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progress test > gen med > Flashcards

gen med Flashcards

1
Q

what happens in ckd bone disease

A 
raised phosphate
low vitamin d
low calcium 
high pth
bone is broken down to release calcium 
needs treatment with phosphate binders, vitamin d and possibly a parathyroidectomy
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2
Q

what might blood results show in multiple myeloma?

A
  • raised calcium
  • renal failure
  • high total protein
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3
Q

which beta blockers reduce mortality in stable heart failure?

A

bisoprolol

carvedilol

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4
Q

treatment of heart failure

A

1st line: ACEi and a Beta Blocker

2nd line: add aldosterone antagonist or ARB or Hydralazine with a nitrate

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5
Q

how can you treat metastatic bone pain

A
  • opioids
  • bisphosphonates
  • radiotherapy
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6
Q

why should you not use verapamil in systolic heart failure?

A

as a rate limiting calcium channel blocker,

it reduces the hearts contractility and thus may increase symptoms such as pulmonary oedema or peripheral oedema

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7
Q

features of UC

A
  • pseudopolyps on endoscopy
  • bloody diarrhoea
  • continuous disease : rectum to ileo-caecal valve
  • primary sclerosing cholangitis
  • inflammation does not extend beyond the submucosal layer
  • can get tenesmus
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8
Q

features of crohns disease

A

-skip lesions , cobblestone appearance on endoscopy, increased goblet cells, granulomas
-full thickness of the wall
mouth to anus
-usually non bloody diarrhoea

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9
Q

treatment of crohns. ( acute and then remission)

A

Acute: Budesonide or 5ASA (Mesalazine) therapy
Remsission: azathioprine, mercaptopurine, or methotrexate

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10
Q

treatment of UC (acute and then remission)

A

acute: IV hydrocortisone and biologic eg infliximab or ciclosporin
IV fluids
could also give a topical 5 ASA

Remission: 5ASA therapy (mesalazine) or tnf inhibitors

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11
Q

drugs to avoid in renal failure

A

metformin
lithium
antibiotics- especially tetracycline and nitrofurantoin
nsaids

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12
Q

management of migraine acute

A

NSAID and triptan or

Paracetamol and triptan

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13
Q

migraine prophylaxis

A

propranolol or topiramate

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14
Q

headache red flags

A
  • immunocompromised
  • head trauma within last few months
  • history of malignancy
  • sudden onset severe headache
  • headache which changes with posture
  • headache associated with vomiting with no explanation
  • heaahce with focal neurology
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15
Q

signs of raised intracranial pressure

A
  • papilloedema
  • hypertension
  • bradycardia
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16
Q

symptoms of raised intracranial pressure

A

headache- worse with bending forward
blurring of vision
vomiting
altered consciousness level

17
Q

what is the most common type of thyroid cancer?

A

papillary thyroid carcinoma

18
Q

how should you investigate a neck lump?

A

USS and then FNA of the lump

19
Q

what are the three most common causes of hyperthyroidism in the UK?

A
  • graves
  • toxic multi nodular goitre
  • solitary toxic adenoma
20
Q

treatment options for hyperthyroidism

A
  • carbimazole
  • ptu
  • radioactive iodine
  • thyroidectomy
21
Q

treatment regimes for hyperthyroidism with carbimazole or ptu

A
  • block and replace t4

- or just a constant dose

22
Q

multiple endocrine neoplasia type 1

A 
3 Ps:
parathyroid
pancreas tumours 
phaechromocytoma
presents with hypercalcaemia
23
Q

men type 2a

A

medullary thyroid carcinoma
2Ps and 1 T
phaeochromocytoma
parathyroid

24
Q

men type 2b

A

medullary thyroid carcinoma and phaeochromocytoma

25
Q

management of stemi?

A

pci within 2 hours of presentation
if not then thrombolysis

management with aspirin and ticagrelor
morphine for pain (1mg can titrate up)
gtn

26
Q

management of an nstemi

A 
batman
beta blockers
aspirin
ticagrelor
morphine 
anti-coagulant LOW MOLECULAR WEIGHT HEPARIN
nitrate
27
Q

how do you manage a paracetamol overdose/

A
  • if <1 hour then can give activated charcoal

- if > 1 hour ago/staggered/ don’t know, then measure blood paracetamol and give acetylcysteine

28
Q

causes of aortic stenosis?

A
  • degenerative calcification
  • bicuspid aortic valve
  • post rheumatic disease
29
Q

daily fluid requirements?

A

25-30ml/kg/day
1mmol/kg/day potassium, sodium, chloride
50-100g glucose a day

30
Q

daily fluid requirements in the elderly/cardiac failure/malnourished and at risk of refeeding

A

20-25ml/kg/day

progress test (6 decks)

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