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07/24-02 class (copy-pasted cards issue) > deck 3 (more than 30 cards) > Flashcards

deck 3 (more than 30 cards) Flashcards

1
Q

Acute Bronchitis - Aetiology

A

Viral

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2
Q

Acute Bronchitis - Key findings

A

loose rattly cough + sputumpost-tussive glut/vomitwellpost URTINO creps/wheeze

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3
Q

Acute Bronchitis - Managment

A

Supportive

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4
Q

Acute Bronchitis - Prognosis

A

Self-limiting

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5
Q

Anaemia - Aetiology

A

Deficiencies (iron, B12, folate)ThalassaemiamalignancySecondary (of chronic disease)

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6
Q

Anaemia - Epidemiology

A

Menstruating girls and womenPregnant/PPYoung children

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7
Q

Anaphylaxis - Key findings

A

Sudden and rapid progressionABC problems +- skin and mucosal changesurticaria, pruritus, flushingVasodilation -> warm extremtities, low BPCapillary leak -> hypovolaemia, oedemaBronchospasmGI symptoms

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8
Q

Anaemia - Key findings

A

Low HgPallor. fatigue, dyspnoea, anorexia, headache, bowel disturbance

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9
Q

Anaemia - Investigations

A

FBCBlood filmFerritinReticulocyte count

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10
Q

Anaemia - Managment

A

IMAGE HERE - DM

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11
Q

Anaphylaxis - Aetiology

A

Type I hypersensitivityFood, drugs, venom

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12
Q

Anaphylaxis - Investigations

A

Tryptase blood sample (ASAP = 1-2 h after)

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13
Q

Anaphylaxis - Managment

A

AdrenalineChlorphenamineHydrocortisoneNebulised salbutamolADMIT

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14
Q

Anaphylaxis - Prognosis

A

ResolutionDeath due to resp failure or cardio collapse

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15
Q

Anxiety disorder - Aetiology

A

Biopsychosocial factors???

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16
Q

Anxiety disorder - Epidemiology

A

Most common psych disorder1-7% prevalence in EuropeF>M35-55 yo

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17
Q

Anxiety disorder - Key findings

A

Excessive worry about everyday issues disproportionate to risk3 or more of: restless/nervous, easily fatigued, poor concentration. irritability, muscle tension, sleep disturbance>6msignificant distress or impairment

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18
Q

Anxiety disorder - Investigations

A

GAD-7 questionnaire

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19
Q

Anxiety disorder - Complications

A

Impaired functioningComorbidities (depression, substance misuse or dependance)SuicideIncreased use of healthcare

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20
Q

Anxiety disorder - Prognosis

A

Chronic fluctuatingLow rates of remission

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21
Q

Anxiety disorder - Managment

A

Step approach (if marked impairment - 3.)1. Communicate and educate, monitor2. Individual non-facilitated self-help, individual guided self-help, psychoeducational groups (all CBT based)3. Hight-intensity psych intervention (CBT, 12-15w 1 h), SSRI (sertraline, paroxetine, escitalopram), SNRI (duloxetine, venlafaxine) - monitor weekly for first month for suicide4. Referral

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22
Q

Atrial Fibrillation - Aetiology

A

Unknown

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23
Q

Atrial Fibrillation - Epidemiology

A

2.5% in EnglandM>F

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24
Q

Atrial Fibrillation - Key findings

A

Supraventricular tachyarrhythmiaHR 160-180Irregularly irregular pulseParoxysmal/persistant/permanentBreathless, palpitations, chest discomfort, syncope, dizziness

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25
Q

Atrial Fibrillation - Investigations

A

12-lead ECG (normal/ambulatory)EchoCXRBloodsCHA2DS2-VASCc

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26
Q

Atrial Fibrillation - Complications

A

StrokeHeart failure

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27
Q

Atrial Fibrillation - Managment

A

If CHADSVASC 2 or more - DOAC (Apixaban, dabigatran, edoxaban and rivaroxaban)If CI - vit K antagonist (warfarin)Beta blockerRate-limiting calcium channel (verapamil)

