline rate control in AF
- Atenolol 50-100mg daily
- CCB if no heart failure
- Digoxin if sedentary
How is stroke management determined in AF?
Congestive HF
HTN
Age > 75
Diabetes
Stroke/TIA
Vascular disease
Age 65-74
Sex (female)
If CHADSVAS >=1 what is given for AF?
NOACs
Warfarin if NOACs dont work
How do you manage Diabetes mellitus?
T1DM: Insulin
T2DM:
1. Metformin 500mg
2. + gliptin/sulfonylurea/SGLT-2I/pioglitazone
3. + another of above drugs
4. Metformin + sulfonylurea + GLP-1 mimetic
COPD management?
What are the typical first line treatments for Parkinson’s disease?
Typically co-beneldopa/carledopa
mild + concerned about levodopa: DA or MAO-I
Outline the management for the following seizures…
Generalised tonic-clonic
Absence seizures
Myoclonic
Tonic
Focal
Sodium valproate apart from
Absence: can use ethosuximide
Focal: Carbamazepine or lamotrigene
What are the side effects of…
Lamotrigene
Carbamazepine
Phenytoin
Sodium valproate
Lamotrigene: Rash, SJS
Carbamazepine: Rash, cerebellar, low Na
Phenytoin: Cerebellar, neuropathy, liver damage
Sodium valproate: Tubby, tremor, teratogenic
How to distinguish between Crohn’s and UC
Crohn’s // UC
RIF mass // LIF pain
Anywhere // recto-caecal
Deep, skipping ulcers // continuous ulcers
Gallstones // PSC
Granulomatous // crypt abscesses
What is the induction regime for Crohn’s
- Steroids
- 5-ASA
+azathioprine/mercaptopurine
Consider biologics if > 5 days without improvement
What is the induction regime for UC?
Mild-moderate flare (4-6 stools)
1. Topical 5-ASA + oral 5-ASA/steroid if proctitis
Severe
IV steroids + ciclosporin if no improvement
What are the maintenance options for Crohn’s and UC
Crohn’s
Stop smoking
1st line: Azathioprine/mercaptopurine
UC
Mild-mod: topical 5-ASA/oral/both
Severe: Azathioprine/mercaptopurine
