Counselling Flashcards
What are some indications for a gastroscopy?
Barrett’s oesophagus
Gastric or oesophageal cancer
Coeliac disease
Hiatus hernia
Oesophageal varices
Dysphagia and dyspepsia
Nausea and vomiting
Haematemesis or malaena
Unexplained weight loss
Upper abdominal mass
What is the alternative to a gastroscopy for assessing motility problems?
Barium swallow
doesn’t require sedation, less detail, no intervention
What is the preparation required before undergoing gastroscopy?
No eating 6 hours before
No clear liquids 2 hours before
Stop PPI 2 weeks before
Check for blood thinners/other meds and allergies
What are the two options for anaesthesia during the procedure?
Local anaesthetic throat spray
IV sedation
What are some common side effects with a gastroscopy?
Gagging and retching
Sore throat
Bloating or nausea
Abdominal pain
Minor bleeding from biopsies
What are the risks associated with a gastroscopy?
Damage to teeth/dental work
Aspiration pneumonia
Perforation
Infection
Sedation risks (allergies, oversedation, cardiorespiratory depression)
What should a patient do if they experience severe symptoms after a gastroscopy?
Call 999 or go to A&E if experiencing vomiting blood, severe abdominal pain, difficulty breathing, or fever
What is the expected time frame for biopsy results after a gastroscopy?
8-10 weeks
What questions should be asked to confirm patient understanding before a procedure?
ICE
What do you already know?
Anything worrying you?
Is there anything in particular you wanted to know about?
What is an alternative to colonoscopy?
CT colonography, which involves pumping air into the colon to expand it; it is less invasive but less detailed and cannot remove lesions.
What preparation is required before a colonoscopy?
Low fibre diet for 2-3 days prior
High water intake
Moviprep strong laxatives the day before to clear the bowel
No eating on the day of the procedure - clear fluids until 2 hours before
What are common side effects after a colonoscopy?
Nausea
bloating
Crampy abdominal pain
Minor rectal bleeding
What are some risks associated with a colonoscopy?
Allergy to sedation/equipment
Heavy bleeding
Bowel perforation
Incomplete examination requiring a repeat test
Risk of missed pathology
How long should a patient avoid driving after sedation?
24 hours
How does vaccination protect society?
Through herd immunity
Herd immunity protects individuals who cannot receive vaccines due to conditions like immunodeficiency.
What is a common side effect of vaccinations in children?
Crying, irritability, and loss of appetite
Other side effects may include local reactions and fever.
What serious side effects can occur from vaccinations?
Allergic reactions, anaphylaxis, febrile convulsions
Anaphylaxis occurs in about 1 in 1 million doses in the UK (about same chance as being struck by lightning)
What are 13 diseases routinely vaccinated against in the UK?
Diphtheria
Haemophilus influenzae type B
Hepatitis B
Human papillomavirus
Measles
Meningococcal
Mumps
Pneumococcal
Polio
Rotavirus
Rubella
Tetanus
Whooping cough (pertussis)
What type of vaccine is used for Measles?
Live attenuated vaccine
What type of vaccine is used for Mumps?
Live attenuated vaccine
What type of vaccine is used for Polio?
Inactivated virus
what are 3 complications of polio?
Irreversible paralysis
Respiratory failure
Death (5-10% of those paralysed)
What are potential complications of Rotavirus infection?
Dehydration
Electrolyte imbalance
What type of vaccine is used for Rotavirus?
Live attenuated vaccine (given orally)
What organism causes Tetanus?
Clostridium tetani
what framework can be used in breaking bad news type consultations?
SPIKES
Setting
Perception - patient ideas/what they know
Invitation - do they want to discuss now?
Knowledge - are they taking in info
Emotion and empathy
Summary/strategy
what framework can be used to explain a diagnosis?
BrUCES
Brief Hx
Understanding
Concerns (ideas and expectations)
Explanation
Summarise
what are 2 ways to detox alcohol?
Cut down 10 percent per day for 10 days
Benzodiazepine withdrawal
what are 3 medications that can help with alcohol abstinence?
Acamprosate - reduces cravings (GP)
Disulfiram - increases hangover effect
Naltrexone - reduces effect of alcohol
How long does it take amitriptyline to work for migraines?
4-6 weeks
what are side effects of amitriptyline?
Anticholinergic - weight gain, fatigue, constipation, drowsiness, blurred vision, dry mouth
long QT
what are 3 complications of appendicectomy?
Pain and bruising - shoulder tip pain due to gas
Constipation
bleeding and infection
how long does it take for bisphosphonates to have an effect?
6 months
How often do people on bisphosphonates need dental checkups?
yearly for osteonecrosis of the jaw
How often is bowel cancer screening and what age range?
every 2 years
54-74 years
How quick are bowel screening results?
2 weeks
what are some side effects and risks of bronchoscopy
sore throat, bloody phlegm, feeling a bit under the weather
risk of pneumonia 1 in 100, pneumothorax, perforation
what are some risks of catheters?
Infection
leakage, bladder spasm
perforation, damage to urethra
when is cervical sceening done and what ages?
every 3 years 25-50
every 5 years 50 - 65
what needs to be checked before cervical screening?
Any possibility you’re pregnant?
When was your last period?
Any irregular bleeding?
Any pain?
what are some side effects of clozapine?
Agranulocytosis, Qt prolongation, seizures
Constipation
Excess salivation
do not stop suddenly
what are 4 potential alternatives to blood transfusion?
Iron replacement
cell salvage
EPO injection
do nothing
what are the risks of blood transfusion?
less than 1 in 10 000
identification error
reactions
TACO
TRALI
infection
formation of antibodies - could cause problems in future pregnancies
iron overload
not able to donate blood
