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Medicine > Elective 1 > Flashcards

Elective 1 Flashcards

0
Q

Biliary colic

A 
RUQ 
Radiates to scapula 
After food
Gradually builds over hours
Early hours morning
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1
Q

Pancreatitis

A

Pain through to back
NV
Gall stones, alcohol

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2
Q

Jaundice

A

Pale stools, dark urine
Pain
Offensive stool, difficulty flushing
Trigger, RF

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3
Q

IHD

A

Central heavy CP radiates L
Exertion, rest, nitrates
Hx MI, angina, cardiac RF
NV, sweaty, clammy

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4
Q

Arrhythmia

A

Type of rhythm
Dizzy, fall LOC
CP, orthopnea
Infx; fever, cold, LRTI, UTI, skin

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5
Q

ACS
V
Angina

A

ACS; pain >20mins
V
Angina; walking distance/ rest time, nitrate spray

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6
Q

HF

A

SOB at rest, sentences
Orthopnea
Edema
Cause???

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7
Q

Endocarditis

A

New murmur
Fever
+- petechiae

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8
Q

Dissection

A

Tearing -> interscapula/ back
Weakness/ numbness arms
Diff arm BP
CXR widened mediastinum

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9
Q

Pericarditis

A 
Pleuritic pain
Worse lying, better leaning forward
Recent viral illness
Pericardial rub
Saddle shape ST
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10
Q

Acute asthma attack

A 
SOB; sentences
Wheeze, cough
Triggers
Normal meds
Previous admissions
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11
Q

Acute exacerbation COPD

A 
SOB; sentences
Wheeze, cough, sputum, fever
Normal meds; inhaler, steroids, O2
Still smoke? 
Previous admissions - ventilation
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12
Q

Pleural effusion

A

Gradual onset SOB
+- pleuritic CP
Dull percussion note

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13
Q

Pneumothorax

A 
Sudden onset SOB
Pleuritic CP
RF; smoking, COPD, chronic chest condition, tall thin male 
Hyper resonant
Deviated trachea?
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14
Q

ARDS

A

SOB

Concurrent severe illness

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15
Q

Anaphylaxis

A

Trigger; food, drugs
Itching, rash
Swelling
SOB

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16
Q

Pneumonia

A 
SOB
Cough, sputum
Fever
Confusion, muddled
Hx Chest condition, smoking
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17
Q

Peptic ulcer

A 
Epigastric/ chest pain
Heartburn, bloating, burping
Antacids 
Melaena
RF; Previous ulcers, NSAIDs, alcohol
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18
Q

Gastric ulcer
V
Duodenal ulcer

A

G: Worse with food
V
D: Better with food, night pain

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19
Q

Esophageal cancer

A 
Swallowing; pain, sticking
Haematemesis
Hoarseness, Cough
Lymphadenopathy, hepatomegaly 
RF; GORD, smoking
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20
Q

Stomach Ca

A

Dyspepsia
Epigastric pain
Virchows node
RF ulcers, gastritis, blood group a

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21
Q

Perforation

A

Sudden onset
Worse on movement/ coughing
RF ulcers, Ca, IBD, NSAIDs, alcohol
No bowel sounds

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22
Q

GORD

A 
Burning CP +\- reflux
\+\~ Waterbrash; excess saliva 
Worse bending forwards
Nocturnal cough 
Antacids better
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23
Q

Diverticular ds

A 
Pain/ cramps
Better on BO
Irregular BO
Flatus, bloating
PR bleed
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24
Q

Renal colic

A

Exclude AAA
Acute loin to groin
N&V
Haematuria, dysuria, frequency

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25
Q

Jaundice ddx

A

Pre; Gilbert, haemolysis, malaria
Hepatic; paracetamol, viral, alcohol, medications, vascular
Obstructive; luminal, mural, extra

26
Q

Causes of chronic pancreatitis

A 
Alcohol
Gall stones
Hyperparathyroidism 
CF
Familial
27
Q

Migraine

A 
4-72h
Unilateral
Pulsating
Avoid activity
N or V
Photophobia, photophobia
Aura 25% pt, lasts 5-60mins
28
Q 
Meningitis
V
Encephalitis
V
Cerebral abscess
A

M: headache, fever, stiff, photophobia
- common to all
E; focal signs and cognitive deficits - headache is not usually not the primary feature
A: subacute onset

29
Q

Courvoisiers law

A

In the presence of jaundice
A palpable gall bladder
Is unlikely due to gall stones
Rule out Ca

