Corrections 8 Flashcards
Corrections of Kaposi’s sarcoma in paeds?
Much rarer to find the characteristic skin lesions.
Most common symptom –> lymphadenopathy
Which NSAID is contraindicated in breastfeeding?
Naproxen
Cause of hepatic encephalopathy after a TIPS?
Due to inadequate metabolism of nitrogenous waste products by the liver.
TIPS causes blood from the portal system to bypass the liver and enter the systemic circulation without the metabolism of nitrogenous waste products such as ammonia.
As these build up in the systemic circulation, increased ammonia is able to cross the blood brain barrier resulting in hepatic encephalopathy
Mechanism of dabigatran?
Direct thrombin inhibitor
Mechanism of rivaroxaban & apixaban?
Factor Xa inhibitors
Mechanism of heparin?
Activates antithrombin III
Why is a multi-level PT required instead of a standard PT following TOP?
A standard pregnancy test is unable to quantify the levels of hCG.
A multi-level pregnancy test helps guide further management if hCG levels have not fallen adequately.
Referral criteria for suspected cancreatic cancer?
2ww referral: ≥40 y/o + jaundice
Direct access urgent CT scan: ≥60 y/o + weight loss and one of the following; diarrhoea, N&V, constipation, new onset diabetes, abdo pain, back pain
When are ACEi indicated in CKD?
CKD stage 3 or higher
ACR >30
What mutation is seen in Li-Fraumeni syndrome?
p53 (tumour suppressor)
Breast cancer screening?
Mammogram every 3 years in women aged 50-70
What can be considered in very high/refractory cases of hypercalcaemia?
Calcitonin
Liver cancer referral guidelines?
Urgent direct access US (within 2 weeks) to assess in people with an upper abdominal mass consistent with an enlarged liver.
Which lung cancer has the strongest association with smoking?
Squamous cell lung cancer
Most common side effect of ondansetron?
Constipation
1st line anti-emetic for intracranial causes of nausea and vomiting?
Cyclizine
Pharmacological management of hiccups in palliative care?
Chlorpromazine or haloperidol
Describe WHO performance status
0 = normal
1 = Ambulatory and able to perform light work, but restricted from strenuous activity
2 = Ambulatory and able to perform self-care, but unable to work
3 = Confined to bed or chair >50% waking hours
4 = Bedbound and unable to perform self-care
5 = Dead
What drug is indicated for agitation and confusion in patients who are NOT in the terminal phase?
Haloperidol
(midazolam in the terminal phase)
What side effect of radiation therapy can cause difficulty swallowing, hoarseness and coughing?
Radiation induced laryngeal oedema
Typical dose of morphine in end-of-life?
2.5-5mg SC every 4 hours
What cancer can long-term exposure to high levels of benzene in the air lead to?
Benzene
What is the usual treatment regime for active tuberculosis? (4)
Rifampicin for 4 months
Isoniazid for 6 months
Ethambutol for 2 months
Pyrazinamide for 2 months
What is required to exclude malaria in a patient where malaria is a possible diagnosis?
3 negative malaria blood films taken over 3 days
What is involved in the Mantoux test?
Injecting tuberculin into the intradermal space on the forearm and assessing the reaction after 72 hours
What is the usual first-line treatment for severe or complicated malaria? (1)
IV artesunate
What are the key characteristics that distinguish gram-positive bacteria from gram-negative bacteria? (2)
Gram +ve bacteria have a thick peptidoglycan cell wall that stains with crystal violet stain.
For patients with acute heart failure, what may be useful if the patient has concomitant myocardial ischaemia or severe hypertension?
Nitrates e.g. GTN
Nitrates function by dilating the coronary arteries, thereby enhancing blood flow to the cardiac myocardium. In addition, the vasodilatory effects of nitrates reduce preload and afterload.
what is seen on a peripheral semar in malaria?
Parasites
What urine osmolality result post-water deprivation excludes diabetes insipidus?
> 600
What urine osmolality result post-water deprivation indicates diabetes insipidus?
Urine osmolality < 400mOsm/kg and raised serum osmolality indicates an inability to concentrate urine
1st line mx of superficial thrombophlebitis?
NSAIDs +/- compression stockings