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28
Q

Asthma - Aetiology

A

Unknown

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29
Q

Asthma - Epidemiology

A

12 % of UKChildren (M>F)M=F in adulthoodCould be occupational

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30
Q

Asthma - Key findings

A

SOBWheezeCoughChest tightness Episodic, diurnal, triggers

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31
Q

Asthma - Investigations

A

Hx FeNOSpirometry PEFRBronchodilator reversibility

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32
Q

Asthma - Management (Adults)

A

IMAGE HERE - DM

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33
Q

Asthma - Management (Children)

A

IMAGE HERE - DM

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34
Q

Asthma - Complications

A

Acute exacerbation

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35
Q

Asthma - Acute exacerbation management (adults)

A

Admit if life threatening or near fatal or severe persistent after initial treatment (according to PAAP)OxygenBeta agonists (Salbutamol) + steroids (Prednisolone, 40-50 mg for at least 5 days)Nebulised Ipratropium bromide (severe or life-threatening asthma or those with a poor initial response)IV Magnesium SulfateIV Aminophylline

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36
Q

Asthma - Acute exacerbation (children)

A

IMAGE HERE - DM

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37
Q

Asthma - Acute exacerbation managment (children)

A

OxygenSABAIpratropium bromide (every 20-30 mins)Oral prednisoloneNebulised magnesium sulfate if severe2nd lineIV SalbutamolIV Aminophylline if severeIV Magnesium sulfate

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38
Q

Eczema - Aetiology

A

Skin barrier dysfunction??? FilaggrinEnvironmental factors or allergens

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39
Q

Eczema - Epidemiology

A

Children 20%Adults 10%

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40
Q

Eczema - Key findings

A

Dry, pruritic skin, and is typically an episodic disease of flaresChronic inflammatoryPersonal and familial atopic hx

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41
Q

Eczema - Investigations

A

HxExam rash

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42
Q

Eczema - Management

A

EmollientsTopical CorticosteroidsAntihistaminesOral corticosteroids

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43
Q

Eczema - Complictaions

A

Eczema herpaticum (admit)Infected eczema (weeping, pustules, crusts, fever and malaise)

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44
Q

Bronchiolitis - Aetiology

A

Viral

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45
Q

Bronchiolitis - Epidemiology

A

Peak at 3 - 6 m<1 yo (up to 2yo)

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46
Q

Bronchiolitis - Key findings

A

Symptom peak at 5dResolution within 3wCoryzal prodromePersistent cough + tachypnoea/chest recession + wheeze/cracklesYoung infants (<6 we) may only have apnoea

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47
Q

Bronchiolitis - Differentials

A

Pneumonia if high fever and/or persistently focal cracklesViral induced wheeze (older, no crackles, recurrent episodes, atopic hx)

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48
Q

Bronchiolitis - Investigations

A

Oxygen satsTempResp exam

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49
Q

Bronchiolitis - Managment

A

Reassure + conservativeAdmit to hospital if apnoea, sats <90% (<92% if under 6w), inadequate fluids, persistent sever reps distress, risk factorsOxygenCPAPNG tube

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50
Q

Bronchiolitis - Complications

A

Acute resp distress syndromeBronchiolitis obliterans Congestive HF

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51
Q

Heart failure - Aetiology

A

Coronary artery diseaseMIIschaemiaHypertension Cardiomyopathy Arrhythmias Valvar and congenital heart diseaseAlcohol and drugsPericardial diseaseHigh output

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52
Q

Heart failure - Epidemiology

A

Age

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53
Q

Heart failure - Key findings

A

SOBFatigue Swollen ankles and legsLightheaded mess and faintingCoughWheezeBloatingAppetite lossWeight gain/lossConfusionFast HRPalpitations

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54
Q

Heart Failure - Investigations

A

N-terminal pro-B-type natriuretic peptide >400ng/L diagnostic (if >2000ng/L refer urgently)EchoECGCXRBloodsUrinalysis Peak flow/spirometry

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55
Q

Heart failure - Managment

A

Lifestyle adviceTreat underlying causeIf reduced ejection fraction - ACEi + beta blocker, Ivabradine, Savibitril valsartan, DigoxinAll HF types - diuretics, calcium channel blockers, amiodarone, anticoagulant, vaccinations