30
Q

IBS

A 
Central/ lower pain
Relieved by BO
Changeable BO
Bloating
Minimal mucus
31
Q

Causes of imbalance/ ataxia

A

Cerebellar disorder; DANISHP
Spinal ds; dorsal column
Peripheral neuropathy

32
Q

Post LP headache

When? Tx

A

Usually within 24h, but up to 7d
Tx
Lie pt flat
Analgesia, increase fluid intake

33
Q

Tx seizures

A 
Start clock
High flow O2
Recovery position
Venous access, take bloods
Check BM
>5 mins
- call senior
- Lorazepam (IV)/ diazepam (PR)
34
Q

Tx

Hypoglycaemia

A 
Hypostop
Low GCS
- 50ml, 50% glucose
- 100ml, 20% glucose 
Aim BM over 5
35
Q

Ix and Tx

DKA/ HONK

A

BM, ABG, urine dip
1L normal saline stat
Insulin
Insulin plus glucose

36
Q

Painful arc aka

A

Supraspinatus tendinitis

Impingement syndrome

37
Q

Facet joint pain

A

Acute or chronic
Worse in morning and on standing
Worse in extension of back
May be tender over facets

38
Q

Extra dose of morphine for breakthrough pain

A

1/6 daily morphine dose

39
Q

Worrying fevers in children

A

> 38C under 3m; red flag
39C: 3-6m, yellow flag
Fever >5d; yellow flag

40
Q

Legionella features

A 
Flu like Sx 
Dry cough
Hyponatraemia
Deranged LFT
Pleural effusions; 30%
41
Q

L dopa drug names

A

Madopar

Sinemet

42
Q

Causes of purpuric rash

A

Vascular;
- meningococcus, HSP, scurvy, vWds
Thrombocytopenia
- idiopathic, infx, drug, DIC

43
Q

K+ additives to fluid rules

A
  • No more than 40mmol per L

- 10mmol per hour max

44
Q

Sx thyrotoxicosis

A 
Goitre
Palpitations, tremor
Heat intolerance, sweating
Weight loss, diarrhoea
SOB, tired, increase appetite
45
Q

Before azathioprine tx

Check

A

Thiopurine methyl transferase (tpmt) deficiency

Results in azathioprine toxicity

46
Q

Chondromalacia patella

A

Softening of cartilage
Common teenage girls
Anterior knee pain: up/ down stairs
Tx physio

47
Q

Max lidocaine infiltration dose

A

200mg

500mg with adrenaline

48
Q

Guidelines for paracetamol OD tx

A

N acetyl cysteine
Tx: Staggered overdose, or if any doubt over time of OD
Or
Plasma conc above tx line at 4-15hrs

49
Q

Lidocaine conc

A 
1% = 10mg/ml
2% = 20mg/ml

w/o adrenaline max 200mg

50
Q

Doses of adrenaline

A

0.5mg IM ; anaphylaxis

1mg : cardiac arrest

51
Q

Length warfarin tx

DVT

A

Unprovoked: 6m
Provoked: 3m

52
Q

Causes of confusion/ behavioural changes

A 
CVA
MI
Infx: LRTI/ UTI/ CNS infx
metabolic conditions
drug overdoses or poisonings.
53
Q

Blatchford score criteria

A

Urea
Hb
sBP
Other markers; pulse, malaena, syncope, HF, LF

54
Q

Drugs to be taken at night

A

Simvastatin

Amitriptyline

55
Q

Daily fluid, Na, K requirements

A

1.5 ml/kg/hr : 2-3L / day
Na: 1-2mmol/ kg
K: 1mmol/ kg

56
Q

Typical maintenance fluids

NBM pt

A

3x8h bags
2 sweet 1 salty, all with 20mmol K

5% dextrose
Normal saline
5% dex

57
Q

Medications contra indicated in HF

A

Verapamil : neg inotrope
NSAIDs/ steroids : fluid retention
Pioglitazone: fluid retention

58
Q

Beclometasone inhaler names

A

Clenil
Qvar
Easyhaler

59
Q

When to gradually withdraw steroids

A

> 40mg for >1w
3w of tx
Recently received repeated courses

60
Q

Deep ST depression. V1-V3 and talk at waves

A

Posterior STEMI

61
Q

Posterior STEMI

ECG changes

A

Deep ST depression V1-V3

and tall T waves

62
Q

Contraindications

Exercise tolerance test

A 
MI less than 7d ago
Unstable angina
Uncontrolled HTN/ hypotension
Aortic stenosis
LBBB
63
Q

Status epilepticus tx

A 
Oxygen
BM - correct blood sugar
After 5 mins: IV lorazepam 4mg
- or PR diazepam, buccal midazolam
Repeat after 10mins if no response/ recur

Medicine (20 decks)

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