General mix (2) Flashcards
complications of MI
- cardiogenic shock
- mitral regur- flash oedema
fracture healing timings
Maintenance treatment of addisons
- Lifelong replacement
- Glucocorticoid: hydrocortisone, prednisolone
- Mineralocorticoid: fludrocortisone -> do you don’t get hypoaldonsteronism
- Education
- Double dose of glucocorticoid at time of illness
- Emergency HC injection if vomiting
- Steroid card and bracelet
HF management: FAB SID
- furosemide
- ACEi
- Beta blocker
- Sprionolaction
- Isomonitrate -look)
- Digoxin – slow ventricles more blood pumped per beat
investigations for Pheochromocytoma and paraganglioma
24h urine metanephrines
medullary thyroid cancer causes
high calcitonin
when adding a 4th agent to control BP what do you need to think about
think about potassium
>4.5 - add alpha or beta blocker
<4.5 add spironolactone
tests before starting anti-hypertensive
- U and E, urine dip/ ACR, cholesterol, HbA1c and ECG
IUD and emergency contraception
licened for either 5 days post UPSI or five days post earliest possible ovulation
- Can presume reversible cause of AF
- Due to CAP
- No evidence of previous AF
- Give amiodarone (rhythm control)
=Side effects of amiodarone
- dizziness, lightheadedness, or fainting.
- pulmonary fibrosis
- numbness or tingling in the fingers or toes.
- painful breathing.
- sensitivity of the skin to sunlight.
- trembling or shaking of the hands.
- trouble with walking.
management of AF >48 hours with no reversible cause
rate control
- first line: B blocker (or cardioselective CCB)
- CHADSVASC
- >1
- >2 female
management of AF <48 hours reversible cause
rhythm control: amiodarone
managemnt of paroxysmal supraventricular tachycardia
- vagal manoevres
- second line: IV adenosine
management of atrial flutter
same as AFG
- radiofrequency ablation
manageemnt of Wolff-partinson white
IV amiodarone
- radiofrequency ablation
when to DC cardiovert
tachycardias with haemodynamic instability
who not to give adenosine to
asthmatics
name 3 antiemetics
cyclizine
ondansetron
metoclopramide
cyclizine
anti-histamine and anti-muscarinic
- for vertigo and motion sickness
- side effects: drowsniness e.g. antihistamine
ondansetron
- 5HT3 receptor antagonist
- PONV, chemo induce NV or gastroenteritis
metoclopramide
dopamine antognist
- post op Nausea and motion sickness
- beware bowel obstruction
mid inguinal point vs midpoint of inguinal ligament
mid-inguinal point- femoral artery
midpoint of inguinal ligment- cough reflex
brachial plexus
The brachial plexus is a network of nerve fibres that supplies the skin and musculature of the upper limb. It begins in the root of the neck, passes through the axilla, and runs through the entire upper extremity.
The plexus is formed by the anterior rami (divisions) of cervical spinal nerves C5, C6, C7 and C8, and the first thoracic spinal nerve, T1.
Acronyms
Real Teenagers Drink Cold Beer- roots, trunks, divisions, cords, branches
Men Are Mean Really Usually- musculocutaneous, axially, median, radial, ulnar
3 Musketeers (C5, C6, C7)
2 Assassinations (C5, C6)
4 Mice (C6, C7, C8, T1)
5 Rats (C5, C6, C7, T1)
2 Unicorns (C8, T1)
what do you need to give if someone has a compound fractures
tetanus jab
which organism causes epiglottis
HiB
gustiloo anderson for open fractures: who needs to be involved
- Type 1: <1cm wound and clean
- Type 2: 1-10cm wound and clean
- Type 3A: >10cm wound and high-energy, but with adequate soft tissue coverage
- Type 3B: >10cm wound and high-energy, but with inadequate soft tissue coverage
- Type 3C: All injuries with vascular injury
A simple summary in how this can help to guide management is: 3A can be managed by orthopaedics alone, 3B requires plastics input, and 3C requires vascular input
cervical screening
25-49 every 3 years
breast screening
50-70 every 5 years
colon screening
60-74 every 2 year
FIT
- looking for human HB
vascular screening
65th year
FeverPAIN
fever
Purulent tonsils
Attending within 3 days
Inflammation (severe)
No cough
>4 points for PENICILLIN V
most common thyroud cancer
papillary
good prognosis for thyroid
papillary and follicular
bad prognosis for thyroid
anaplastic
which thyroid causes high calcitonin
medullary→ cause low calcium
how to lose weight safely
- reduce calories by 600lcal/day
- 150 mod exercise a week
how many units of alcohol
14 units over 3 days
alcohol abstinence.. appropriate for
people with alcohol dependence
alcohol moderation… appropriate for
for harmful drinking or mild dependence, without significant comorbidity
CAGE questionaire
alcohol
- Cut down
- Annoyed
- Guilty
- Eyeopener
hypokalaemia c=goes hand in hand with
alkalosis - think hyperaldosteronism
potassium moves into cells and hydrogen moves out
SIADH treatment
tolvaptan (ADH antagonist) and fluid restrict
how to look for evidence of recent Group A B-streptococcal infection
anti-streptolysin O titres
bulk forming laxative
ispaghula husk
stimulant laxative
senna
osmotic
macrogel
movicol
lactulose
