Core random Qs Flashcards
What are the 3 catergories of depression Sx
Biological
Somatic
Psychological
What is PHQ-9 and give 2 other things similar to it
Patient Health Questionnaire it assess depression severity
Geriatric Depression Scale (GDS)
Hospital Anxiety and Depression Scale (HAD)
What do you need to always ask for a patient with suspected mental health problem
Suicide or self harm
Any past attempts to harm yourself?
any current attempts?
Risk to self
Did you think of harming anyone around you?
R u able to cope at home? and managing basic living skills? intoxication?
Psych drugs
selective seratonin reuptake inhibitors SSRI e.g. fluoxetine, citalopram
noradrenergic and specific serotonergic antidepressant NaSSA
selective norepinephrine reuptake inhibitor SNRI e.g. venlafaxine
Dementia
causes - alzheimer Rx with acetylholinestrase inhibitor, vascular Rx with aspirin, parkinson’s
DDx - delirium,pseudo-dementia (with depression)
Sx - mostly family recognised
Rx- support all aspects of life
Awareness of place and time and date
5 As of alzheimers
Amnesia - short or complete memory loss
Aphasia - speech
Agnosia - inability to use senses for recognition (visual agnosia
Apraxia - inability to perform certain actions (dressing apraxia)
BPSD? - behavioral and psychological symptoms of dementia
whats aphasia
Aphasia expressive - can understand perfectly but cant articulate
Aphasia receptive - cant understand but speech is perfect
What is the IQ of a person with learning disability
An IQ under 70
Learning Disability’, ‘Learning Difficulty’ and ‘Intellectual Disability
Learning disabilty is a big problem
learning difficulty - dyslexia
learning difficulty and intellectual disability are interchangeable terms
Degrees of learning disablities
50-69 - fair language, reasonable independance
35-49 better receptive than expressive
20-34 50% will have epilepsy, receptive and expressive
20> increased need and vulnerability 12M developmental level (profound)
what is not learning disability
people who develop an IQ less than 70 after age of 18 of any cause
people who have dyslexia or delayed language and speech development
Learning disablity puts you at risk of which conditons
Dementia
Alzheimer’s in downs syndrome
psychological 2-3 times higher risk
physical health problems often missed
1/3 of LD develop epilepsy with Sleep disorder Mood change and Self harm
important things with learning difficulties
safeguarding
capacity
consent
Deprivation of liberty
Illicit Drugs
Heroin A constricted pupils
Cocaine A - stim MI tachy
N LSD A No W/D -DOP-5ht antagonist -halluc- psychosis
N MDMA A -stim dilated pupils- de and over hydration paranoia - rhabdomyolysis
N Psilocybin Mushrooms A - No W/D -5ht partial agonist relaxed, hullc - poisoning, stomach pain paranoia
Cannabis B anxious diarrhea cravings paranoia schiz
Amphetamines B stim monoamine agonist/antagonist
Ketamine B - No W/D -NMDA -relaxed, halluc- GA
Mephedrone B - No W/D- Monoamine agonist/ant -stim, seizures epistaxis
GHB/GBL C stim
Benzodiazepines C - relax GABA
Alcohol - GABA
N Amyl Nitrate - rush high - sudden death
Stroke
TIA
complete or in evolotion (progressive)
Sx weakness (reflexes?), visual (x3), visio-spatial (cortex), speech (aphasia, dysarthria), ataxia, headache, coma, apraxia?
seizures and coma?
focal neuro deficit
inv
cardiac emboli
Rx- tissue plasmonigen, aspirin, hep and warf?
risks
causes
ABCD2
Reflexes
Parkinson’s disease
vascular or idiopathic
triad of PD - tremor, tone, bradykinesia
Rx - levodopa, decarboxylas, MONO, COMPT, anticholinergics
Holiperidol ?
when to inv? - pyramidal involvement
risks - familial, age, gender, environmental
Epilepsy
type of seizures tonic clonic absence myoclonic clonic tonic atonic - flaccid
focal - simple and complex
inv
Rx
Meningitis
Meningism
viral causes - headache?
pnemonia?