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56
Q

Heart failure - Complications

A

Arrhythmias DepressionCachexia AnaemiaCKDAKISexual dysfunction Sudden cardiac death

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57
Q

Chronic kidney disease - Aetiology

A

DiabetesHypertension Glomerulonephritis

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58
Q

Chronic kidney disease - Epidemiology

A

Over 65sF>M

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59
Q

Chronic kidney disease - Key findings

A

FatigueTrouble concentratingPoor appetite Trouble sleeping

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60
Q

Chronic kidney disease - Investigations

A

U&EscreatinineeGFRUrine albumin-to-creatinine ratiourine dipstick for haematuriaCheck nutritional status, BMI, BP, and serum HbA1c and lipid profile (cardiovascular risk factors)renal US if indicated, (suspected urinary tract stones or obstruction, FHx of polycystic kidney disease and > 20 yo)

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61
Q

Chronic Kidney Disease - Managment

A

Underlying causesMonitor serum creatinine and eGFRManage hypertension urinary ACR of 70 mg/mmol or more - lisinopril or losartan irrespective of blood pressureatorvastatin 20 mgantiplateletsavoid nephrotoxic drugs

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62
Q

Chronic Kidney Disease - Complications

A

AKIHypertension and dyslipidaemiaCVDRenal anaemiaRenal mineral and bone disorderPeripheral neuropathy and myopathyMalnutritionMalignancyEnd stage renal disease

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63
Q

COPD - Aetiology

A

SmokingOccupationalAir pollutionAlpha1-antitrypsin deficiency

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64
Q

COPD - Epidemiology

A

1.2 million in UK>40 yoM=F

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65
Q

COPD - Key Findings

A

Breathlessness — persistent, progressive, and worse on exertionChronic/recurrent coughRegular sputum productionFrequent lower respiratory tract infectionsWheezeCyanosisRaised jugular venous pressure and/or peripheral oedema CachexiaHyperinflation of the chestUse of accessory muscles and/or pursed lip breathingWheeze and/or crackles on auscultation of the chest

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66
Q

COPD - Investigations

A

Spirometry - post bronchodilator FEV1/FVC less than 0.7 confirms persistent airflow obstructionCXRFBC

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67
Q

COPD - Managment

A

Stop smokingOffer pneumococcal and influenza vaccinationsOffer pulmonary rehabilitation if indicatedSABA/SAMA if limited by breathlessnessLABA + LAMA (if no asthmatic features/no steroid responsiveness)LABA + ICS

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68
Q

COPD - Complications

A

Reduced QoL, increased mortalityExacerbation (frequent chest infection)Depression and anxietyCor pulmonaleSecondary polycythaemia (due to hypoxia)Respiratory failurePneumothoraxLung cancerMuscle wasting and cachexia

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69
Q

COPD - Exacerbation treatment

A

Oral steroids - 30 mg oral prednisolone once daily for 5 daysAbx may be neededAmoxicillin 500 mg three times a day for 5 daysDoxycycline 200 mg on first day, then 100mg once a day for 5-day course in totalClarithromycin 500 mg twice a day for 5 days

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70
Q

COPD - End of life treatment

A

Advanced care planOpioids, Benzodiazepines, tricyclic antidepressants, major tranquillisers or oxygen

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71
Q

Conjunctivitis - Aetiology

A

80% viralAdenovirus, Streptococcus pneumoniae, Staphylococcus aureus and Haemophilus influenzae

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72
Q

Hyperacute conjunctivitis

A

Hyperacute conjunctivitis is a rapidly developing severe conjunctivitis typically caused by infection with Neisseria gonorrhoeae

73
Q

Ophthalmia neonatorum (ON)

A

Conjunctivitis occurring within the first 4 weeks of lifeInfectious or non-infectious.Neisseria gonorrhoeae or Chlamydia trachomatisSerious complications if not treated promptly and appropriately

74
Q

Conjunctivitis - Epidemiology

A

1% of all GP consultations in the UK

75
Q

Conjunctivitis - Key Findings

A

Acute onset conjunctival erythema.Discomfort which may be described as ‘grittiness’, ‘foreign body’ or ‘burning’ sensationWatering and discharge which may cause transient blurring of vision

