Chapter 3 Qs Flashcards

1
Q

Q3.4 What is neutropaenic sepsis and how is it managed

A

Neutropenic sepsis = any source of sepsis with neutrophils <1.

Most common regimen is piperacillin + tazobactam + gentamicin.

Should go through PReSCRIBER mnemonic and know that R is relief of pain – so needs paracetamol for fever and pain.

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2
Q

Q3.5 How can carbmazepine affect electrolytes

A

carbamazepine -> SIADH -> hyponatraemia

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3
Q

Q3.6 Mx of UTI in pregnancy

A

Trimethoprim = folate antagonist CI in pregnancy as predisposes to neural tube defects.

UTI in early pregnancy therefore treated with co-amoxiclav.

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4
Q

Q.3.7 Management of Digoxin in a patient with slow AF

A

Withold digoxin

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5
Q

Q.3.7 Addisons disease sick day rules

A

Addisonian + sick = increase hydrocortisone;

if postural hypotension not present, just means not severe hydrocortisone depletion, so still need increased steroids.

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6
Q

Q.3.8 To remember re writing up regular medications in an acute exacerbation of asthma

A

Salbutamol inhaler should be stopped whilst being given the same drug by the (more effective) nebulised route.

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7
Q

Q.3.9 Sx for R and L sided HF

A

R-sided HF = peripheral oedema + raised JVP

L-sided HF = bilateral crepitations + SOB.

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8
Q

Q.3.9 Diuretic options in CCF

A

Furosemide is mainstay of treatment in acute HF, in acute setting, give 40mg IV.

Bumetanide is another loop diuretic reserved for patients resistant to furosemide.

Bendroflumethiazide uncommonly used to manage chronic HF.

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9
Q

Q3.10 elderly patient with fast AF + asthma + peripheral oedema

A

Digoxin (as CI BB+CCB)

Beta-blockers (bisoprolol) are CI

CCB (diltiazem) is not recommended in the presence of peripheral oedema as would worsen fluid retention

DC cardioversion only if acute features + cannot be performed if >48h history because of risk of intracardiac thrombus and subsequent stroke with reversion to sinus rhythm. You’d need anticoagulation + echo first.

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