Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2b OSCE > Chronic Disease Stations > Flashcards

Chronic Disease Stations Flashcards

1
Q

What is bilirubin?

A

Breakdown product of RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name 5 factors that can cause a rise in bilirubin

A

Gilbert’s syndrome
Stress
Fasting
Drugs
Haemolytic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Gilbert’s syndrome?

A

Inherited disease where liver can’t process bilirubin properly = raised bilirubin levels on testing + episodes of jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name 3 drugs that can increase bilirubin levels

A

Rifampicin
Sulfonamide Abx
Carbimazole (thyroid meds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is ALT?

A

Alanine transaminase - marker of liver cell damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a high ALT?

A

> 120 IU/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name 4 hepatic causes of raised ALT

A

Alcohol
Viral hepatitis
Drugs
Wilson’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name 4 drugs that can increase ALT levels

A

NSAIDs
Abx
Statins
Anti-epileptics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name 4 non-hepatic causes of raised ALT

A

Coeliac disease
Strenuous exercise
Muscle disease
Hypo/hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is AST?

A

Aspartate aminotransferase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does an AST:ALT >2.1 indicate?

A

Alcohol related liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does an AST:ALT <2.1 indicate?

A

Hepatic steatosis/chronic viral hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is ALP?

A

Alkaline phosphatase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name 2 physiological causes of raised ALP

A

3rd trimester pregnancy
Bone growth in adolescents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name 4 pathological causes of raised ALP

A

Heart failure
Bone diseases
Steroids
Bile duct obstruction/pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is gammaGT used for?

A

Sensitive but non-specific marker for hepatobiliary disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name 7 causes of raised gamma GT

A

Hepatobiliary disease
Pancreatic disease
Alcoholism
COPD
Diabetes
MI
DRugs e.g. OCP, carbamazepine (anti-epileptic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name 5 causes of low albumin

A

Liver disease
Malnutrition/absorption
Pregnancy
Injury/infection
Chronic illness-increased catabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name 4 conditions that can increase HbA1c levels

A

Iron deficiency
Alcoholism
Chronic renal failure
Splenectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name 3 conditions that can decrease HbA1c levels

A

Chronic liver disease
Haemoglobinopathies
RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Name 3 drugs/vitamins that can decrease HbA1c levels

A

Vit C
Vit E
Aspirin
Ribavirin (anti-viral for hepatitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What advice would you give to someone with raised HbA1c levels?

A

High fibre, low sugar diet
Less saturated fats
Exercise + physical activity
Reduce alcohol + smoking
Attend yearly check ups e.g. urinalysis, eye tests, diabetic foot screenings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is INR?

A

International Normalised Ratio - measure of how thick/thin blood is - how well it clots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What symptoms should you ask about for raised INR?

A

Bruising
Bleeding-gums, heavy periods, nosebleeds etc
Blood in stool/urine
Sudden severe back pain-spontaneous retroperitoneal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What symptoms should you ask about for decreased INR?

A

Stroke symptoms
Visual changes
DVT/PE symptoms-pain, red, swollen, chest pain, SOB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Name 4 contraindications for warfarin

A

Pregnancy
Hemorrhagic stroke
Within 72hrs major surgery
Severe hepatic impairment (processed by liver)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Name 3 factors that can exaggerate the effects of warfarin

A

Weight loss
Acute illness
Smoking cessation

28
Q

Name 3 factors that can reduce the effect of warfarin

A

Weight gain
Diarrhoea
Vomiting

29
Q

What questions should you ask about taking medications?

A

Same time every day?
Ever forget doses?
Do you ever double dose?

30
Q

Name 4 key drug interactions that enhance the effect of warfarin

A

Alcohol
Abx-clarithromycin, co-trimox
Aspirin, clopidogrel
Amiodarone
NSAIDs
Cranberry juice

31
Q

Name 4 key drug interactions that decrease the effect of warfarin

A

St John’s wort
Rifampicin
Vit K
Carbamazepine (anti-epileptic)

32
Q

What key questions should you ask about diet in an INR station?