76
Q

Conjunctivitis - Investigations

A

NO routine swabsSwabs for purulent discharge

77
Q

Conjunctivitis - Red flags

A

Reduced visual acuityMarked eye pain, headache or photophobiaRed sticky eye in a neonate (within 30 days of birth)History of traumaCopious rapidly progressive discharge — may indicate gonococcal infectionInfection with a herpes virusSoft contact lens use with corneal symptoms (such as photophobia and watering)

78
Q

Conjunctivitis - Management

A

Bathing/cleaning the eyelids with cotton wool soaked in sterile saline or boiled and cooled water to remove any dischargeCool compresses applied gently around the eye areaUse of lubricating agents or artificial tears

79
Q

Conjunctivitis - Prognosis

A

Self-limiting, 7-14 days

80
Q

Constipation - Aetiology

A

Idiopathic or secondary cause (eg malignancy, IBS, stricture, proctitis, neuro conditions, opioids etc)

81
Q

Constipation - Epidemiology

A

60+ (children chronic idiopathic)PregnancyBlackDeprivation

82
Q

Constipatio - Key findings

A

<3 bowel movements/weekExcessive straining, abdo pain bloatingElderly - confusion/delirium, nausea/loss of appetite, overflow diarrhoea, urinary retention

83
Q

Constipation - Investigations

A

RED FLAGS?Diet?Normal bowel habits?Mental health?DRE

84
Q

Constipation - Management

A

Diet advice (fibre intake, whole grains, fluids)ExerciseToileting routinesBulk-forming laxative (isphagula) - not if opioidsOsmotic laxative (macrogol - movicol, laxido; lactulose)Soft but difficult to pass - stimulant laxative (senna, bisacodyl)

85
Q

Constipation - Management in children

A

Same lifestyle advice as adults + rewards, bowel habit diaryMovicol on escalating dose regimen for disimpaction2w nothing - sennaMaintenance - half the disimpaction dose for weeks - months

86
Q

Constipation - Prognosis

A

Self resolution in children, variable in adults

87
Q

Croup - Aetiology

A

Para’flu 1

88
Q

Croup - Epidemiology

A

Common in children

89
Q

Croup - Key findings

A

Coryza, stridor, hoarse voice, barking cough, well, 1 day

90
Q

Croup - Managment

A

Oral dexamethason

91
Q

Croup - Prognosis

A

Resolution within 48 hours

92
Q

Crystal Arthropathy - Aetiology

A

monosodium urate crystals OR calcium pyrophosphate

93
Q

Crystal Arthropathy - Risk factors

A

HyperuricaemiaCKD, hypertension, DM, hyperlipidaemia, OA, lympho/myeloproliferaive disorders, exfoliative psoriasisAlcohol, sugary drinks, red meat and seafoodExcess weightFHxDiuretics, aspirin

94
Q

Crystal Arthropathy - Epidemiology

A

M>FOlder (>40)

95
Q

Crystal Arthropathy - Key findings

A

Rapid onsetTophiSevere pain, redness and swelling in big toe OR knee

96
Q

Crystal Arthropathy - Investigations

A

Serum urateRefer to secondary care if uncertain - aspiration

97
Q

Crystal Arthropathy - Management of acute episode

A

NSAIDsColchicineOral prednisolone for 3-5 daysIA/IM corticosteroid if previous easures ineffectiveIce packs

98
Q

Crystal Arthropathy - Prevention

A

AllopurinolULT if multiple/bad flareups, CKD, diuretics, tophi, chronic

99
Q

Crystal Arthropathy - Prognosis

A

Usually self-limiting in 5-15 daysRecurrence of 85%

100
Q

Dementia (Alzheimer’s) - Key Findings

A

Most common causeProgressive over yearsForgetfulnessRepetitionMisplacing thingsConfusionMood and behaviour problemsLanguage and speech problems

