Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 4 > GP > Flashcards

GP Flashcards

1
Q

what tool is used for cardiovascular risk assessment?

A

QRISK3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what counts as high blood pressure in clinic?

A

> 140/90 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what counts as hypertension in ambulatory monotoring?

A

> 135/85 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what 4 tests can be done for end organ damage in HTN diagnosis?

A

Urine sample for estimated albumin:creatinine ratio and haematuria
HbA1c, electrolytes, eGFR, creatinine, cholesterol
Fundoscopy - for retinopathy
ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the first line intervention for HTN?

A

LIFESTYLE ADVICE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the first line medication for HTN in those with T2DM or <55 and of non-african family origin?

A

ACEi (ramipril) or ARB (candestartan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the first line medication for HTN in someone >55 or of african family origin?

A

Calcium channel blockers - amlodipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what can be used for HTN if a calcium channel blocker isn’t tolerated or as 3rd line medication?

A

thiazide-like diuretic (indapamide, bendroflumethiazide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the management of HTN uncontrolled by one agent?

A

ADD CCB/ACEi

OR Thiazide-like diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the management of HTN uncontrolled by two agents?

A

CCB + ACEi AND Thiazide-like diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the management of HTN not controlled by three agents?

A

Consider Spironolactone (If K+ <4.5)

Consider Beta blocker/Alpha blocker (if K+ >4.5)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is classed as severe hypertension?

A

180/120 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is stage 1 HTN?

A

Clinical - 140/80 mmHg to 159/99mmHg

Home - 135/85 - 149/94

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is stage 2 HTN?

A

Clinical - 160/100 - 180/120
Home - 155/95 - 175/115

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is stage 3 HTN?

A

180/120 +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the white coat effect?

A

discrepancy of 22/10mmHg between clinical and home BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are 5 renal causes of HTN?

A

CKD
Chronic pyelonephritis
Diabetic nephropathy
Glomerulonephritis
Polycystic kidney disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are 2 vascular causes of secondary HTN?

A

coarctation of aorta
rental artery stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are 5 endocrine causes of HTN?

A

Primary hyperaldosteronism
Phaeochromocytoma
Cushings syndrome
Acromegaly
Hyper/Hypothyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are 5 drugs that can cause HTN?

A

alcohol + other substances
COCP/Oestrogens
Eythropoietin
corticosteroids
NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is stage 1 HTN?

A

140/80 mmHg to 159/99mmHg CLINICALLY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is stage 2 HTN?

A

160/100 mmHg to 180/120mmHg CLINICALLY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is stage 3 HTN?

A

> 180/120 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are 4 side effects of NSAIDs?

A

GI - gastritis, ulcers
renal - AKI (acute tubular necrosis), CKD
CV - HTN, heart failure, MI, stroke
exacerbation of asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how do NSAIDs cause HTN?

A

block prostaglandins which cause vasodilation => use with caution in HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what antibodies are in RhA?

A

rheumatoid factor
anti-CCP (cyclic citrullinated peptide) - most specific and sensitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is atlantoaxial sublaxation?

A

complication of RhA where the axis and odontoid peg shift within atlas causing localised sinovitis and damage to ligaments which can cause spinal cord compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are RhA signs in the hands?

A

Z shaped deformity of thumb
swan neck deformity (hyperextended PIP and flexed DIP)
boutonnieres deformity - hyperextended DIP with flexed PIP
ulnar deviation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are 10 extra-articular manifestations of RhA?

A

pulmonary fibrosis (caplan’s syndrome)
Bronchiolitis obliterans
Feltys syndrome (RhA, neutropenia, splenomegaly)
Secondary Sjogren’s syndrome
anaemia of chronic disease
CVD
episcleritis and scleritis
rheumatoid nodules
lymphadenopathy
carpal tunnel
amyloidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what are 4 x-ray features of RhA?

A

erosions
synovitis
deformity and joint destruction
symmetrical pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is felty’s syndrome?

A

complication of RhA

RhA + neutropenia +splenomegally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is caplan’s syndrome?

