CCE Flashcards
Domestic Violence approach
LIVES Listen non judgementally Inquire as to needs and concerns Validate - explain not her fault Enhance safety - risk assessment and safety planning Support - organise appropriate referrals
When would you be cautious about doing the Epley manouvre
• neck injury
• severe cervical spondylosis
• severe positional dizziness or vertigo.
carotid stenosis
Eligibility criteria for NDIS
Age 7-65 years
Australian citizen/permanent resident
Live in Australia
Permanent disability
Need disability specific supports to complete ADLs
When would you be cautious about doing the Epley manouvre
- neck injury
- severe cervical spondylosis
- severe positional dizziness or vertigo.
when does drivers licence need to be restricted for OSA
ESS >=16
or self reported sleepingess or drowsiness while driving
history of crash caused by inattention or sleepiness
In COPD when do you consider adding an ICS
when FEV1 <=50% AND
2 exacerbations in past 12 months AND
sig symptoms despite LABA/LAMA combo
HASBLED
Hypertension Abnormal liver or renal function Stroke Bleeding history Labile INRs Elderly >65 years Drugs - antiplatelets
Pericarditis causes
TB SLE post myocardial infarction uraemia post coronary intervention HIV
H Pylori treatment
Esomeprazole 20mg orally BD for 7 days
• Amoxicillin 1g orally BD for 7 days
• Clarithromycin 500mg orally BD for 7 days
what sleep apnoea scores are needed for sleep study
STOP Bang >=4
ESS >=8
General medical rules for DSP
your condition will last more than 2 years
your condition is fully diagnosed, treated and stabilised
you have an impairment rating of 20 points or more
your condition will stop you working at least 15 hours a week in the next 2 years.
patient characteristics which may impact medication compliance
• Low literacy • Old age • Ethnic background eg ATSI • Mental health issues - depression, memory loss • Physical disabilities • Low socioeconomic status • Language barrier • Not believing in medication • Busy lifestyle Drug/alcohol issues
When does a patient qualify for home medicines review
• 5 or more medications
• More than 12 doses of medication per day
• Recent significant cahnges made to medications
• Medications requiring therapeutic monitoring
• Symptoms suggestive of adverse drug reaction
• Suspected non compliance
• Sub optimal response to treatment
• Difficulty managing own medications
• Dementia
• Pt has lots of different doctors
Recent discharge from hospital
age eligibility for my aged care
- that you are 65 years or older (50 years or older for Aboriginal or Torres Strait Islander people).
- 50 years or older (45 years or older for Aboriginal and Torres Strait Islander people) and on a low income, homeless, or at risk of being homeless.
signs and symptoms of lithium toxicity
Gastrointestinal Effects :Nausea, vomiting, diarrhoea
CNS effects: tremor, hyper reflexia, ataxia, dysarthria
what are the indications for antipsychotic treatment
Schizophrenia, schizoaffective disorder, depression with psychosis, mania
typical antipsychotics
haloperidol, chlorpromazine
higher risk fo EPSE
atypical antipsychotics
olanzapine, clozapine, risperidone
lower risk EPSE
more metabolic SEs
side effects of clozapine
agranulocytosis
cardiomyopathy
neutropenia
metabolic
Maximum safe dose for lignocaine with adrenaline
7mg/kg
Without adrenaline 3mg/kg
sex post CABG
wait 6-8 weeks
if you can climb 2 flights of stairs without SOB or pain all is good
4Ds smoking cessation
Delay
Deep breathe
Drink
Distract
Examination features IBD
- Arthritis/enthesitis
- Episcleritis/iritis
- Mouth ulcers
- Erythema nodosum
- Pyoderma gangrenosum
- Anaemia: pallor of conjunctivae
- Abdominal mass
- Evidence of weight loss
Perianal fistula, skin tags
How to calculate APRI score
AST to platelet ratio
Anaphylaxis adrenaline dose
- 5mls of 1:1000
0. 01 mL/kg of 1:1000 (maximum 0.5 mL)
Management of severe croup
0.5ml/kg of 1:1000 adrenaline to a maximum of 5ml (5mg) undiluted AND 0.6mg/kg (max 12mg) dexamethasone IM/IV/PO.
Pericarditis treatment
Restriction of exercise
Colchicine 500mcg BD for 3 months
AND
Aspirin 1000mg, TDS for one to weeks with tapering course
when do you do cascade screening for haemochromatosis
Cascade screening is warranted for all first-degree relatives of patients with HHC who are C282Y homozygous or C282Y/H63D compound heterozygous.
Haemochromatosis Mx
Refer for therapeutic venesection, every 1- 2 weeks
Refer to gastroenterologist
Screen for liver complications
Avoid iron tablet and vitamin C
What are the phases of hepatitis B infection
Phase 1: immune tolerance
• High HBV DNA (often >170,000,000)
- Normal LFTs
- HbeAg positive
Phase2: Immune clearance
• High HBV DNA
• Abnormal LFTs
• HbeAg positive
Phase 3: Immune Control
- Low HBV DNA
- Normal LFTs
- HbeAg negative
- Anti Hbe positive
Phase 4: Immune escape - High HBV DNA - Abnormal LFTs - HbeAg neg Anti Hbe pos
Hepatitis B management
Refer to Gastroenterologist for antivirals
Contact trace partners of past 6 months
Advise partners are tested
Advise pt to wear condoms in new sexual relationships
Regular testing of viral load up to 4 times per yr
Annual HbsAg and anti Hbs testing
6 months HCC surveillance with liver ultrasound/afp
Reduce alcohol
Cease smoking
Ensure vaccinations up to date
apixaban dose in DVT
10mg BD for 7 days then 5mg BD
DDx for splenomegaly
CML Myleofibrosis Portal HTN Lymphoma Leukaemia Thalassemia
Causes of thrombocytopenia
medication induced chronic liver disease vitamin B12 deficiency SLE lymphoma HIV Pregnancy ITP artefact
causes of thrombocytosis
• Essential thrombocytosis • Polycythaemia vera • Primary myelofibrosis • Chronic myeloid leukaemia • Myelodysplastic syndromes • Acute myeloid leukaemia Familial thrombocytosis
what are cycloplegic eye drops used for
paralysis of muscles for accommodation
treatment for posterior epistaxis
foley catheter along floor of nasal cavity
Ottawa ankle rules
- The ankle X-ray is required only if there is any pain in the malleolar zone and any one of the following
- bone tenderness along the distal 6cm of the posterior edge of the tibia or the tip of the medial malleolus OR
- bone tenderness along the distal 6cm of the posterior edge of the fibula or tip of the lateral malleolus OR
- an inability to weight bear both immediately and in the ED for 4 steps
Ottawa foot xr rules
pain in the mid foot zone and any one of the following
- bone tenderness at the base of the 5th metatarsal OR
- bone tenderness at the navicular bone OR
- an inability to bear weight
mx of weber A ankle fracture
WBAT in boot
fracture below