confusion week learning points

Question 1

when you prescribe a topical cream what else do you need to do

Answer 1

say the place where it needs to go

Question 2

diarrhoea leads to dehydration how

what does sugar do to bowels

Answer 2

they can lose large amounts of salts and water from their bodies

can loosen bowels making it mucus too

Question 3

when giving novarapid for high glucose what should you do

Answer 3

give it with food to prevent a hypo

Question 4

Glutamate dehydrogenase posotive indicates what

Answer 4

indicates a presence of C-diff bacteria in your bowel.

only treat if c diff present

GDH is an abbreviation for Glutamate dehydrogenase, which is a chemical found in C. diff. If the result is GDH positive a second test is performed to look for toxins that are produced when C. diff is causing an infection.

caused by abx reeducing gut flora so can kill - need oral vancomyin not IV so that it goes into gut where it is

Question 5

why is low albumin a poor prognostic sign

Answer 5

as reflects a state of malnutrition

head and neck on CXR - poor porgnsotic as cannot keep head up

Question 6

staph bacteraeimai you need to find the original site of infection
how to check for endocarditis

Answer 6

TOE - transthoracic echo

Question 7

what is the blue book

Answer 7

used for the last 72 hours of life

stop VTE prophyalxis pointless

Question 8

what is a stoma

Answer 8

opening of the abdomen that can be connected to bowel or urinary system etc

Question 9

poor LV systolic dysfucntion what drug is good

Answer 9

ACEi

Question 10

paroxysmal AF what shoudl patient be on

Answer 10

DOAC

Question 11

loperamide moa

Answer 11

slowing intestinal motility and by affecting water and electrolyte movement through the bowel. Loperamide binds to the opiate receptor in the gut wall.

also CCB

loperamide will cause feacal loading

cosntipation can lead to diverticular

Question 12

if PPI cause diarrhoea what coudl you change to

Answer 12

Famotidine, an H2 antagonist, blocks the action of histamine on the parietal cells, ultimately reducing acid secretion into the stomach.

Question 13

foot drop what physcial aid can you give

Answer 13

toe off splint - help push off when walking

Question 14

What is Todd’s paralysis?

Answer 14

Todd’s paralysis is a neurological condition experienced by individuals with epilepsy, in which a seizure is followed by a brief period of temporary paralysis.

Question 15

bladder scan in aki

Answer 15

to exlcude anything - UR , or more sinister

Question 16

if both platelts and potassium raised on bloods what shoudl you do

Answer 16

get a green tube - lithium and heparin - plasma seperator

Question 17

betahistine is what

Answer 17

anti-vertigo mainly acts as a histamine H1-receptor agonist., meineres disease

Question 18

sodium hyaluronate does what

Answer 18

hydrates skin

Question 19

penumonic acute delirium

Answer 19

PINCHME
pain
infection - UTI
nutrition
constipation
hydration
medications
electroyltes and everything else - high calcium so need bone profiel , B12 and folate and sodium , thryodi, UR ,

Question 20

sleep wake cycle regulalry distrubed same time and sundwonign ( day sleep as worse at night)

Answer 20

dementia

Question 21

community beds are for rehab what is D2A bed

Answer 21

discharge to assess - nrusing home monitor behaviour for 6w then decide what sort of permanent place they need

Question 22

what anti-depressant good for sleep as well

Answer 22

mirtazapine

Question 23

possible causes of hepatic skin lesions

Answer 23

Scarring (cirrhosis) from chronic liver disease, which occurs with hepatitis B, hepatitis C and heavy drinking. Smoking. Hormones found in birth control pills.

Question 24

how does one sided neglect occur

stroke

Answer 24

Neglect is caused by a decrease in stimuli in the contralesional side because of a lack of ipsilesional stimulation of the visual cortex and an increased inhibition of the contralesional side.

Question 25

how does one sided neglect occur

stroke

Answer 25

Neglect is caused by a decrease in stimuli in the contralesional side because of a lack of ipsilesional stimulation of the visual cortex and an increased inhibition of the contralesional side.

Question 26

hoffmans relfex

Answer 26

UMN - flcik nail of middle finger and watch for index finger flexion
If your thumb or forefinger move after the doctor’s flick

Question 27

drift relfex

Answer 27

supinated hands out in front - arm will drift in and pronate
cerbellum

Question 28

low sodium and high potassium what else shiydl you check

Answer 28

glucose Potentially, hypoglycemia episodes are more severe and of higher risk in patients with Addison’s disease because of the deficient counterregulatory excretion of cortisol.

Question 29

sodium zirconium moa

Answer 29

Sodium zirconium cyclosilicate is a non-absorbed cation-exchange compound that acts as a selective potassium binder in the gastro-intestinal tract treat high potassium.

Question 30

anti insulin hormones

Answer 30

GH
glucagon
cortisol
adrenaline
nor adrenlaien

Question 31

hwo tall for tall tented t waves

Answer 31

It is unusual for T waves to be taller than 5 mm in limb leads and taller than 10 mm in chest leads. Hyperkalemia should be suspect if these limits are exceeded in more than one lead.

st elevation not return to base line

Question 32

high take off sign of

Answer 32

Lv strain

Question 33

magensium fucntion

Answer 33

smooth msucles relaxation

Question 34

hypothermai ecg

Answer 34

The classic and well-known ECG manifestations of hypothermia include the presence of J (Osborn) waves, interval (PR, QRS, QT) prolongation, and atrial and ventricular arrhythmias.

Question 35

pursing of lips

Answer 35

tardive Dyskinesia - sign of antipsychotics

Question 36

ischaemic heart disease ecg

Answer 36

The most common ECG sign of myocardial ischemia is flat or down-sloping ST-segment depression of 1.0 mm or greater.

RBBB normal