General mix (4) Flashcards
substance with diuretic action
- Alcohol- inhibits ADH release
- Caffeine- increases GFR and decreases tubular Na reabsorption
ECG finding WPW
Delta wave- slurring
- short PR
hypertensive retinopathy
flame haemorrhage
diabetic retinopathy
dot to blot
what to remember to say when talking about hormones released by cancers
Ectopic
e. g. ectopic ACTH
e. g. ectopic-PTH
causes or pericarditis
post viral
post MI- dressler
management of pericardiits
- NSAIDs and colcichine
causes of septic arthritis and osteomyelitis in sickle cell
salmonella
MOA of angiotensin II
- Increase thirst
- Increase BP by causing vasoconstriction
- Increase release of aldosterone
aldosterone MOA
- Works on the collecting duct
- Upregulation of sodium channels (eNac) and ROMK
- Increasing sodium reabsorption
- Decreasing potassium reabsorption
ADH action
- Antidiuretic hormone (vasopressin)
- Works by increasing insertion of aquaporin-2 into collecting duct
- doesnt effect electrolytes
aldosterone antagonist
spironolactone
e.g. hyperaldosteronism
ADH antagonist
Tolvaptan and lithium
- SIADH
moa of aldosteorne antagonists
- Inhibits upreg of eNac and ROMK
MOA of ADH antagonists
inhibits insertion of aquaporin-2
general treatment of COPD
- first line: SABA and SAMA
- second-line:
- asthmatic
- LABA and ICS
- Second line
- LABA and LAMA (stop SAMA)
- asthmatic
- carbocisteine and theophyline
- home oxygen
home oxygen when
<7.3kPa oxygen
or <8 and cor pulmonale
antibiotic given to prevent infection in COPD
azithromycine
NIV same as
bipap- - type 2 resp failure
oxygen goals for CO2 retainers and non-CO2-retainers
CO2 retainer : 88-92%
non-CO2 retainer: 94-99%
oxygen goals for CO2 retainers and non-CO2-retainers
CO2 retainer : 88-92%
non-CO2 retainer: 94-99%
diff between bronchiectasis and COPD
COPD and mucus
carbocystein
chest physio
pneumonia and COPD
HAEMOPHILUS INFLUENZA
no consolidation on x-ray
no pneumonia
Rita presents with copious yellow discharge that has an fishy odour. Which of these tests would best help to identify her infection?
- VVS
- HVS
- KOH
- Microscopy and Culture
- Endocervical
Answer B
The infection present is trichomoniasis for which a high vaginal swab of the posterior fornix is best. – doxy
Cef IM for -gonnorhoea
missed pills rule: pills missed on week 1
if 1 pill:
- take missed ASAP and todays
If 2 pills
take most recently missed pill straight away and further pills as usual
- emergency contraceptio n
- CONDOMS for 7 dats
missed pills rule: pills missed in week 2
take most recently missed pills and further as usual
- CONDOMS for 7 days
missed pills rule: pills missed in week 3
- take most recently misse dpills and other pills as usual
- omit pill free interval
- condoms for 7 days
*
Edna Mode, 53F, has been admitted with an excruciatingly painful leg that started hurting 2 hours ago. You check her leg and it appears pale and cold. You can not locate her dorsalis pedis pulse.
Given her likely diagnosis, what form of imaging would be most appropriate?
- MRI of her leg
- CT angiography
- Doppler ultrasound scan
- ABPI
- Xray chest
Answer C
Doppler ultrasound should happen first. CT angiography may also be useful, but doppler may be done at the bedside and is more accessible. ABPI may also be useful, but it should be done after the Dopple. It is also not a mode of imaging.
summary of pneumonia causes
Q58.) Which of these would you expect in SiADH ?
- Hyponatraemia, low urine osmolality , low effective arterial volume
- Hyponatraemia, low urine osmolality , normal effective arterial volume
- Hyponatraemia , high urine osmolality , low effective arterial volume
- Hyponatraemia, high urine osmolality, normal effective arterial volume
- Hyponatraemia , high urine osmolality, high effective arterial volume
Answer: D
which cancer is most common among smokers
squamous cell carcinoma
- central
- PTH
Q74.) An 85-year old man is admitted into hospital for pneumonia. This is his 4th episode in the past 6 months. He has a past medical history of COPD and states that he is becoming increasingly breathless despite the pharmacological therapy he is on. He finds it difficult to do daily tasks he normally could without getting breathless. He is an ex-smoker. His last 3 ABG’s have demonstrated O2 <7.3kpa and his resting O2 saturation is 89%. Which is an eligible factor to start long-term oxygen therapy?
- Recurrent episodes of pneumonia
- O2 saturation of 89%
- Worsening breathlessness despite pharmacological therapy
- ABG results of O2 <7.3kpa
- Loss of daily function tasks due to breathlessness
Answer: D
The requirements for LTOT are that you must be a non-smoker and your pO2 is consistently below 7.3kPa or your pO2 is below 8kPa if you have cor pulmonale or you have consisten O2 saturations below 88%. This patient’s O2 saturation is 89%. Answers A, C and E would not be indicators to start LTOT.
Q75.) You are called to see an 83-year old patient on the ward as the nurses are concerned she has not opened her bowels in the past 5 days. The patient has a pmhx of Alzheimer’s dementia and is on the ward recovering from a recent pneumonia infection, but appears well. On abdominal examination you feel a palpable mass in the Lower left quadrant. You decide to perform a PR examination on the patient with a chaperone and you notice a relaxed anal spinter tone with some hard stool in the rectum. How would you manage this patient?
- Stimulant laxative
- Oral macrogol
- Glycerol suppository
- Enema
- Oral lactulose
Answer: B
This patient has hard stool faecal impaction and according to NICE the first line management is to prescribe an oral macrogol laxative. Using a stimulant laxative would not work as the stool needs softening. An enema may not work as the stool is hard so it may fall out.
name ARBs
losartan and candesartan
name dihydropyridine vs nondihydropyridine
HIV
ssRNA
destroys CD4 T hep cells
what to give with isoniazid
pyridozine- B6
- prevent peripheral neuropathy
nepjrotic loss of how much protein in urine
3g
less than 30 in blood
Investigations for bladder cancer
- Flexible cystoscopy under local anaesthetic
- If suspicious lesion identified then a rigid cystoscopy will be required (under general)
Biopsy- Transurethral resection of bladder tumour (TURBT) can be used for diagnosis and resection
ghon focus / complex
TB in kids
(Ghon lesion and ipsilateral mediastinal lymph node)
non small cell cancers
squamous- smoker
adenocarcinoma- non small cell
treartment: radio or chemo
small cell cancer
surgery, radio and chemo
ectopic ACTH
ectopic ADH= causing SIADH
what sort of cancer
mesothelioma
- asbestos exposure