A

Changes in vit K intake e.g. broccoli, kale, spinach
Have they been avoiding grapefruit + cranberries?

33
Q

How does warfarin work?

A

Inhibits vit K dependant clotting factors

34
Q

What are the vit K dependant clotting factors?

A

II, VII, IX, X (1972)

35
Q

What is the target INR for people on warfarin?

A

2-3 (2.5)

36
Q

What should INR be in people not on warfarin?

A

1-2

37
Q

What 3 questions should you ask in an asthma review?

A

-Have you had trouble sleeping due to asthma symptoms?
-Have you had your usual asthma symptoms during the day?
-Has your asthma interfered with your everyday activities?

38
Q

What are the side effects of ACE inhibitors to be aware of for an asthma review?

A

Cough

39
Q

What effect do BB have on asthma?

A

Exacerbate

40
Q

What areas of social history are important in asthma reviews?

A

New pets
Job
Mould/home conditions
Air temp changes
Liver with/near smokers?
Job stress
Recent move?

41
Q

Advice for asthma review

A

Ask family/friend smokers to go outside
Flu vaccine
Avoid cold air/pollen triggers
Regular exercise
Inhaler technique + reviews
Peak flow dairy for next month

42
Q

What is a moderate PEFR?

A

> 50-75%

43
Q

What is a severe PEFR?

A

33-50%

44
Q

What is a life threatening PEFR?

A

<33%

45
Q

How do you manage an acute exacerbation of asthma?

A

Salbutamol
Prednisolone
O2

46
Q

What score is used for measuring breathlessness?

A

MRC dyspnoea score (0-4)

47
Q

What symptoms should you ask about for raised inflammatory markers?

A

Fever, vomiting, diarrhoea, night sweats, weight loss
How are they feeling today?
Impact on daily life

48
Q

What PMHx should you ask about for raised inflammatory markers?

A

Autoimmune disorders
Bone conditions
Active cancers
Lung diseases

49
Q

How should you start a chronic disease station?

A

Intro
Ask about their understanding
Explain test results + problems that can occur due to specific results

50
Q

What should you ask about the patient’s current condition?

A

How are they feeling today?
Recent illness/infection
Symptoms troubling them?
Specific symptoms for condition
Specific complications of condition e.g. diabetic foot

51
Q

What are the 4T’s for diabetic symptoms?

A

Toilet
Thirsty
Tired
Thinner

52
Q

What should you ask about management of their condition?

A

Taking meds?
Med compliance
Technique/taking them correctly-time of day etc
Side effects of meds?

53
Q

Explain purpose of peak flow to a patient

A

Measures how fast you can breath out to see how well your lungs are working

54
Q

Name 7 triggers for asthma

A

Smoking
Damp
Pets
Exercise
Allergies
Infections
Work

55
Q

Name 4 red flags for asthma

A

Worsening wheeze
Affecting ADLs
Waking up at night
Fast heart rate

56
Q

Give 3 pieces of advice for asthma management

A

Stop smoking
Flu vaccine
Exercise

57
Q

What should you ask about patient understanding for INR station

A

Do they know what INR is?
Do they know why they are on warfarin + how it works?

58
Q

Name 2 practical reasons for a high INR

A

Double dosing warfarin
Change in warfarin regimen

59
Q

Why would you ask about liver failure for an INR station?

A

Lack of clotting factors

60
Q

What bleeding disorders would you ask about for an INR station?

A

Haemophilia
Factor 7 deficiency

61
Q

What can binge drinking do to INR?

A

Increases

62
Q

What does smoking do to INR?

A

Increases

63
Q

What can crp/esr tell you?

A

Condition flare up/ new infection

64
Q

What can low albumin show?

A

Malnutrition-Crohns/UC, kidney or liver disease

65
Q

What can high albumin show?

A

Severe infection/dehydration, chronic inflammatory diseases, hepatitis

66
Q

What key part of social Hx should you ask for LFT’s?

A

Travel Hx - hepatitis risks, alcohol, unprotected sex etc

2b OSCE (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions