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Year 4 - 5 Qs A Day > 5/6 > Flashcards

5/6 Flashcards

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1
Q

Ignore what you learnt before - what do you do with pregnant women with chickenpox

A

> 20 weeks give aciclovir if unsure of chickenpox status/ no previous exposure regardless of symptoms

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2
Q

How do you manage cord prolapse?

A

Conservative
Push THE PRESENTING PART (BABY) back inside mum - so it doesnt compress the umblicial cord
DO NOT TOUCH THE UMBILICAL CORD
Insert a urinary catheter and fill bladder with saline
Go on all 4s

Medical
Tocolytics e.g. nifedpine, terbutaline

Surgical
Immediate C-section

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3
Q

What kind of contraception can women not have if they are on epilpesy meds?

A

COCOP and POP

POP can be taken if they are on lamotrogine

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4
Q

If clopidogrel is not tolerated what med should be used instead long-term post stroke?

A

Just aspirin 75mg

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5
Q

What is a further organic cause of almost all psych presentations?

A

Neurosyphilis

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6
Q

Explain syphilis testing

How is each stage managed?

A

Non-treponemal tests - +ve if active

Treponemal - +ve if active/past infection

If early latent or before = IM benzylpenicillin
If late latent or after = IM benzylpenicillin weekly for 3 weeks

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7
Q

Contact tracing for chlamydia, gonorrohoea, trichomonias vaginalis and syphilis

A

Gonorrohea
2wks back from symptoms for symptomatic men
3mnths for women and asymptomatic men

Chlyamdia (double above)
4wks back from symptoms for sympomatic men
6mnths for women and asymptomatic men

Trichomnias
- current sexual partners

Syphilis
- primary = 3mnth
- secondary + = 2 years

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8
Q

How long post-exposure can you take PrEP?

What is used to test for HIV?

CD4 level below what is dangerous?

What medication is given alongside ART?

A

72hrs

p24 and HIV Ig

<200

Prophylatic co-trimaxazole for pneumocystis jirovecii pneumonia

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9
Q

Why does a pt need a tetanus jag if exposed to dirty/punctuating wound?

A

full course = 5 vaccines

full course w/ last dose <10yrs ago = no vaccine or tetanus Ig

full course w/ last dose >10yrs ago = booster (if high risk e.g. heavy contamination, extensive deviatlised tissue, surgical intervention) = booster + Ig

vaccine hx unknown/incomplete = booster regardless of severity
if prone/high risk = booster + Ig

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10
Q

Match each of the following presentations to their genetic cause:
1. single palmar crease, upward sloping palpebral fissures, brachycephaly
2. Tall height, wide hips, small testicles, reduced libido, appear as male until puberty
3. Short stature, webbed neck and widely spaced nipples
4. Constant insatiable hunger, hypotonia

A
  1. Downs syndrome - trisomy 21
  2. Klinefelter syndrome 47 XXY
  3. Turner’s syndrome 45 XO
  4. Prader-Willi syndrome
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11
Q

What testing would indicate down’s?

A

USS - increased nuchal translucency

b-HCG - high
PAPPA - low

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12
Q

Treatment for Prader-Willi syndrome?

A

Conservative
- keeping food locked away and dietican help

Medical
- Growth hormone

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13
Q

Management for DKA

A

IV fluids
IV fixed rate insulin 0.1unit/kg/hr
Monitor K+
LWMH - thromboembolism risk

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14
Q

Management of thyroid storm

A

HIPP - busted out ur HIPP during the storm

Hydrocortisone IV (reduces inflam of thyroid)
Iodine (4hrs post PTU)
Propylthiouracil (blocks conversion)
Propranolol IV (symptom control - give digoxin if asthmatic/low BP)

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15
Q

What differentiates DKA from HHS?

How do you manage HHS?

A

No ketones and no acidosis
Glucose >/= 30mmol/L

IV fluids
If thats not enough 0.05units/kg/hr fixed rate insulin
LWMH

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16
Q

What are the different ways you will bring a patients glucose levels back up with a hypo

A

Concious with swallow = 15-30grams of short-acting glucose e.g. 150ml of OJ followed by long acting e.g. toast or biscuit

Concious with no swallow = 1.5-2 tubes of glucose gel

Unconcious = IV 200ml of 10% glucose OR 1mg/kg glucagon IM

16
Q

4Hs and 4Ts of MI

Treatment of ACS

How does this differ for STEMI vs NSTEMI?

A

Hs
- Hypothermia
- Hypo/hyper electrolytes
- Hypovolemia
- Hypoxia

Ts
- tension pneumothorax
- tamponade
- toxins
- thrombus

MMONA+T

Morphine (if in extreme pain)
Metroclopramide
Oxygen (sats <94%)
Nitrates (GTN spray unless hypotensive)
Aspirin 300mg
Ticagrelor

STEMI
<2hrs to PCI
- no a/c previous - aspirin + prasgurel
- a/c previous - aspirin + clopidogrel
>2hrs - fibrinolysis

NSTEMI
- fondapurinaux if no signifcant bleeding risk
- if immediate angioplasty to take place LWMH

16
Q

What bug causing pneumonia is associated with erythema multiforme?

A

Mycoplasma

16
Q

OSHITMAN is same for acute flare of COPD.
What is different in terms of ventilation and O2 delivery?

A

CPAP - if type 1
BiPAP - if type 2

24% O2 (BLUE) venturi mask 88-92%

16
Q

How can you tell if pt has had a true episode of anaphlyaxis?

A

Tryptase levels

16
Q

Pneumonia with lymphopenia, hyponatraemia & deranged LFTs?

A

Legionella

16
Q

Describe the differences in lithium tremors

A

Fine tremor with chronic use
Coarse tremor in acute toxicity

17
Q

What are the contraindications to the following airways
- oropharygeal
- nasopharnygeal

What airway support should be used if significant trauma has happened affecting potentially spine?

A

Oropharngeal = concious - can cause gagging and aspiration in semi-concious pts

Nasopharngeal = potential base of skull factures as small but v dangerous risk of perforation

Jaw thrusts

17
Q

What should be done in addition to OSHITMAN for acute asthma?
How is response monitored?

A

SIT UP

Multiple peak flow measurement

18
Q

What should you do if pt not responsive to first dose of adrenaline?
How much and what dose again?

A

0.5mg of 1:1000 IM in anterolateral aspect of middle thigh
6-12 years old = 0.3mg
<6years old = 0.15mg

Repeat after 5 minutes -> still no response -> HELP -> IV adrenaline from consultant

19
Q

How would you manage each of the following electrolyte imbalances:
- Hyperkalaemia
- Hypokalaemia
- Hypercalcemia
- Hyponatremia

A
  1. IV insulin and dextrose
    Calcium gluconate to protect the heart
    Calcium resonium (to prevent reabsorption - move long term)
  2. IV K+
    Check Mg+ - K+ cannot rise without it and telemtery
  3. IV FLUIDS
    Biphosphates too
  4. 1.8% saline but be careful - low to high - pons might die (central pontine demylineation)
20
Q

What ECG finding can be seen in HYPERcaleamia?

A

Short QT interval

21
Q

How would you describe asthma to a pt?

A

Chronic inflammatory response of the windpipe

Stays tightened and can struggle to get air in

Blue inhaler helps to open up the airways in the short term

Steroid inhaler helps to reduce the inflammation overall

We call it a reversible obstructive inflammation

Year 4 - 5 Qs A Day (122 decks)

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