A

complication of RhA

pulmonary fibrosis in people with RhA usually in relation to particulate exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

which joint is spared in rheumatoid?

A

Distal interphalangeal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

when is urgent referral for RhA needed?

A

if small joints of hands and feet are affected
if multiple joints are affected
if symptoms >3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what score can be used to objectively measure severity of RhA?

A

disease activity score (DAS) 28

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what score can be used to measure subjective severity of RhA?

A

health assessment questionaire

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is the long term treatment of RhA?

A

Acute - NSAIDs/Coxibs (+PPI), glucocorticoids (only in confirmed)

long term
1st - DMARDs (methotrexate, leflunomide, sulfasalazine), hydroxychloroquine consider in mild disease
2nd - combination DMARDs
3rd - DMARD + biologics (TNF inhibitor, JAK inhibitors)
4th - DMARD + rituximab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

how long can it take for DMARDs to work?

A

2-3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what is a side effect of biological agents?

A

immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what are 4notable side effects of methotrexate?

A

mouth ulcers and mucositis
liver toxicity
bone marrow suppression and leukopenia
teratogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

how is methotrexate taken?

A

orally once a week
OR
Injection once a week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what should always be co-prescribed with methotrexate?

A

folic acid 5mg OW - to be taken on different day to methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

how does methotrexate work?

A

interferes with folate metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what are 5 notable side effect of leflunomide?

A

raised BP
rashes
peripheral neuropathy
teratogenic
bone marrow suppresion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

how does leflunomide work?

A

interferes production of pyrimidine used to make RNA and DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

how does hydroxychloroquine work as an immunosuppressant?

A

interferes with toll-like receptors disrupting antigen presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what are 4 notable side effects of hydroxychloroquine?

A

nightmares
macular toxicity
liver toxicity
skin pigmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what is a notable side effect of sulfasalazine?

A

male infertility - reduction in sperm count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what is a notable side effect of anti-TNF?

A

reactivation of TB and hepatitis B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what are 2 notable side effects of rituximab?

A

night sweats
thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what scale is used to grade COPD?

A

MRC dyspnoea scale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what is grade 1 on the MRC dyspnoea scale?

A

breathless on strenuous exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what is grade 2 on the MRC dyspnoea scale?

A

breathless walking up hill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what is grade 3 on the MRC dyspnoea scale?

A

breathless walking on the flat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what is grade 4 on the MRC dyspnoea scale?

A

breathlessness walking less than 100m on flat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what is grade 5 on the mrc dyspnoea scale?

A

unable to leave house due to breathlessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what will be seen on spirometry with COPD?

A

obstructive => FEV1:FVC <70%
little/no reversibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

how can severity in COPD be measured?

A

FEV1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what is the non-medical management of COPD?

A

annual flu and pneumococcal vaccine
pulmonary rehab
stop smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what is the medical management of COPD?

A

1 - SABA or SAMA (ipratropium bromide)

2 - un steroid responsive - LABA + LAMA
2- steroid responsive - LABA and ICS (fostair, seretide)

3 - LABA, LAMA, ICS combo - trimbow, trelegy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

when might someone with COPD need LTOT?

A

if chronically hypoxic - O2 SATs <92%
polycythaemia
cyanosis
cor pulmonale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

what is cor pulmonale?

A

R sided heart failure causes by resp illness - COPD, pulmonary embolism, ILD< CF, pulmonary hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

what is the first line management of trigeminal neuralgia?

A

carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what are the 2 shockable pulseless rhythms?

A

ventricular tachycardia
ventricular fibrilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

how long should the QRS complex be?

A

0.12 seconds

3 small squares

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what are the 4 main causes of narrow complex tachycardias?

A

sinus tachy
supraventricular tachy
AF
Atrial flutter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

what is the management for suraventricular tachycardia?

A

vagal manoeuvres - valsalva, diving reflex

adenosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what is a prolonged cQT interval?

A

> 0.44s in men
0.46s in women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

what is torsades de pointes?

