Clinical Conditions Flashcards
What is the disease progression of alcoholic liver disease?
fatty liver disease –> alcoholic hepatitis –> cirrhosis
What treatment options are there for alcoholic liver disease?
Abstinence from alcohol. Disulfiram can be used.
What are the treatment options for anaemia?
Treat underlying condition. Iron supplements and/or blood transfusions
Explain to a patient what a blood smear is
Sample of blood under microscope to examine size, shape and colour of your RBCs.
Explain to a patient microcytic, normocytic and macrocytic anemia
anemia caused by the RBCs being smaller/same size/ or bigger.
What are the treatment options for asthma?
Medicines - SABA –> + inhaled steroid –> +LABA –> +4th drug or increase inhaled steroid –> +oral steroid OR anti-IgE therapy
Exercise, stop smoking, vaccinations to prevent infections
Explain spirometry to a patient
Breathing test. Take a deep breath and exhale as fast as possible. Measures air breathed out in total and in the first second and compares to averages in your age, gender and height to see if your airways are obstructed.
Explain peak expiratory flow to a patient
measures how fast you can blow air out of your lungs in one breath.
What are the treatment options for AF?
Treat underlying cause
Medicines - restore heart rhythm (flecainide, sotalol, amiodarone) or rate (beta blocker, atenolol, or CCB, verapamil). Digoxin can be added. Warfarin may be necessary
Cardioversion
Pacemaker
Explain a subarachnoid haemorrhage to a patient
Blood leaks from blood vessels on surface of brain underneath a layer of the brain called the arachnoid.
Explain vascular dementia to a patient
Loss of mental abilities caused by damage to brain cells as a result of haemorrhage or lack of blood.
What are the risk factors of CVD?
hypertension, AF, hyperlipidaemia
What are the treatment options for CVD?
Statins, anticoagulants, antiplatelets
Explain COPD to a patient
smoking irritates and inflames the lungs resulting in scarring which leads to permanant changes in the lungs. Walls thicken and more mucus produced. Damage to air sacs leads to emphysema.
Or deficiency in a1antirypsin which prevents proteases breaking down lungs
How would you treat COPD?
SABA, ICS, LABA, pulmonary rehabilitation, smoking cessation
What are the treatment options for IHD?
antiplatelets, statins, beta blockers, nitrates, ACEi, CCBs, diuretics
Explain an angiogram to a patient
Tube passed into an artery and then guided to the necessary arteries. Dye injected and Xray used to highlight arteries and blockages
How is T2 DM treated?
Lifestyle advice –> +Metformin –> +sulphonylureas –> +TZD or insulin therapy
How do sulphonylureas work? ADRs? Explain to patient
Increases amount of insulin produced by pancreas
ADRs - risk of hypo, weight gain, nausea,
How do glitazones/TZDs work? ADRs? Explain to patient.
Makes bodys cells more sensitive to insulin
ADRs - weight gain, ankle swelling
How do gliptins work? ADRs? Explain to patient
Prevent breakdown of GLP-1. Hormone that helps produce insulin.
ADRs - Nausea, GORD
How do GLP-1 agonists work? ADRs? Explain to patient
Acts like GLP-1 which is a hormone that helps to produce insulin
ADR - GI, GORD
Explain epilepsy to a patient
Cells in brain called neurons. Neurons behave strangely in a seizure and fire off quickly, causing brain and body to behave strangely. Can be in only part of the brain or all of it.
Explain a simple partial seizure to a patient
Remain fully conscious. Get aura experience.
Explain a complex partial seizure to a patient
Lose sense of awareness. No memory of event and not able to respond to anyone else.
Explain a generalised seizure absence to a ptient
Losing awareness of surroundings. Vacant stare. No memory.
Explain a generalised myoclonic seizure to a patient
remain conscious. parts of body twitch or jerk
Explain a generalised clonic seizure to a patient.
May lose consciousness. Muscles twitch and lasts longer than myoclonic
Explain a generalised atonic seizure
all muscles relax. fall and injure self
Explain a generalised tonic seizure
all muscles become stiff, may lose balance and fall
explain a generalised tonic clonic seizire
Classic epileptic fit
Explain status epilepticus
Any seizure or groups of seizures that lasts longer than 30 mins. Emergency
What AEDs do you prescribe for which seizures?
