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OSCE > Clinical Conditions > Flashcards

Clinical Conditions Flashcards

1
Q

What is the disease progression of alcoholic liver disease?

A

fatty liver disease –> alcoholic hepatitis –> cirrhosis

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2
Q

What treatment options are there for alcoholic liver disease?

A

Abstinence from alcohol. Disulfiram can be used.

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3
Q

What are the treatment options for anaemia?

A

Treat underlying condition. Iron supplements and/or blood transfusions

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4
Q

Explain to a patient what a blood smear is

A

Sample of blood under microscope to examine size, shape and colour of your RBCs.

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5
Q

Explain to a patient microcytic, normocytic and macrocytic anemia

A

anemia caused by the RBCs being smaller/same size/ or bigger.

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6
Q

What are the treatment options for asthma?

A

Medicines - SABA –> + inhaled steroid –> +LABA –> +4th drug or increase inhaled steroid –> +oral steroid OR anti-IgE therapy

Exercise, stop smoking, vaccinations to prevent infections

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7
Q

Explain spirometry to a patient

A

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.

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8
Q

Explain peak expiratory flow to a patient

A

measures how fast you can blow air out of your lungs in one breath.

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9
Q

What are the treatment options for AF?

A

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

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10
Q

Explain a subarachnoid haemorrhage to a patient

A

Blood leaks from blood vessels on surface of brain underneath a layer of the brain called the arachnoid.

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11
Q

Explain vascular dementia to a patient

A

Loss of mental abilities caused by damage to brain cells as a result of haemorrhage or lack of blood.

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12
Q

What are the risk factors of CVD?

A

hypertension, AF, hyperlipidaemia

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13
Q

What are the treatment options for CVD?

A

Statins, anticoagulants, antiplatelets

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14
Q

Explain COPD to a patient

A

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

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15
Q

How would you treat COPD?

A

SABA, ICS, LABA, pulmonary rehabilitation, smoking cessation

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16
Q

What are the treatment options for IHD?

A

antiplatelets, statins, beta blockers, nitrates, ACEi, CCBs, diuretics

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17
Q

Explain an angiogram to a patient

A

Tube passed into an artery and then guided to the necessary arteries. Dye injected and Xray used to highlight arteries and blockages

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18
Q

How is T2 DM treated?

A

Lifestyle advice –> +Metformin –> +sulphonylureas –> +TZD or insulin therapy

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19
Q

How do sulphonylureas work? ADRs? Explain to patient

A

Increases amount of insulin produced by pancreas

ADRs - risk of hypo, weight gain, nausea,

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20
Q

How do glitazones/TZDs work? ADRs? Explain to patient.

A

Makes bodys cells more sensitive to insulin

ADRs - weight gain, ankle swelling

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21
Q

How do gliptins work? ADRs? Explain to patient

A

Prevent breakdown of GLP-1. Hormone that helps produce insulin.
ADRs - Nausea, GORD

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22
Q

How do GLP-1 agonists work? ADRs? Explain to patient

A

Acts like GLP-1 which is a hormone that helps to produce insulin
ADR - GI, GORD

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23
Q

Explain epilepsy to a patient

A

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.

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24
Q

Explain a simple partial seizure to a patient

A

Remain fully conscious. Get aura experience.

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25
Q

Explain a complex partial seizure to a patient

A

Lose sense of awareness. No memory of event and not able to respond to anyone else.

26
Q

Explain a generalised seizure absence to a ptient

A

Losing awareness of surroundings. Vacant stare. No memory.

27
Q

Explain a generalised myoclonic seizure to a patient

A

remain conscious. parts of body twitch or jerk

28
Q

Explain a generalised clonic seizure to a patient.

A

May lose consciousness. Muscles twitch and lasts longer than myoclonic

29
Q

Explain a generalised atonic seizure

A

all muscles relax. fall and injure self

30
Q

Explain a generalised tonic seizure

A

all muscles become stiff, may lose balance and fall

31
Q

explain a generalised tonic clonic seizire

A

Classic epileptic fit

32
Q

Explain status epilepticus

A

Any seizure or groups of seizures that lasts longer than 30 mins. Emergency

33
Q

What AEDs do you prescribe for which seizures?

A

Primary generalised - valproate sodium or lamotrigine
Partial seizures - carbamezepine or lamotrigine
Pregnancy - lamotrigine

34
Q

What AED do you prescribe for status epilepticus?

A

lorazepam and iv phenytoin

35
Q

How do you treat gallstones

A

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

36
Q

Explain function of gallbladder

A

contains concentrated bile that is secrdeted to help digest fats

37
Q

How do you screen for gallstones?

A

CT, MRI, or US

38
Q

How do you treat HF?

A

beta blockers, ACEi, diuretics, ARBs, digoxin (last resort), anti coagulants and antiplatelets

NOT CCBs

39
Q

How do you treat hypertension?

A

55 yo or black - CCBs

–> +ACEi or CCB –> + diuretics –> +alpha blockers, beta blockers, centrally acting drugs or vasodilators

40
Q

Explain crohns to a patient

A

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.

41
Q

how do you treat crohns

A

croticosteroids to induce remission. immunosuppressants to maintain remission.

42
Q

How would you test for crohns?

A

Colonoscopy, stool sample (blood and mucus)

43
Q

Explain UC to a patient

A

Inflammation of large intestine and rectum. Ulcers form

44
Q

What dietary advice could you give to a UC patient?

A

Drink lots of fluids, avoid alcohol and caffeine, keep a food diary to avoid certain triggering foods

45
Q

How do you treat UC?

A

aminosalicylates e.g. sulphasalazine to reduce inflammation and get remission. Immunosuppressants to maintain. Surgery - colectomy - to remove large colon

46
Q

Explain vasovagal syncope to a patient

A

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.

47
Q

Explain how you would treat vasovagal syncope

A

Keep a diary of what could have caused your fainting. Avoid being dehydrated and eat regular meals to avoid hypo.

48
Q

What is a carotid sinus test?

A

Carotid sinus is massaged whilst lying down to see if it makes you feel faint

49
Q

What are the possible causes of DVT and PE??

A

Inactivity - causes slowing of blood flow.
Surgery - damage to blood vessels
BV damage - smoking, hypertension, hyperlipidaemia
OCP - pill makes risk of dvt increased

50
Q

How would you treat/prevent a DVT?

A

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

51
Q

Explain what the D-dimer test is

A

blood test to detect peices of blood clots. More fragments = increased risk of blood clot

52
Q

Explain what a venogram is

A

Dye injected into vein in foot and x-ray used to see dye. Shows blood clots.

53
Q

How would you treat PE?

A

heparin, warfarin, alteplase

54
Q

What is a ventilation perfusion scan?

A

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.

55
Q

Explain graves diseaes

A

Overactive thyroid caused by immune system which attacks the thyroid gland and produces lots of thyroid hormones.

56
Q

What can cause hyperthyroidism?

A

Excess iodine in diet, amiodarone (antiarrhythmic), cancer

57
Q

How do you treat hyperthyroidism?

A

Carbimazole - ADR is itchiness or joint paint
Beta blockers to relieve symptoms of hyperthyroidism
Radioiodine - shrinks thyroid gland

58
Q

Explain the thyroid function test

A

Blood testing for TSH and T3 and T4

59
Q

How would you determine the underlying cause of hyperthyroidism

A

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

60
Q

What can cause hypothyroidism?

A

Autoimmune attacks e.g. hashimoto

Previous thyroid treatment complication

61
Q

How do you treat hypothyroidism?

A

Thyroid hormone replacement therapy - Levothyroxine

OSCE (12 decks)

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