A

type of ventricular tachycardia caused by long QT which causes progressive changing heights of QRS complexes with ventricular tachycardia which can either revert to sinus rhythm or progress to ventricular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

what are 3 causes of long QT?

A

long QT syndrome
medications
electrolyte imbalances - hypokalaemia, hypomagnesaemia, hypocalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

what are 6 meds that can cause long QT?

A

antipsychotics
citalopram
flecainide
sotalol
amiodarone
macrolides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

what is the acute management of torsades du pointes?

A

correct underlying cause
magnesium infusion
defibrilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

what PR interval indicates 1st degree heart block?

A

> 0.2 s (one big square)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

what is 2nd degree mobitz type 1 heart block?

A

PR interval gets progressively longer until conduction fails and then the cycle repeats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

what is 2nd degree type 2 heart block?

A

intermittent failure of conduction in a certain ration of P waves to QRS complexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

what is 3rd degree heart block?

A

no relationship between p waves and QRS complexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

what is sick sinus syndrome?

A

dysfunction of SA node often causes by idiopathic degenerative fibrosi s

78
Q

what arrhythmia carry risk of asystole?

A

mobitz type II
3rd degree HB
previous asystole
ventricular pauses longer than 3s

79
Q

what medication can be used first line in unstable patients at risk of asystole?

A

IV atropine

80
Q

what are 4 features of AF?

A

irregularly irregular hr
tachycardia
heart failure - due to impaired filling in diastole
increased risk of stroke (5X)

81
Q

what are 5 common causes of AF? mneumonic

A

SMITH

Sepsis
Mitral valve pathology
Ischaemic heart disease
Thyrotoxicosis
Hypertension

Alcohol and caffeine

82
Q

what are 3 ecg findings in AF?

A

absent p waves
narrow QRS complex tachycardia
irregularly irregular ventricular rhythm

83
Q

what is the first line management for AF?

A

rate control
1 - beta blocker - propanolol

2 - calcium channel blockers (diltiazem or verapamil), digoxin

84
Q

what score is used to assess need for anticoagulation in AF?

A

CHA2DS2-VASc

85
Q

what is the first line anticoagulant to be used in AF?

A

DOAC - apixiban, edoxaban, riveroxaban

2 - warfarin

86
Q

how do DOACs work?

A

direct factor Xa inhibition

87
Q

what is the antidote to apixiban?

A

andexanet alfa

88
Q

what is he target range for INR?

A

02-Mar

89
Q

what does chad2ds2-Vasc stand for?

A

Congestive heart failure
Hypertension
Age >75 (2+)
Diabetes
Stroke or TIA (+2)

Vascular disease
Age 65-74
Sex (female)

90
Q

what is the ORBIT score?

A

bleed risk in anticoag in af

Older age >75
Renal impairment
Bleeding previously
Iron - low haemoglobin/haematocrit
Taking antiplatlets

91
Q

what can be seen on ecg with supraventricualar tachycardia?

A

tachycardia with narrow complex QRS COMPLEXES (<0.12s)

92
Q

what is wolff-parkinson white syndrome?

A

caused by extra electrical pathway connecting atria and ventricles which leads to episodes of supraventricular tachycardia

93
Q

what ecg changes are seen in woff-parkinson white syndrome?

A

short PR <0.12s
Wide QRS complexes >0.12s
delta waves - slurred upstroke in QRS complexes

94
Q

what is a major complication of wolff-parkinson white syndrome?

A

if in combination with AF can cause polymorphic wide complex tachycardia which is lifethreatening

95
Q

what medications are contraindicated in wolff-parkinson white syndrome?

A

most anti-arrythmics as increase risk of conduction through acessory pathways

96
Q

what is the stepwise management of supraventricular tachycardia?

A

vagal manoeuvers
adenosine
verapamil/beta blocker
Synchronised DC cardioversion

97
Q

in what conditions is adenosine contraindicated?

A

Asthma or COPD
COPD
Heart failure
heart block
severe hypotension
potential atrial arrhythmia with underlying pre-excitation (WPW syndrome)

98
Q

what is the stepwise dosage of adenosine?

