bits n bobs from formatives Flashcards
when do you prescribe lorazepam for delirium
if also got lewy body dementia or Parkinson’s
usually would give haloperidol as sedation in derlerium but antipsychotics are contraindicated in Parkinson’s/LB dementia
causes of spinal cord compression
high energy injury
tumour
-extradural usually metastatic
-intradural (coming from the spine)
treatment of spinal cord compression - oncological emergency
dexamethasone as a holding measure (15mg IV then 8mg oral bd)
surgery if fit enough and no evidence of mets
radiotherapy - main treatment
how do you treat AF in a patient who is asymptomatic
don’t do it bruh just chill
if no other risk factors, chadvasc 0 and rate normal
CKD and going for a contrast CT scan - what do you give first
0.9% NaCL
what is raised by loads in rhabdomyelitis
CK (>10,000)
drugs that cause hyponatraemia
SSRIs Tricyclics carbamazepine sodium valproate ACEis PPIs diuretics- bendroflumetazide
investigation for cervical spine fractures
CT neck
what investigations are done for endocarditis
blood cultures
transoesophageal echo
indications for CT head after head injury within 1 hour of arrival to A&E
GCS <13 GCS<15 if 2 hours after injury suspected skull fracture post traumatic seizure focal neurological deficit >1 episode of vomiting
indications for CT head for head injury within 8 hours of arrival to A&E
none of the factors for CT within 1 hour but..
on anticoagulation >65 hx of bleeding or clotting disorder dangerous mechanism of injury >30mins retrograde amnesia of events before the injury
which bone disorder has:
low vit D, low Ca, Low phosphate, normal/high ALP
osteomalacia
which bone disorder has:
norm Ca, normal phosphate, norm ALP
osteoporosis
which bone disorder has:
norm Ca, norm phosphate, v raised ALP
pagets disease
causes of paralytic ileus
surgery - most common
trauma
inflammation/infection
electrolyte imbalance (hypokalaemia/hyponatraemia)
treatment of paralytic ileus
nil by mouth NG tube IV fluids mobilisation - helps stimulate peristalsis Total parenteral nutrition
when would you do an aldosterone:renin ratio
is suspicious of primary hyperaldosteronism (Conn’s syndrome)
aldosterone will be high in comparison to renin
usually renin causes release of aldosterone, but will be high if adrenals are producing too much aldosterone
when would you do a albumin:creatinine ratio vs a protein:creatinine ratio
albumin creatinine ration when looking for microalbuminaemia as the cause of protein in urine (usually due to diabetic retinopathy)
protein:creatinine ration when you suspect a non-albumin cause of the protein in the urine
secondary prevention of a non-cardioembolic ischaemic stroke
anti platelet - clopidogrel 75mg (give lansoprazole as well for gastro protection in patients at risk of ulcers)
antihypertensive - ACEi, thiazide or CCB
statin
- simvastatin 40mg if low atherosclerotic burden
- atorvastatin 80mg if high atherosclerotic border
which antibiotics is contraindicated with statin therapy
clarithromycin
secondary prevention of a cardioembolic stroke in AF
anticoagulant
antihypertensive
statin
when would you give prednisolone for gout
if patient cant tolerate NSAIDs - eg. in CKD
which brain lobe is most likely to be affected in early Alzheimers
temporal
- loss of semantic memory
treatment for tricyclic overdose with prolonged QRS
give IV sodium bicarbonate
what pain relief should be used for patients post-bowel surgery
epidural
good in patients with resp problems as opiates can make that worse?
which drug can cause pulmonary fibrosis
amioderone
classically pulmonary fibrosis without finger clubbing
septic + hypotensive despite fluid irescusitiation
give IV adrenaline
