General Medicine Block Flashcards
MFE - what does the term “deconditioning” mean?
When a patient loses the strength in their muscles
Wasting of the muscle bulk
How can you test if a patient has deconditioning in their legs (quads)?
Stand up from chair with arms folded
Define sarcopenia
Loss of muscle mass and muscle function with ageing (pathological, more than the normal amount of mass and function lost)
With age, the following normal changes happen:
Muscle mass - increase/decrease ?
Body fat - increase/decrease ?
Cerebral blood flow - increase/decrease ?
Cardiac output - increase/decrease?
Muscle mass - decreases
Body fat - increases
cerebral blood flow - decreases
Cardiac output - decreases
Postural hypotension is defined in a drop in ___ mmHg or more in the systolic OR a drop in ___ mmHg or more in the diastolic?
20mmHg or more systolic
10mmHg or more diastolic
What is the largest weight bearing joint and therefore the joint most likely to be affected by OA ?
Knee
Name features suggestive of metabolic syndrome?
Overweight
High blood glucose
Lipid profile off (Lots of LDL, low HDL)
Sedentary lifestyle
Constipation increases/decreases with age?
Increases
Older patients with constipation should always get a laxitive?
True
Patient admitted to hospital and at night he/she asks for a sleeping tablet. Should you prescribe and justify your answer?
No!! Try to avoid as much as possible
- highly addictive
- can increase likelihood of falls
Which type of medications are sleeping tablets?
Benzodiazepines
- diazepam etc
What should you do for patients instead of giving them sleeping tablets?
Sleep hygine
Define frailty
When normal ageing has become pathological.
Loss of biological reserves (ie homeostasis is not as good as it should be) across multiple body systems resulting in increased vulnerability to relatively minor events and leading to adverse outcomes
What is dyspepsia?
Indigestion
Epigastric pain
Associated with eating
Differential diagnoses of dyspepsia?
GORD
Peptic ulcer disease (gastritis, gastric erosions)
Malignancy
Angina
Upper GI red flag symptoms
Weight loss
Dysphagia
Recurrent vomiting
2 main causes of peptic ulcer disease?
H. Pylori (most common)
NSAIDs
Investigations for H. Pylori include
Urease breath test
Stool antigen test
H. Pylori antibody serology
Urease breath test and stool antigen test for H. Pylori - are often done. What do you need to remember medication wise before carrying out these investigations?
Off antibiotics for previous month
Not on PPI for 2 weeks beforehand
Patients getting tested for H. Pylori should stop their PPI medication for __ weeks before the investigation?
2 weeks
Management of H. Pylori infection
PPI + amoxicillin + metronidazole (total 7 days)
use clarithromycin in penicillin allergic pt
If patient has had treatment of H. Pylori but experiences recurring symptoms, what should you do?
Re-check H. Pylori test
Patient presents with symptoms of GORD. What should you do?
No need for investigations.
Trial of PPI and if symptoms settle, continue PPI
Curative Tx for oesophageal cancer
Oesophagectomy Radical radiotherapy (Squamous cell carcinoma)