A

6mg

12mg

18mg

99
Q

what is a side effect of adenosine bolus?

A

feeling of impending doom like dying

100
Q

what is the secondary prevention for cardiovascular disease?

A

4As

Antiplatelets - aspirin, clopi, ticagrelor
Atorvostatin 80mg
Atenolol - or other beta blocker
Acei - ramipril

101
Q

what is the antiplatelet of choice in peripheral arterial disease?

A

clopidogrel

102
Q

what are 6 features of critical limb ischaemia?

A

6Ps

Pain
Pallor
Pulseless
Paralysis
Paresthesia
Perishingly cold

103
Q

what are 7 features of arterial ulcers?

A

smaller than venous
deeper than venous
well defined borders
punched out appearance
occur peripherally
reduced bleeding
painful

104
Q

what are 7 features of venous ulcers?

A

occur after minor injury
larger than arterial
more superficial than arterial
irregular gently sloping borders
affect gaiter areas - mid calf to ankle
less painful
occur with other signs of chronic venous insuficciency

105
Q

what are 3 investigations for peripheral vascular diseae?

A

ankle branchial pressure index
duplex uss
angiography - ct or mri

106
Q

what medication can be used in peripheral vascular disease that acts as peripheral vasodilator?

A

naftidrofuryl oxalate - 5-HT2 receptor antagonist

107
Q

what is menopause?

A

12 months no period

108
Q

when iis the average menopause?

A

51 years

109
Q

what is premature menoopuse?

A

<40 years

110
Q

what are 8 perimenopausal symptoms?

A

hot flushes
emotional lability/low mood
premenstrual syndrome
irreular periods
joint pain
heavier or lighter peiods
vaginal dryness and atrophy
reduced libido

111
Q

what are 4 conditions that reduced oestrogen increases the risk of?

A

CVD and stroke
osteoporosis
pelvic organ prolapse
urinary incontinence

112
Q

what are 5 good contraceptive options in women approaching menopause?

A

barrier methods
mirena or copper coil
progesterone only pill
progesterone implant
sterilisation

113
Q

what are 2 side effects of the progesterone depot injection?

A

weight gain
reduced bone mineral density

114
Q

what are 8 management options for perimenopausal symptoms?

A

HRT
tibolone - only after 12 months amenorrhoea
clonidine
CBT
SSRIs
testosterone - for libido
vaginal oestrogen
vaginal moisturisers

115
Q

what are the 2 most common mets sites for prostate cancer?

A

lymph nodes
bone - spine v comon

116
Q

what is the first line investigation for prostate cancer?

A

multiparametric mri

117
Q

what are 2 methods of prostate biopsy?

A

transrectal ultrasound guided biopsy
transperineal biopsy

118
Q

what grading system is used for prostate cancer>

A

gleason grading system

119
Q

what are 2 hormone therapies used in prostate cancer?

A

androgen receptor blockers - bicalutamide
GnRH agonists - goserelin or leuprorelin

120
Q

what are 4 types of psoriasis?

A

plaque - normal psoriasis plaques
guttate psoriasis
pustular psoriasis - med emergency
erythrodermic psoriasis - extensive erythema which peels in large patches - med emergency

121
Q

what is guttate psoriasis?

A

common in children, many small papules on trunk and limbs that develop to plaques. usually after strep throat infection

122
Q

what are 3 specific signs of psoriasis?

A

auspitz sign - small points of bleeding when plaques scraped off
koebner phenomenon - psoriatic lesions in areas of trauma
residual pigmentation once lesions resolve

123
Q

what is the management of psoriasis?

A

topical steroids
topical vitamin D
topical dithranol
topical calcineurin inhibitors - tacrolimus
phototherapy with narrow band uv b light

124
Q

what are 2 potent steroid + vitamin d

A

dovobet and enstilar

125
Q

what are 5 hand signs of psorisis?

A

nail pitting
oncholysis
dactylisis
nail thickening
swollen joints

126
Q

how many tender sites must be identified in fibromyalgia?

