End of block assessment Flashcards
Drug causes of hyponatraemia
SSRIs PPIs Loop and thiazide diuretics ACEI NSAIDs
what drugs can be associated with complete heart block
B blockers
digoxin
CCB
(antiarrhythmics)
What proportion of people with parkinsons have a slow shuffling gait with forward stoop
about a third
when is a high steppage gait seen
in patients with foot drop
What gait is seen in patients with stroke
hemiplegic gait where the steps are slower and the leg is dragged in an arc
what is the cause of an antalgic gait
pain
Cerebellar disease has increased muscle tone and exaggerated reflexes, true or false
False
In cerebellar disease, Rhombergs test is positive, true or false
false, it is positive in sensory ataxia
What is acute brain injury
non-degenerative injury to the brain resulting from trauma, stroke, hypoxia, metabolic conditions, tumour
the gold standard method for diagnosing dementia is the MMSE, true or false
false
It requires a good history as well as examination
a score of <10/30 is severe impairment in the MMSE, true or false
true
Delirium is associated with increased mortality, true or false
true
what can precipitate acute urinary retention
constipation - from impaction of stool on the bladder outflow tract
infection - inflammation and narrowing if urinary tract
medications - anticholinergics
symptoms of urinary retention
anuria urinary frequency urge incontinence delirium palpable bladder
what investigation can you do for urinary retention
post void bladder scan USS can confirm larger residual volumes
management of acute urinary retention
catheterisation
leucocytes, protein and blood from a catheter sample is indicative of infection, true or false
false
could be from irritation by the catheter, patient must have symptoms corresponding to a UTI
risk factors for fractures in the elderly
smoking osteoporosis steroids calcium and vit D deficiency previous fall older age sex hormone deficiency
palliative care is only for patients with a diagnosis of cancer, true or false
false
patients can be referred for cancer, organ failure, chronic pain
In AF, what do B blockers and digoxin control
ventricular rate
how can amlodipine, perindopril and tamsulosin cause hypotension
through vasodilatation
Topical B blockers can have systemic side effects, true or false
true
How does digoxin cause hypotension
AV node blockade causes bradycardia and hypotension
List drugs that can cause a tremor
salbutamol lithium sodium valproate cyclosporin caffeine
what is refeeding syndrome
fatal condition with hypophosphataemia/kalaemia/magnesaemia and arrhythmias
occurs after feeding a malnourished patient with a high protein calorie intake
A MUST score of ??? requires referral to a dietician
MUST >2
criteria for diagnosing postural hypotension
SBP drop >20 DBP drop >10 taken after: 5 min flat 1 min standing 3 min standing
How do PPIs work
inhibit gastric acid secretion through the H/K ATPase in gastric parietal cells
side effects of PPIs
hyponatraemia decreased gastric acidity increased C.diff risk alopecia osteoporosis
side effects of corticosteroids
weight gain thin skin osteoporosis myopathy thrush delirium / psychosis hypokalaemia insulin resistance / DM dyspepsia fluid retention adrenal suppression
NSAID side effects
renal impairment
PUD and GI bleeding
fluid retention
risk factors for osteoporosis
low BMI vit D and calcium deficiency female prolonged corticosteroid use FH
what treatments can reduce fracture risk
bisphosphonates
Vit D + Calcium (but not alone)
which patients have a waddling gait
those with proximal myopathy in the pelvic girdle
