end of unit test Flashcards
what drug associated with long QT syndrome
what drug specifically
how long should you continue into remission
SSRI - should do an ECG - citalopram
another 6 months into remission
which SSRI should yo take a break from before starting another one
fluoxetine - long half life
bipolar treatment
citalopram and risperidone
acute mania with agitation what to do
stabilise mood with antipsychotic like Benzo
without agitation - sedation and lithium
acute depression in bipolar
lithium , atypical antipsychotic , antidepressant and support
chronic management of bipolar
lithium monotheapy
valproate 2nd line
what do you need to keep lithium levels below and what symptom to high
1.5
tremor coarse
impaired coordination and renal failure
what drug can you not take with lithium
NSAID
cannabis use is a RF for what disease
schizophrenia
rubella and CMV
1st line for schizo
atypical antipsychotics e.g. risperidone
referred to typical like haloperidol due to reduced risk of extea-pyramididal symptoms
hesitant - clozapine - after 2 tried
behavioural disturbance - lorazepam
treatment fro alcohol withdrawal
chlordiazepoxide
if seizures IV lorazepam
pabrinex to prevent wernickes encephalopathies
naltrexone following wethdrawal to prevent relapse
acamprostate aid abstinence
gamma gt classic for alcoholism and AST higher
true
liver cirrhosis can be compensated or decompensated
caused by
alcohol heaptisi sarcoid alpha 1 antitrypsin budd chiarir suydnroem - blocco and vier methotrexate amiodaraone isoniazid sphillis
liver cirrhosis can be compensated or decompensated
caused by
alcohol hepatitis sarcoid alpha 1 antitrypsin budd chiarir syndrome - blocco and vier methotrexate amiodaraone isoniazid sphillis
complications of liver cirrhosis
bacterial peritonitis hepatic encephalopahty portal hypertension varcieal bleeding hepatorenal syndrome
what does donepezil treat
Acetylcholinesterase inhibitor
Donepezil, rivastigmine and galantamine all prevent an enzyme called acetylcholinesterase from breaking down acetylcholine. This means there is a higher concentration of acetylcholine in the brain, which leads to better communication between nerve cells
alzieherms dementia
opiates vs cannabis overdose what are the features
opiates cause drowsiness, confusion, decreased RR and HR , constricted pupils - needle track marks
drowsiness, impaired memory, slowed reflexes and motor skills, bloodshot eyes, dry mouth, paranoia
stimulants such as cocaine - TAAE1 cause what
euphoria
increased BP, HR and temp
You are the FY1 on the gastroenterology ward. You are called to assess a 70-year-old man originally admitted for investigation of jaundice, who has started vomiting blood. On examination, he is distressed and continuing to vomit fresh red blood. There is no abdominal tenderness. Further examination is difficult.
His latest observations are as follows:
This patient is shocked and requires fluid resuscitation. It will also likely become necessary to transfuse red cells once cross-matched blood, or emergency O- blood is available. However, fluids should be used until these are available.
Terlipressin, a synthetic analogue of ADH, acts as a splanchnic vasoconstrictor to reduce bleeding from oesophageal varices. This should be given promptly to all patients with suspected variceal bleeds as it improves mortality rates. However fluid resuscitation takes precedence.
A 48-year-old man is recovering on the gastroenterology ward after suffering from a large variceal haemorrhage. He is found to have grade II varices on endoscopy, which are banded. Which of the following is recommended with respect to long term prophylaxis against further bleeding?
Non-selective beta-blockers reduce portal blood pressure and are therefore potentially useful with respect to prophylaxis against further variceal bleeds. As such they are the long term intervention of choice.
Atypical antipsychotics have fewer extrapyramidal side effects (eg. involuntary muscle contraction, tremors, stiff muscles, and involuntary facial movements)
true