A

11/18 designated tender point sites

127
Q

How often is diabetic eye screening?

A

annually from age of 12

128
Q

in what age range is breast screening offered?

A

50-70 years

129
Q

how often is breast screening?

A

every 3 years

130
Q

In what age range is bowel screening offered?

A

60-74 years

131
Q

How often is bowel screening done?

A

every 2 years

132
Q

what are 4 screening tests in pregnancy?

A

Hep B, HIV and syphilis screen
Down’s, pataus and edwards screen - combined/quadruple test
sickle cell/thallsaemia test
20 week anomaly scan
diabetic eye screen - if have diabetes

133
Q

what are 3 new born screening tests?

A

NIPE
hearing test
blood spot heel prick test

134
Q

when do you offer Abx in acute bronchitis?

A

if CRP >20 offer delayed prescription
if CRP >100 offer ABx now

135
Q

what is the first line abx in acute bronchitis?

A

doxycycline

not in preggos or children - Amoxacillin

136
Q

what is a Meibomian cyst?

A

internal infection of meibomian glands in eyelid causing lump - like what dan had - hot compress and analgesia should go away on own

137
Q

what is the management for gingivostomatitis (ulcers) in HSV?

A

oral acyclovir and chlorohexadine mouth wash

138
Q

what is the management for genital herpes?

A

acyclovir

139
Q

what is the management of herpes in pregnancy?

A

elective c-section if primary genital infection >28 weeks

140
Q

which herpes virus is most commonly responsible for herpes encephalitis?

A

HSV-1

141
Q

BMI =

A

weight/height squared

142
Q

what is the medical management of obesity?

A

orlistat
liraglutide

143
Q

when is orlistat used?

A

BMI >28 with 2+ risk factors
BMI >30

with continued weight loss of 5% at 3 months
use for <1 year

144
Q

how does orlistat work?

A

pancreatic lipase inhibitor

145
Q

How does liraglutide work?

A

glucagon-like peptide mimetic used in T2DM given OD SC injection

146
Q

when is liraglutide used?

A

BMI > 35 kg/m²
prediabetic hyperglycaemia (e.g. HbA1c 42 - 47 mmol/mol)

147
Q

what is the ideal blood glucose conc?

A

4.4-6.1 mmol/L

148
Q

what are 4 macrovascular complications of DM?

A

coronary artery disease
Peripheral ischaemia
Stroke
HTN

149
Q

what are 3 microvascular complications of DM?

A

peripheral neuropathy
retinopathy
kidney disease

150
Q

what are are 4 infection related complications of DM?

A

UTI
Pneumonia
skin and soft tissue infection
fungal infection

151
Q

How often do diabetics get their HbA1c measured?

A

every 3-6 months

152
Q

what is the name of the darkening skin on neck axilla and groin seen in insulin resistance?

A

acanthosis nigricans

153
Q

what HbA1c level is pre-diabetes?

A

42-47 mmol/mol

154
Q

what is the HbA1c level for diabetes?

A

> 48 mmol/mol

155
Q

what is the 1st line treatment for T2DM?

A

metformin

156
Q

what medication can be added to patients on metformin with an existing CVD or QRisk >10%?

A

SGLT-2 inhibitor - dapagliflozin

157
Q

what is the second line management of T2DM?

A

sulfonylurea

pioglitazone, DPP-4 inhibitor or SGLT-2 inhibitor

158
Q

what is the MOA of metformin?

A

increases insulin sensitivity and decreases glucose production - a biguanide

159
Q

what are 2 side effects of metformin?

A

GI symptoms
Lactic acidosis - secondary to AKI

NOT hypos NOT weight gain

160
Q

what is the MOA of SGLT-2 inhibitors?

A

prevent sodium glucose co-transporter 2 protein from reabsorbing glucose in proximal tubules allowing for greater excretion

161
Q

what are 8 side effects of SGLT-2 inhibitors?