Primary generalised - valproate sodium or lamotrigine
Partial seizures - carbamezepine or lamotrigine
Pregnancy - lamotrigine
What AED do you prescribe for status epilepticus?
lorazepam and iv phenytoin
How do you treat gallstones
keyhole or open surgery. Can use ursodeoxycholic acid to dissolve small gallstones that dont contain calcium but this rarely works and takes 2 yrs to work
Explain function of gallbladder
contains concentrated bile that is secrdeted to help digest fats
How do you screen for gallstones?
CT, MRI, or US
How do you treat HF?
beta blockers, ACEi, diuretics, ARBs, digoxin (last resort), anti coagulants and antiplatelets
NOT CCBs
How do you treat hypertension?
55 yo or black - CCBs
–> +ACEi or CCB –> + diuretics –> +alpha blockers, beta blockers, centrally acting drugs or vasodilators
Explain crohns to a patient
inflammation of lining of digestive system. Cann affect anywhere of GI. Disease can enter remission. Cause unknown but could be down to genetics, overactive immune system, environmental factors.
how do you treat crohns
croticosteroids to induce remission. immunosuppressants to maintain remission.
How would you test for crohns?
Colonoscopy, stool sample (blood and mucus)
Explain UC to a patient
Inflammation of large intestine and rectum. Ulcers form
What dietary advice could you give to a UC patient?
Drink lots of fluids, avoid alcohol and caffeine, keep a food diary to avoid certain triggering foods
How do you treat UC?
aminosalicylates e.g. sulphasalazine to reduce inflammation and get remission. Immunosuppressants to maintain. Surgery - colectomy - to remove large colon
Explain vasovagal syncope to a patient
Fainting that comes about due to a reduction in blood flow to the brain, restored when you fall to the floor. Caused by lack of sympathetic drive to tell the blood vessels to constrict and prevent blood pooling in legs. Can occur due to an external trigger such as unpleasnat sight or heat.
Explain how you would treat vasovagal syncope
Keep a diary of what could have caused your fainting. Avoid being dehydrated and eat regular meals to avoid hypo.
What is a carotid sinus test?
Carotid sinus is massaged whilst lying down to see if it makes you feel faint
What are the possible causes of DVT and PE??
Inactivity - causes slowing of blood flow.
Surgery - damage to blood vessels
BV damage - smoking, hypertension, hyperlipidaemia
OCP - pill makes risk of dvt increased
How would you treat/prevent a DVT?
Reduce risk with compression stockings and after DVT to prevent recurrence and post DVT damage
Exercise
Raising legs when resting to relieve pressure on veins in calf
Anti-coagulation - heparin or warfarin
Explain what the D-dimer test is
blood test to detect peices of blood clots. More fragments = increased risk of blood clot
Explain what a venogram is
Dye injected into vein in foot and x-ray used to see dye. Shows blood clots.
How would you treat PE?
heparin, warfarin, alteplase
What is a ventilation perfusion scan?
Used to examine flow of air and blood in lungs. Patient inhales radioactive gas that highlights air flow of lungs. Radioactive injection also given to show blood vessels in lungs. Test can reveal parts of lungs that have air in them but no blood supply, showing PE.
Explain graves diseaes
Overactive thyroid caused by immune system which attacks the thyroid gland and produces lots of thyroid hormones.
What can cause hyperthyroidism?
Excess iodine in diet, amiodarone (antiarrhythmic), cancer
How do you treat hyperthyroidism?
Carbimazole - ADR is itchiness or joint paint
Beta blockers to relieve symptoms of hyperthyroidism
Radioiodine - shrinks thyroid gland
Explain the thyroid function test
Blood testing for TSH and T3 and T4
How would you determine the underlying cause of hyperthyroidism
Radioactive substance swallowed and scan used to see how much of it is absorbed by thyroid. If lots its likely graves. If low it could be due to thyroiditis, too much iodine in diet, thyroid cancer
What can cause hypothyroidism?
Autoimmune attacks e.g. hashimoto
Previous thyroid treatment complication
How do you treat hypothyroidism?
Thyroid hormone replacement therapy - Levothyroxine
