Basic knowledge Flashcards
1
Q
Hazard screening component
A
- Lead to serious effects towards an individual and pose a risk of spreading to the community
- HIV
- Hepatitis B: HBsAg, HBeAg, anti-HBs, anti-HBe
- Hepatitis C: anti-HCV antibody (first line, but usually positive only after 3 months), HCV core antigen (identify current HCV infection)
- Tuberculosis
2
Q
Type and example of direct oral anticoagulant**
A
- Direct thrombin inhibitor: Dabigatran
- Direct factor Xa inhibitor: Rivaroxaban, Apixaban
3
Q
Warfarin vs DOAC
A
> Warfarin
- Advantage: low cost, well-establish clinical profile
- Disadvantage: long half life, require regular monitoring of INR, wide range of drug-drug and drug-food interaction
- Antidote: prothrombin complex concentrate
> DOAC
- Advantage: does not require regular INR monitoring
- Disadvantage: expensive, contraindicated in prosthetic heart valve and valvular AF
- Antidote: idarucizumab (Dabigatran)
4
Q
Routh of administration for Vit K
A
- Most adult: oral 10mg
- In malabsorption -> parenterally (subcutaneous or IV)
- IV is preferred when trying to rapidly reverse coagulopathy
5
Q
What to do when INR too high
A
- 5-8, no bleed: withhold 1-2 doses. Restart warfarin at a lower maintenance dose once INR <5
- 5-8, minor blood: stop warfarin and admit for urgent IV vitamin K. Restart warfarin when INR <5
- > 8, no bleed: stop warfarin, seek hematology advice
- > 8, minor bleed: stop warfarin, admit for urgent IV vitamin K. Restart warfarin when INR <5
- Major bleed: stop warfarin. Give prothrombin complex concentrate 50 units/kg and 5-10mg vit K IV
6
Q
How to diagnosed hypertension*
A
- Persistent elevation of systolic BP >=140mmHg or diastolic BP >= 90mmHg
- Taken at least twice on two separate occasion
7
Q
Complication of hypertension*
A
- Left ventricular hypertrophy
- Heart failure
- Ischemic stroke
- Intracerebral hemorrhage
- Ischemic heart disease
- Chronic kidney disease and ESRF
8
Q
Why Heparin given before Warfarin
A
- Takes a numbers of days for all the Vit K-dependent factors to become depleted (factors II, VII, IX and X)
- Approx. 5 days
- In addition, reduction of proteins C and S occurs shortly after warfarin therapy and potentially renders a procoagulant state
9
Q
Dietary advice for Warfarin
A
- Not to have large day-to-day variations in the amount of vit K intake from food
- Food with high Vit K: broccoli, spinach, lettuce, cabbage
10
Q
Causes of hypertension
A
> Primary: essential hypertension > Secondary: - Endocrine (hyperthyroidism, Cushing's syndrome, hyperaldosteronism) - Renal (polycystic kidney disease) - Cardiovascular (coarctation of aorta) - Respiratory (sleep apnea)
11
Q
Grading of hypertensive retinopathy
A
- 1: Tortuous arteries with thick shiny walls
- 2: AV nipping
- 3: Flame hemorrhage and cotton wool spot
- 4: Papilledema
12
Q
Hypertensive urgencies vs emergencies
A
> Severe HPT
- > 180/120mmHg
- Further categorized as emergencies or urgencies
> HPT urgency
- Without progressive target organ dysfunction
> HPT emergencies
- Evidence of impending or progressive target organ dysfunction
13
Q
Uncontrolled vs Controlled oxygen therapy
A
> Uncontrolled
- eg: nasal cannula, simple face mask, non-rebreather mask
- depends on depth and rate of breathing -> can produce unexpectedly high concentration of O2
- fatal consequence in chronic hypercapnia
> Controlled
- eg: Venturi
- O2 of known concentration irrespective of breathing pattern
14
Q
Stages of HPT according to AHA
A
- Normal: <120/80
- Elevated: 120-129/ <80
- Stage 1: 130-139/ 80-89
- Stage 2: >=140/ >=90
- HPT Crisis: >180/ 120
15
Q
WHO classification of Asian BMI
A
- Underweight: <18.5
- Normal: 18.5-22.9
- Overweight: 23.0-27.4
- Obese C1: 27.5-32.4
- Obese C2: 32.5-37.4
- Obese C3: >=37.5
