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O&G > Gen Med > Flashcards

Gen Med Flashcards

1
Q

Most common cause of CAP (and treatment?)

A

Strep pneumonia (doxy)

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2
Q

Miosis of the eye is what?

A

Constriction of the pupils by the p’symp NS

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3
Q

Atropine does what?

A

Blocks P’symp on musc R’s. Ie, decreases SLUDGEM

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4
Q

SLUDGEM?

A

Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis, Miosis

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5
Q 
Adrenergic Receptors:
a1?
a2?
B1?
B2?
A 
a1 = smooth mm contractoin, vasoconstriction of BVs and increased sodium from kidneys
a2 = vasodilation of arteries, vasoCONstrictino of coronaries, decreased smooth mm activity in gut
B1 = increased HR, increased Contractility
B2 = bronchodilation, smooth mm relaxation, sk mm dilation, decreased histamine release
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6
Q

S+S of HypERcalcaemia?

A

Stones - kidney stones and nephrocalcinosis,
Bones - OP, osteomalacia, arthritis
Groans - constipation, indigestion, N+V, PUD (increased gastric acid secretion), acute pancreatitis,
Thrones - polyuria, Diabetes Insipidus and osborne waves, Psychiatric overtones - memory, lethargy, depression
+ HTN

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7
Q

S+S of HypOcalcaemia

A

CATS go numb:

  • Convulsions
  • Arrhythmias
  • Tetany - chvostek (face), Trouseau (hand/BP cuff)
  • Numbness of mouth, hand, feet
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8
Q

When does pupil sparing occur

A

P’symp fibers are found peripherally thus receive blood supply longer than central fibers in compression of CNIII

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9
Q

Empiric treatment for meningitis?

1yr

A

2 months - Ceftriaxone + steroids (to decrease hearing loss)

+Add acyclovir if viral suspected

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10
Q

Common causes of Meningitis:
Neonates?
>2months?
Adults?

A 
Neonates: 
    Group B streptococcus
    E. coli and other Gram-negative organisms
    Listeria monocytogenes  
Over 2 months age:
    Streptococcus pneumoniae 
    Neisseria meningitidis 
    Haemophilus influenzae type B (in unimmunised children)
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11
Q

Treatment of meningococcus?

A

Benpen 4 hourly

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12
Q

Wilson’s disease

A

Copper accumulation (hepatolenticular degeneration)

  • Autosomal recessive
  • Presents as neurological, psych or liver disease
  • Often in 6-20 year olds with fatigue, encephalopathy/confusion, increased bleeding, portal HTN, ascites
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13
Q

B12?

  • other name?
  • S+S of deficiency
A

Cobalamin.

  • Found in meat/animal products
  • req INTRINSIC factor
  • deficiency = macrocytic anaemia, pallor, SOB, CP, palp, fatigue
  • O/E: glossitis, dec vibraiton sense, distal numbness and parasthesia, mm weakness, decreased reflexes, plus UMN signs, diarrhoea + anorexia
  • personality changes - depression, iritability, psychosis
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14
Q

Ddx dementia with VITAMIN D VEST

A 
Vit D defic
Intracranial tumour
Trauma
Anoxia
Metabolic (DM)
Infection (HIV, enceph)
Normal pressure Hydroceph
Degenerative - AD, Huntingtons, CJD
Vascular
Endocrine (hypothyroid)
Space occupying lesion
Toxic - alcohol
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15
Q

Aphasia

A

Partial or total loss of the ability to communicate verbally or with written words.
Nominal Aphasia = Naming difficulties

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16
Q

Apraxia

A

Inability to perform skilled voluntary motor sequences that cannot be accounted for by weakness, sensory loss, impaired comprehension or inattention
(Ideomotor - combing hair, blowing out candle)
(Ideational - inability to sequence actions - preparing and mailing and envelope)
(Constructional - inability to draw/copy a figure)
(dressing - inability)

17
Q

Extrapyramidal signs are what?

