Extras paper 2 Flashcards
What are the co-morbidities associated with bipolar disorder?
A: Increased risk of diabetes, cardiovascular disease, and COPD (2-3 times higher).
What are the management strategies for fibromyalgia?
A psychosocial and multidisciplinary approach.
Aerobic exercise (strongest evidence base), cognitive behavioural therapy (CBT), and medications such as pregabalin, duloxetine, and amitriptyline.
What is the first-line management for binge eating disorder in adults according to NICE?
NICE recommends a ‘binge-eating-disorder-focused’ guided self-help programme.
What is the first-line treatment for bulimia nervosa in adults according to NICE
NICE recommends bulimia-nervosa-focused guided self-help for adults.
What is recommended when switching from an SSRI to a tricyclic antidepressant (TCA)?
Cross-tapering is recommended, where the current drug dose is reduced slowly while the dose of the new drug is increased slowly, except for fluoxetine, which should be withdrawn, with a 4-7 day gap before starting the TCA at a low dose.
What are the common adverse effects of lithium?
Nausea/vomiting, diarrhoea, fine tremor, nephrotoxicity (polyuria secondary to nephrogenic diabetes insipidus), thyroid enlargement (leading to hypothyroidism), T wave flattening/inversion on ECG, weight gain, idiopathic intracranial hypertension, leucocytosis, hyperparathyroidism and resultant hypercalcaemia.
What factors can precipitate lithium toxicity?
Dehydration, renal failure, and drugs such as diuretics (especially thiazides), ACE inhibitors/angiotensin II receptor blockers, NSAIDs, and metronidazole.
What is the mechanism of action of nitrous oxide when inhaled?
Nitrous oxide acts as a dissociative anaesthetic by blocking NMDA receptors, impairing the perception of pain and inducing a state of euphoria and relaxation. It also causes the release of endogenous opioids and dopamine, contributing to its addictive potential.
How long should detoxification of opioids last in an inpatient/residential setting versus the community?
Detoxification should last up to 4 weeks in an inpatient/residential setting and up to 12 weeks in the community.
What are the indications for haemodialysis in salicylate overdose?
Serum concentration > 700 mg/L, metabolic acidosis resistant to treatment, acute renal failure, pulmonary oedema, seizures, and coma.
Why do salicylates cause sweating and pyrexia?
Salicylates uncouple oxidative phosphorylation, which decreases adenosine triphosphate (ATP) production, increases oxygen consumption, and leads to increased carbon dioxide and heat production, resulting in sweating and pyrexia.
when stopping fluoxetine, do you need to taper
no
where do typical antipsychotics work
dopamine D2 receptor
What are other common side effects of antipsychotics?
Other side effects include antimuscarinic effects (dry mouth, blurred vision, urinary retention, constipation), sedation, weight gain, raised prolactin (which can lead to galactorrhoea), impaired glucose tolerance, neuroleptic malignant syndrome (characterized by pyrexia and muscle stiffness), reduced seizure threshold (greater with atypicals), and prolonged QT interval (particularly with haloperidol).
What are the normal stages of grief according to a popular model?
Denial, Anger, Bargaining, Depression, Acceptance.
what xray would you do for acute epiglottitis
lateral xray - thumb sign
what xray would you do for croup
PA xray - steeple sign
go through paeds asthma management
What is the treatment for Homocystinuria?
Vitamin B6 (pyridoxine) supplements
What vaccines are given at 12-13 months of age?
Hib/Men C vaccine
MMR (Measles, Mumps, Rubella)
PCV
Men B vaccine
learn risk factors for pre eclampsia
how long do you continue iron treatment after preg
3 months
what is thelassys test used for
meniscal tear
what nerve does meralgia paraesthetica damage
lateral femoral cutaneous nerve
what test is done for meralgia paraesthetica
pelvic compression test
what does froments sign test for
ulnar nerve palsy
what do you give after hip surgery
lmwh for 4 weeks
when do you offer DEXA
> 50 with fragility fracture
What are common investigation findings in antiphospholipid syndrome?
Thrombocytopenia and prolonged APTT
What are the most common causes of drug-induced lupus?
The most common causes include procainamide and hydralazine.
what is management for polymyositis
high dose steroids
positive simmonds sign
achilles rupture
difference between achilles tendionpathy and plantar fasciitis
achilles tendinopathy is worse with exercise
plantar fasciitis is worse on rest
do psych quesmed
what causes malignant otitis externa
pseudomonas
what scan is done for malignant otitis externa
CT
what is first line treatment for nasopharyngeal carcinoma
radiotherapy
what is the mechanism of dabigtran
thrombin inhibitor
most common cause of neutropenic sepsis
staph epidermidis
management for VWD
desmopressin
sensitivity
TP/(TP + FN)
SPECIFICITY
TN(TN+FP)
POSITIVE PREDICTIVE VALUE
TP(TP + FP)
NEGATIVE PREDICTIVE VALUE
TN(TN + FN)
LIKELIHOOD RATIO FOR POSITIVE RESULT
SENSITIVITY / (1-SPECIFICITY)
LIKELIHOOD RATIO FOR A NEGATIVE RESULT
(1- SENSITIVITY) / SPECIFICITY)
VARIANCE
SD SQUARED
what drug si given to reverse neuromuscular blockade
neostigmine
drug used for hiccups in palliative care if hepatic lesions present
dex
what is used for opioid induced nausea and vomiting in palliative care
ondansetron
morphine to oxycodone
*2
which opioid do you give through a syringe driver
diamorphine
what is fregolis syndrome
when a patient is having persecutory beliefs and believes everyone they meet is the same person (the supposed perpetrator) but with different disguises.
what is folie a deux
Delusions shared by two or more people. One may have a psychotic illness, and the other is submissive.
what is agoraphobia
Fear of open spaces and associated factors like the presence of crowds or the perceived difficulty of immediate easy escape to a safe place, usually home (may occur with or without panic disorder).
what is social phobia
Most common anxiety disorder.
ICD-11 criteria: Fear of scrutiny by others in relatively small groups (as opposed to crowds), resulting in the avoidance of social situations.
what do you give after anaphylaxis once stable
non sedating antihistamines, or IM chlorphenamine if they cant swallow
where should you be referred to if you had a new diagnosis of anaphylaxis
specialist allergy clinic