LP and CT - PCR, blood cultures
bacterial
Rx
Migraines
Causes - CHOCOLATE the pill HRT
Rx
DDx
prevention
AAA
8:1 age 3M:1F scary
abdo pain going to the back or groin like renal colic
complications- rupture, fibrosis, hydronephrosis, thrombus
weird Rx
all >5.5 surgery
> 6 DVLA >6.5 no drive
layers
Asthma
3 asthma
hay fever
ladder
acute and chronic
PEFR
Pneumonia
CAP- strep. pneumonia, H.influenzae, mycoplasma pneumonoa
HAP gram-ve entero, staph aureas, pseudomonas
CURB65
COPD
COPD ladder
emphysema
Genetics
Surgical sieve
V: vascular I: infective/Inflammatory T: traumatic A: autoimmune M: metabolic I: iatrogenic/idiopathic N: neoplastic C: congenital D: degenerative/developmental E: endocrine/environmental F: functional
UTI
umbrellax4
organisims
Rx
Gram -ve vs gram +ve
blue +ve
more susceptible to Abx, penicillin and vancomycin Vgood
streptococcus, staphylcoccus, clostridium
steroptomycin and tetracyclines dnt do shit
red -ve
More resistant to Abx Penicillin and vancomycin Bad
E coli
H. influenzae
pesuedomonas
neisseria meningitidis
steroptomycin and tetracyclines killsem
Urinary tract obstruction
Common places
Hydronephrosis
Inv
Rx
causes - calculi mostly
AKI
Commonest causes
ischaemia to kidneys
Drugs
sepsis
Commonest risks for developing AKI
Diabetes
Sepsis
Drugs
STOP AKI
Sepsis
Toxins - nephrtoxic drugs stop
Optimized BP
Prevent complications: hyperkalaemia, pulmonary oedaema, acidosis, pericarditis
Identify cause
CKD
Stages
Rx
ELSA BCD
Electrolyte imbalances
Life - diet exercise smoking
Stop nephrotoxins
ACE or ARB for proteinuria
BP 130/80
Complication screen
Vit D for renal bone disease
Sx
fluid overload,
Aims of Rx - prevent further damage, complications, prepare for RRT
BPH
Hx - diurnal, frequency, night, volume
Sx - HIFU
Rx - med and surgery
black>white
Black>white
HTN
CKDx4
BPH
Prostate cancer
Adenocarcinomas
Breast
Pancrease
Prostate
Colon
bladder - squamos cell carncinoma
Prostate cancer
Adenocarcinoma
metastasis - B and L
Men 1-9UK and 26% of men cancer
risks- Fx age black
Sx - FIHU heamturia incontinence
DDx
Inv
.
Rx
prognosis - die with it not from it, >10% live >10yrs, >10% die within 6 months
GORD
Causes- HGOOSAS
complications
extra-oesophageal Sx
Peptic ulcer
Gastric and duedenal
Causes hiatus hernia NSAIDs
risks smoking alcohol
comp - perf, stricture, malignancy bleeding
IBD
UC HLADR103
eyes - uveitis
sx - bouts of diarrhoea +/- blood or mucus
sigmoidoscopy - loss of vascular patter
risk - 15-30, less in smokers, appendectomy protects
IBD eyes- conujuctivitis, iritis, episcliritis
Investigations? barium,CT
crohns
symptoms - dirarhoea urgency wakeup in morning and tfjeer in 45minz
signs - mouth ulcers, anal tags, fistulas, perianal abscess, anal stricture, abdo tender/mass
crohn’s risks - commoner in smokers
GI bleed
Upper - haematemesis - from oesophagus, stomach, or deuodenum.
causes Hpylori, mallory weiss, alcohol, NSAIDs, peptic ulcer
causes of lower GI bleed - divericular disease, meckels diverticulum, mesenteric
Hepatitis
Check normal cards
Pancreatitis
Causes I GET SMASHED3
Sx sudden severe epi pain to back with vomiting
cauda equina 3 features
saddle area numbness
1 or 2 leg weakness
bowel or urine incontinence
AF
Flexanide PO if it is paroxysmal AF - infrequent episodes
