Block 3 - DMOP

Question 1

CAM - Confusion Assesment Method Diagnostic Algorithm

Answer 1

1 - Acute and fluctuating

2 - Inattention

3 - Disorgonised thinking

4 - Altered level of consiousness

Delrium - 1 + 2 + 3/4

Question 2

Symptoms of hypercalcaemia

Answer 2

Bones, stones, groans and psychic moans

Question 3

What is Chvostek’s sign?

Answer 3

Tapping of temaralis muscle leading to it twitching.

Hypocalcaemia

Question 4

What are the most common causes of dementia?

Answer 4

1. Alzheimer’s
2. Vascular dementia

Question 5

What are the most common cause of hypokalaemia?

Answer 5

1. GI loss - D&V
2. Renal loss - Diuretics and conns
3. Intracellular shift - B₂ Agonist, insulin alkalosis

Question 6

How is parkinsons clincally diagonosed

Answer 6

Bradykinesia and one of:

Tremor

Rigidity

Postural instability

Question 7

What in a urine dip stick test indicates a UTI?

Answer 7

Nitrites

Question 8

Causes for Delirium

Answer 8

Base line - dementia

Infections

Drugs and withdraw

Metabolic

Electrolyte disturbances

Question 9

Delirium Vs Dementia

How is delirium differentiated?

Answer 9

Delirium is:

Acute

Variation in consciousness

Impaired attention

Question 10

When patients are aggitated with delirium, what can be given to calm them down?

Answer 10

haloperidol - antipsychotic

lorazepam - benzo

Question 11

What is orthostatic hypotension?

Answer 11

Low BP whe standing up.

Change > 25mmHg standing up vs sitting after 3 mins.

Question 12

What is the treatment of orthostatic hypotension?

Answer 12

Rule out underlying: PD, DM, medications, hypothyroid, Addisons etc.

Flucortisone 50mg

Question 13

What is cinacalcet?

Answer 13

Drug for hypercalcaemia

reduces PTH

Question 14

When is tricuspid regurtitation heard and what is its causes?

Answer 14

Pansystolic

Indicates right sided herat failure

Question 15

A high Urea Creatinine ration indicates?

Answer 15

Dehydration

AKI

Question 16

How long is anticoagulation for:

1st DVT

Perisurgical DVT

Recurrent or clotting disorder

?

Answer 16

1st DVT = 6 months

Peri surgical DVT = 3 months

Recurrent or clotting disorder = life long

Question 17

What organism causes Psuedomembraneous collitis?

Answer 17

C. Diff

Question 18

What causes toxic megacolon?

Answer 18

C Dif

IBS - Ulcerative collitis and Crohns disease

Question 19

Metastatic cancer which are likely to spread to the spine leading to cauda equina syndrome?

Answer 19

Breast

Prostate

Thyroid

Renal

Myeloma

2nd metastesis is the most comon cause for cauda equina syndrome.

Question 20

What symptom may present for a anal fistula?

Answer 20

Sharp pain when passing stools

Burning after passing stools

PR bleeding

Question 21

Back pain red flag questions

Answer 21

Parathesia or loss of power in limbs

Pelvic parathesia - new incontinence and urine retension

Trauma

Fever

Question 22

When is a pneumothorax decompressed with a canula?

Answer 22

< 2 cm

Breathless

Question 23

What indications are there for dialysis?

Answer 23

Acidosis

Electrolytes - K, Na, Ca

Intoxicants

Overload (fluid)

Ureamic (pericarditis, encephalopathy)