A 
Dystonia - continuous spasms and muscle contractions), Akathisia (motor restlessness), 
Parkinsonism (characteristic symptoms such as rigidity, bradykinesia, and tremor), and 
Tardive dyskinesia (irregular, jerky movements)

Often caused by antipsychotics, any D2 antagonists like metoclopramide, plus some antidepressants, like SSRIs and more

18
Q

Agnosia

A

Disorder in recognition of the significance of sensory stimuli in the presence of intact sensation and naming

19
Q

Gerstmann’s syndrome

A

Parietal lesion of the DOMINANT (L) Hemisphere:

- agraphia, acalculia, finger agnosia and L-R disorientation

20
Q

Neglect occurs most severely with which type of lesion?

A

Non-dominant (R) sided parietal lesions

21
Q

Pharmacological Rx of Alzheimers Disease

A

1) Anticholinesterase inhibitors
- donepezil, rivastigmine, galantamine
2) NMDA-R antagonist - during later stages (MMSE

22
Q

Frontotemporal dementia/Pick’s dementia S&S

A

Behavioural variant of FTD most common - social conduct disorder
Language variants:
- progressive nonfluent aphasia: laboured articulation/speech, anomia, word-finding difficulty
- semantid dementia: fluent, normal rate, anomia, use words of generalisation (‘thing’), or supraordinate catagories (animal instead of dog)
- 3rd most common type of dementia

*Early decline in social interpersonal conduct, emotional blunting and loss of insight with supportive features of declinein personal hygeine etc IN THE ABSENCE OF severe amnesia, aphasia, perceptual disorder

23
Q

Lewy Body dementia

A

Progressive cog decline interfering with social or occupational funtion

  • *memory loss not often early feature
  • FLUCTUATING cognition with pronounced variation in alertness and attention
  • recurrent VISUAL HALLUCINATIONS
  • PARKINSONISM (not to be conf w parkinsons’ disease dementia)
  • slightly quicker decline/average life expectancy than AD
24
Q 
Delirium v Dementia
Definition
Onset:
Course
Consciousness
Attention
Orientation
Memory
Thinking
Perception
Behaviour
A

Delirium : Dementia
A state of temporary confusion : Progressive irreversible decline
Rapid : insiduous
Short, with DIURNAL fluctuations : Chronic, progressive, often worse at night
Attention: impaired, distractable ++
Consciousness: altered, confused (usaully worse at night or on waking) : clear except in extreme cases
Memory: Recent and immediate impaired : recent and remote impaired
Thinking: disorganised and incoherent : impoverished
Perceptions: misperceptions common : misperceptions usually absent

25
Q

Medication given in Dementia vs Parkinsons

A

Dementia: acetylcholinesterase inhibitors
- donepezil, rivastigmine, pyridostigmine, galantamine
Parkinsons: Anticholinergics
- Benztropine

26
Q

Pharmacological Mx of Parkinsons disease

A

Treatment in EARLY PD: DA agonists, MAOI, AMantadine
Cabergoline
Levodopa = DA precursor, converted in the brain
Carbidopa = decreases periph DA metabolism
Amantadine - antiviral

Adjuncts:
Cabergoline
Anticholinergics - benztropine
MAO-B inbibitor = seleg

27
Q

Myasthenia gravis

  • Presentation
  • Pathol
  • Treatment
A

Fatiguable Ocular/bulbar paresis, limb weakness, can be assymetric or symmetric, with NORMAL reflexes and NO sensory change
- Occular diplopia/ptosis, bulbar dysarthria/dysphagia
Pathol: anti-AChR antibodies, resulting in early saturation at the NMJ
- Dx:
Improvement post AChEsterase Inhibitor
EMG: decremental response to repetative stim
Rx: Thymectomy, AChEsterase Inhibitors (pyridostigmine)

28
Q

Pyridostigmine is?

A

An Anticholinesterase inhibitor

Used in Myasthenia gravis Rx primarily

O&G (6 decks)

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