101
Q

Dementia - Lewy body

102
Q

Dementia - Frontotemporal

103
Q

Dementia - Vascular

104
Q

Depression

105
Q

Type 1 Diabetes

106
Q

Type 2 Diabetes

107
Q

Hypertension

108
Q

Gastro-oesophageal reflux

109
Q

Herpes Simplex Virus

110
Q

Hiatus Hernia

111
Q

Hyperthyroidism

112
Q

Hypothyroidism

113
Q

Impetigo

114
Q

Influenza

115
Q

Irritable Bowel Syndrome

116
Q

Ischaemic Heart Disease

117
Q

Migraine

118
Q

Osteoarthritis

119
Q

Osteoporosis

120
Q

Otitis Media

121
Q

Parkinson’s Disease

122
Q

Pelvic Inflammatory Disease

123
Q

Polymyalgia Rheumatica

124
Q

Prostate Cancer

125
Q

Psoriasis

126
Q

Rhinosinusitis

127
Q

Sexually Transmitted Infections

128
Q

Stress Inocntinence

129
Q

Substance Use Disorder

130
Q

Tonsillitis

131
Q

Urinary Tract Infection

132
Q

Urticaria

133
Q

Varicella Zoster

134
Q

Vasovagal Syncope

135
Q

Viral Gastroenteritis

136
Q

Dementia (Alzheimer’s) - Investigations

A

Memory testsPsych evaluationBrain imagingLumbar puncture - amyloid and tau proteins

137
Q

Dementia (Alzheimer’s) - Managment

A

Cholinesterase inhibitors (donepezil, rivastigmine, galantamine) for mild/moderateMemantine - NMDA receptor antagonist (ebixa, axura) for moderate/severe

138
Q

Anaemia - SE of treatment

A

Iron* Feeling or being sick (nausea or vomiting)* Stomach discomfort or heartburn* Losing your appetite* Constipation* Diarrhoea* Darker than usual poo* Black stained teeth (from the liquid only)B12 Injection

139
Q

Anaemia - CI to treatment

A

Iron* hereditary hemochromatosis* hemosiderosis* a history of hemolytic anemiaB12 injection

140
Q

Anaemia - Drug interactions

A

Iron may reduce effect of:* tetracycline* penicillin* ciprofloxacin* Parkinson’s disease drugs* seizure medicationsB12 injections - reduced absorption* aminosalicylic acid* colchicine* metformin* proton pump inhibitors* vit C

141
Q

Dementia (Alzheimer’s) - Aetiology

A

Amyloid plaques and tau tangles

142
Q

Dementia (Alzheimer’s) - Epidemiology

143
Q

Anaemia - SE of treatment

A

Iron* Feeling or being sick (nausea or vomiting)* Stomach discomfort or heartburn* Losing your appetite* Constipation* Diarrhoea* Darker than usual poo* Black stained teeth (from the liquid only)B12 Injection* Pain, swelling or itchy skin where you had the injection* Feeling or being sick (nausea or vomiting)* Diarrhoea* Headaches* Feeling dizzy* Hot flushes

144
Q

Anaphylaxis - SE of treatment

A

Cardiomyopathy (rare)pain, swelling, warmth, redness at site of injection

145
Q

Anaphylaxis - Drug interactions (Epipen)

A
  • digoxin* diuretics* levothyroxine* chlorpheniramine or diphenhydramine (antihistamines that a commonly contained in cold, allergy, or over-the-counter sleep medications)* antidepressants* beta-blockers* ergot medicines* heart rhythm medications* MAO inhibitors
146
Q

Anxiety disorder - Treatment SE

A

SSRIs* feeling agitated, shaky or anxious* feeling or being sick* indigestion* diarrhoea or constipation* loss of appetite and weight loss* dizziness* blurred vision* dry mouth* excessive sweating* sleeping problems (insomnia) or drowsiness* headaches* low sex drive* difficulty achieving orgasm during sex or masturbation* in men, difficulty obtaining or maintaining an erection (erectile dysfunction)*

147
Q

Anxiety Disorder - Treatment CI

A

SSRIs* bipolar disorder* bleeding disorder* DM* epilepsy (uncontrolled)* narrow angle glaucoma* kidney/liver/heart problem* pregnancy (esp 1st trimester)

