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Royal college IM > CTU jeopardy > Flashcards

CTU jeopardy Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Lights criteria

A

TRANSUDATIVE
Pleural Protein: serum protein <0.5
Pleural LDH: serum LDH <0.6
Pleural LDH<2/3 upper limit of normal

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2
Q

Examples of transudative pleural effusions

A 
Liver failure
Heart failure
Kidney failure
nephrotic syndrome
peritoneal dialysis 
CSF leak into the pleural space
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3
Q

Examples of exudative pleural effusions

A

Connective tissue disease
infection
Malignancy
esophageal perforation

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4
Q

Differentials for hypomagnesia

A 
Starvation
PPI's
Loop diuretics
GI losses
Renal losses
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5
Q

Define anuria

A

<0.3ml/kg/hr

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6
Q

define oliguria

A

> 0.3 - <0.5ml/kg/hr

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7
Q

Major nephrotoxic drugs to know

A

Acyclovir
NSAIDs
ACE/ARB
Lithium

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8
Q

what are the 2 types of ATN

A

Ischemic and toxic

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9
Q

Causes of Toxic ATN

A

PIPTAZO
Vancomycin
Aminoglycosides
Chemotherapy

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10
Q

Causes of ischemic ATN

A

Pre-renal AKI

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11
Q

Causes of acute interstitial nephritis

A 
PPI
ABx
NSAIDs
Allopurinol
Antiepileptic agents
(you can look for eosinophils in the urine if you are worried about AIN)
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12
Q

Causes of acute glomerulonephritis

A 
Post Strep glomerulonephritis
HIV
Hep C
Lupus glomerulonephrittis
Systemic sclerosis
Anti-GBM
IgA
ANCA vasculitis
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13
Q

What 2 questions should you ask on AKI history

A

Ins and outs

Symptoms of obstruction

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14
Q

What are cast cells in the urine? (brown casts)

A

Shedding of necrotic cells

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15
Q

What are cocci in clusters known as

A

Staphylococcus

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16
Q

What are gram positive in chains known as

A

Streptococcus

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17
Q

give an example of gram positive bacilli

A

Listeria

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18
Q

example of gram negative cocci

A

Neisseria

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19
Q

examples of atypical bacteria

A

legionella
Mycoplasma
Chlamydia

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20
Q

Antibiotics to cover skin

A

cephalexin or cefazolin

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21
Q

ABX to cover MRSA

A 
Vancomycin
Daptomycin
Linezolid
Septra
Doxycycline
22
Q

CLINDAMYCIN IS RESERVED FOR…

A

GAS GANGRENE
NECROTISING FASCIITIS
(as it is super high risk for C.diff)

23
Q

Antibiotics to cover atypical infections (STI’s or respiratory)

A

tetracyclines (doxycycline)
Macrolides
fluoroquinolones
ahminoglycosides

24
Q

Antibiotics to cover Pseudomonas

A 
PIPTAZO
Ciprofloxacin
meropenem
Levofloxacin
ceftazadime
25
Q

common bacteria causing UTI’s in order

A

E.coli
Staphylococcus saprophyticus
Proteus mirabilis
Enterococcus sp./ Kelbsiella (both 3%)

Mnemonic KEEPS

26
Q

Antibiotics which cover ESBL

A 
carbapanems
nitrofurantoin
Septra
aminpglycosides
fluoroquinolone
27
Q

SPICE organisms

A 
Serratia
providentia (pseudomonas)
Indole - positive proteus
citrobacter
Enterobacter
(have beta lactam resistance despite having in vitro susceptibility)
28
Q

antibiotics for cystitis

A

Nitrofurantoin

fosfomycin

29
Q

Antibiotic to treat Klebsiella ESBL in the community

A

Fosfomycin

30
Q

causes of hepatitis

A

HIV (acute conversion syndrome)
Alcohol
DILI (isoniazid, phenytoin, acetaminophen, chemotherapy)
metabolic such as Wilsons, hemochromatosis
ischemic - budd-chiari, shock,
HELLP

31
Q

how do you define acute liver failure

A

coagulopathy with an INR>1.5
Encephalopathy
Elevated enzymes

32
Q

causes of AST/ALT to be in the 1000’s

A

Viral

Autoimmune

33
Q

viral screening for hepatitis includes:

A

CMV, EBV, VZV, HEP A, B, C

34
Q

Screening Blood test for Wilsons

A

Ceruplasmin

35
Q

Screening blood test for hemochromatosis

A

ferritin and iron saturation

36
Q

for a diagnosis of cirrhosis you need

A

Stigmata of liver disease (spider nave, gynecomastia, caput medusa)
Portal hypertension

37
Q

Indications for SBP prophylaxis

A

Previous SBP

Cirrhosis + low protein ascites <1.5g and either renal or hepatic impairment

38
Q

Treatment for hepatorenal syndrome

A

midrodine
octreotide
albumin

39
Q

treatment of vatical bleed

A

octreotide
panto infusion
abx

40
Q

PMN count for diagnosis of SBP

A

> 250

41
Q

cut off for proteinuria in nephrotic syndrome

A

3.5g

42
Q

6 neurocognitive domains

A 
planning
Language
Social
motor
memory
complex attention
43
Q

activities of daily living include

A 
eating
drinking
bathing
transferring
dressing
44
Q

examples of instrumental ADLs

A

shopping
laundry
housekeeping
using a phone

45
Q

Lewy body dementia is caused by the deposition of which protein

A

cytoplasmic alpha-synuclein

46
Q

Alzheimers disease is caused by the deposition of

A

Amyloid plaques

TAU proteins

47
Q

protective factors for dementia

A

NSAIDs
Antioxidants
intellectual activity

48
Q

quantified screening tests for dementia include

A

MoCA

MMSE

49
Q

CAM criteria for delirium

A
  1. Acute onset and fluctuating.
  2. inattention -
  3. Disorganised thinking
  4. Altered L0C
    I and 2 and either 3 or 4 needed.
50
Q

causes for delirium

A 
Infections 
Deficiencies 
Withdrawal Endocrinopatives 
Acute metabolic 
Acute vascular Trauma. Toxins or drugs. CNS pathology. Heavy metals. Hypoxia.
51
Q

predisposing risk factors for delirium

A

over 60
depression
male
visual impairment

Royal college IM (18 decks)

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