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Specialities > General Medicine and Surgery > Flashcards

General Medicine and Surgery Flashcards

1
Q

What is CEA used for?

A

Measuring response to surgery

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2
Q

What bloods should be done in the setting of colon cancer?

A

FBC
- anaemia

LFTS
- metastasis

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3
Q

What is the clinical findings on the tibia in people with Grave’s disease?

A

Pre-tibial myxoedema

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4
Q

What antibiotics can be used in MRSA who is penicillin allergic?

A

Linezolid

Clindamycin

Vancomycin

Doxycycline can be be given PO

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5
Q

When do you give tetanus vaccine/ immunoglobulins for a wound?

A

Nothing if they are up to date with their vaccines and they were delivered within 10 years.

Puncturing wound and >10 years since vaccines:
- tetanus vaccine
+/-
- immunoglobulin (if a large wound and large risk)

*same as above for unknown vaccination history

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6
Q

Do you treat asymptomatic bacteriuria in catheter patients?

A

no.

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7
Q

Which type of pneumonia is associated with guillain barre syndrome?

A

Mycoplasma

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8
Q

What are the core indications for dialysis:

A

Hyperuricemia

  • encephalopathy
  • pericarditis

Refractory metabolic Acidosis

Refractory hyperkalaemia

Diuretic resistant pulmonary oedema

Dialyzable toxins

  • lithium
  • salicylates
  • alcohol metabolites (glycols)
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9
Q

How is Hydronephrosis managed in the acute setting?

A

Nephrostomy if upper tract obstruction

Suprapubic catheter is lower tract

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10
Q

What is the hormone that is released from the hypothalamus which stimulates the anterior pituitary to release TSH?

A

TRH

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11
Q

What are some side effects of sub-total thyroidectomy and radioactive iodine:

A

Radioactive iodine
- initial worsening of symptoms to begin with

Thyroidectomy

  • bleeding, recurrent laryngeal nerve damage
  • life long requirement of thyroxine
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12
Q

Colicky pain vs peritonitis:

A

Colicky:

  • blocked visera
  • Waves of pain
  • move about a lot, can’t stay stll

Peritonitis:

  • irratants/ infection to the parietal peritoneum
  • constant pain
  • rigid abdomen
  • don’t want to move, stay very still
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13
Q

List some irratants to the peritoneum:

A 
Blood 
Gastric juices 
Bile 
Pancreatic juice 
Urine
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14
Q

What are some signs of a DVT? What investigations should be conducted and what is the treatment?

A

Pain in the leg
Swelling
Pyrexia
Prominent leg veins

Well DVT
*need a score of >1 to trigger further investigation
which is an ultrasound

Treatment:
1st line: DOAC - apixaban
*note dabigatran requires LMWH

warfarin may be added for 3 months

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15
Q

What other things may raise the D-dimer?

A

Recent surgery

Infection

Liver disease

Pregnancy

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16
Q

In recurrent P.E which are known to be due to recurrent DVTs, what device can they have fitted to prevent this?

A

IVC filter

17
Q

What is your management of a P.E?

A

Wells Score:
<4 = D- dimer
>4 = CTPA or V/Q scan
*if CTPA negative then do leg US

Management:
- Apixaban or Rivaroxaban (DOACs)
or
- LMWH

Continue DOACS for at least 3 months
LMWH switch to warfarin following 5 days for 3 months

18
Q

In suspected pancreatitis what two tests must be done prior to a patient leaving the ED? and what is your general management?

A

Serum amylase
Erect chest x-ray (must rule out a perf)

IV fluids 
IV anti-emetics 
ABG - for oxygen support 
NG tube 
Catheter

*early feeding is recommended as it can help reduce the severity associated with pancreatitis

19
Q

What type of surgery is conducted for primary parathyroid adenoma?

A

Minimally invasive - total parathyroidectomy

20
Q

Which diabetic medication is delivered via subcutaneous injection (apart from insulin)?

A

GLP-1 Analogues

21
Q

How often should diabetics monitored their blood glucose, presuming they are well?

A

4 times daily

- before each meal and before bed

22
Q

Why is secondary hyperparathyroidism why is alendronic acid used even if the calcium is normal?

A

Reduced phosphate clearance results in increased PTH released in order to create more Ca2+ to bind to the phosphate.

23
Q

What are some of the risk factors for gastric ulcers and duodenal ulcers:

A

Both:

  • NSAIDs
  • H.Pylori

Gastric:

  • delayed emptying
  • Smoking (induces reflux from duodenum)

Duodenum:

  • Gastric hyperacitity
  • smoking
  • stress

*note that when a duodenal ulcer perforates it goes into the peritoneal cavity
when a gastric perforates it goes into the lesser sac

24
Q

Coeliac disease: If the results are negative but coeliac is still suspected what should you do?

A

Test for IgA deficiency
- if deficient then request:

IgG for TTG and EMA
and/ or
Anti - deaminated gliadin peptide antibodies

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