148
Q

Anxiety Disorder - Drug Interactions

A

BLANK HERE - DM

149
Q

Anxiety Disorder - Serious treatment SE/complications

A

Serotonin syndrome* Nervousness* Nausea and vomiting* Diarrhea* Dilated pupils* Muscle issues, like twitching, involuntary contractions, spasms and rigidity* Sweating and shivering* Side-to-side eye movementsSevere symptoms include:* Confusion or delirium (altered mental status)* Rapid heart rate (tachycardia)* High blood pressure* Fever* Seizures* Loss of consciousnessGet immediate medical help, can be fatal if it’s not treated in timeAntidepressant discontinuation syndrome (when stopped suddenly after 6+ weeks)* Flu-like symptoms, such as fatigue, headache, achiness and sweating* Insomnia* Nausea* Dizziness and lightheadedness* Sensory issues, such as burning, tingling, “buzzing” or mild electric shock-like sensations* Anxiety, irritability and agitation

150
Q

Atrial Fibrillation

A

BLANK HERE - DM

151
Q

What are the side effects of vit K antagonists?

152
Q

What are the side effects of Beta blockers?

A

BLANK HERE - DM

153
Q

What are the side effects of

A

BLANK HERE - DM

154
Q

What are the side effects of SSRIs/SNRIs?

A

SSRIs/SNRIs* feeling agitated, shaky or anxious* feeling or being sick* indigestion* diarrhoea or constipation* loss of appetite and weight loss* dizziness* blurred vision* dry mouth* excessive sweating* sleeping problems (insomnia) or drowsiness* headaches* low sex drive* difficulty achieving orgasm during sex or masturbation* in men, difficulty obtaining or maintaining an erection (erectile dysfunction)

155
Q

What are the CI to SSRI use?

A

SSRIs* bipolar disorder* bleeding disorder* DM* epilepsy (uncontrolled)* narrow angle glaucoma* kidney/liver/heart problem* pregnancy (esp 1st trimester)/BF* <18

156
Q

What drugs do SSRIs interact with?

A

SSRIs* NSAIDs* antiplatelets* theophylline* clozapine and pimozide* lithium* triptans* other antidepressants

157
Q

What are some serious SE/complications of SSRIs/SNRIs?

A

Serotonin syndrome* Nervousness* Nausea and vomiting* Diarrhea* Dilated pupils* Muscle issues, like twitching, involuntary contractions, spasms and rigidity* Sweating and shivering* Side-to-side eye movementsSevere symptoms include:* Confusion or delirium (altered mental status)* Rapid heart rate (tachycardia)* High blood pressure* Fever* Seizures* Loss of consciousnessGet immediate medical help, can be fatal if it’s not treated in timeAntidepressant discontinuation syndrome **(when stopped suddenly after 6+ weeks) Flu-like symptoms, such as fatigue, headache, achiness and sweating Insomnia* Nausea* Dizziness and lightheadedness* Sensory issues, such as burning, tingling, “buzzing” or mild electric shock-like sensations* Anxiety, irritability and agitation

158
Q

What are the side effects of DOACs?| Apixaban, rivaroxaban, edoxaban

159
Q

What are the side effects of rate-limiting calcium-channel blockers?

A

change here - DM

160
Q

What are the side effects of vit K antagonists?| warfarin

A

BleedingA mild rashHair loss

161
Q

What are the side effects of Beta blockers?

162
Q

What are the side effects of rate-limiting calcium-channel blockers?

163
Q

insert new card - position 11 with blank Answer

A

update answer

164
Q

insert new card - position 11 with blank Answer

A

update blank to answer

165
Q

new card 166 with blank Answer

166
Q

new card 167 with Answer

167
Q

new card with image with blank A

168
Q

insert new card 165 with 4 cards below and blank A

169
Q

NEW CARD 170

A

switch to advanced

171
Q

INSERT NEW card 162 with blank

172
Q

Anaemia - Investigations

A

FBCBlood filmFerritinReticulocyte count

174
Q

Anaemia - Investigations

A

FBCBlood filmFerritinReticulocyte count

175
Q
176
Q

NEW CARD 2 WITH BLANK

177
Q

Acute Bronchitis - Aetiology

178
Q

NEW CARD 2 WITH BLANK

07/24-02 class (copy-pasted cards issue) (10 decks)

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