A

Glycosuria
Increased urinary output and frequency
UTIs + genital infections
weight loss
DKA
Lower limb amputation
Fourniers gangrene
Hypoglycaemia

162
Q

what are 4 side effects of pioglitazone?

A

weight gain
heart failure
increased risk bone fractures
small increase risk bladder cancer

163
Q

what are 2 side effects of sulfonylureas?

A

weight gain
hypoglycaemia

164
Q

what is a rapid acting insulin and how long does it work for?

A

Novorapid - works after 10 mins for 4 hours

165
Q

what is a short acting insulin and how long does it work for?

A

Actrapid - works after 30 mins for 8 hours

166
Q

what is an intermediate acting insulin and how long does it work for?

A

Humulin I - works after 1 hour for 16 hours

167
Q

what is a long acting insulin and how long does it work for?

A

Levemir and lantus - works after 1 hour for 24 hours

168
Q

what is the 1st line antihypertensive in T2Dm?

A

acei

169
Q

what are 4 signs of PE? (CXR and ECG)

A

Fleischner sign = dilated central pulmonary vessel. Westermark sign (collapse of vasculature distal to PE) Hampton’s hump - wedge-shaped infarct
ECG features - sinus tachycardia and/or ST depression.

170
Q

what is the management of pericarditis?

A

NSAIDs

171
Q

what is the MOA of N-acetylcysteine?

A

Replenishes body stores of glutathione preventing hepatocyte damage.

172
Q

what is the moa of methotrexate?

A

competitively inhibits dihydrofolate reductase

173
Q

what drug can be used to reverse heparin?

A

Protamine

174
Q

what medication can be used to reverse DOACs?

A

Beriplex

175
Q

what is the chronic management for ACS?

A

Block An ACS

Beta Blocker + ACEi + Aspirin + Clopidogrel + Statin

176
Q

what is the MOA of aspirin?

A

Cox-1 inhibitor

177
Q

what is the MOA of clopidogrel?

A

P2Y12 inhibitor

178
Q

what is stage 1 AKI?

A

Creatinine is 1.5-1.9 times higher than baseline/ urine output < 0.5ml/kg for > 6 consecutive hours

179
Q

what is stage 2 AKI?

A

Creatinine is 2-2.9 times higher than baseline/ urine output < 0.5ml/kg for > 12 consecutive hours

180
Q

what is stage 3 AKi?

A

Creatinine is >3 times higher than baseline / urine output < 0.5ml/kg for > 24 consecutive hours/ anuria for > 12 hours

181
Q

what is conn syndrome?

A

adrenal hypertrophy causing increased aldosterone leading to hypertension, hypernatraemia and hypokalaemia

182
Q

what is the management of conn syndrome?

A

spironolactone

183
Q

what is severe asthma in adults?

A

PEF 33–50% best or predicted
RR ≥25/min
HR ≥110/min
inability to complete sentences

184
Q

what is life threatening asthma in adults?

A

PEF <33% best or predicted
SpO2 <92%
PaO2 <8 kPa
‘normal’ PaCO2 (4.6–6.0 kPa)
altered conscious level
exhaustion
arrhythmia
hypotension
cyanosis
silent chest
poor respiratory effort

185
Q

what is chronic suppurative ottitis media?

A

otitis media >2 weeks with recurrent ear discharge

186
Q

what is the 1st and 2nd line management of UTI in men and women?

A

1 - Nitrofurantoin OR Trimethoprim

2 - Nitro (if not used) or Pivmecillinam

Treat for 3 days BD in women and 7 days BD for men

187
Q

what risk score is used for pressure ulcers?

A

Waterlow score

188
Q

what risk score is used for upper GI bleeds?

A

Glasgow-Blatchford

189
Q

what is the name of the sign where muscle twitching is elicited in the face by tapping in front of the ear which is indicative of hypocalcaemia?

A

Chvostek sign

190
Q

what is examination finding in otitis media with effusions?

A

grey tympanic membrane
fluid level
loss of cone of light reflex

AKA glue ear

191
Q

what is examination findings in suppurative otitis media?

A

mucopurulent discharging ear

Phase 4 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions