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Phase 2b > History Reviews > Flashcards

History Reviews Flashcards

1
Q

General Questions

A

Fever, Weight change, Tiredness, Loss of appetite, night sweats, SOB, urine/bowels, recent infections

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2
Q

Cardiac

A

Chest pain, SOB, Palpitations, Orthopnoea, PND, Ankle swelling, Calf pain/swelling/tenderness, syncope

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3
Q

Respiratory

A

Cough, sputum (blood), SOB, Fever, Night sweats, calf swelling, chest pain, Wheeze

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4
Q

GI

A

Change in appetite, Problems swallowing, Indigestion/acid reflux, Bowel habit change, diahorroea/constipation, blood in poo, nausea, vomiting, haematemesis, pain, jaundice

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5
Q

Neuro

A

Headaches, Visual disturbances/ hearing/ speech, dizziness, faints/fits, weakness/numbness, sleep, tremors, concentration, N+V

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6
Q

GU

A

Incontinence, frequency/dysuria/nocturia, hesitancy/dribbling, change in quanitiy/colour, blood in urine, genital rashes/lumps, menstrual cycle/pregnancy

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7
Q

Endocrine

A

Heat or cold intolerance, sweating, fatigue, tremor, neck swelling, gain weight or loss, polydipsia/polyuria

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8
Q

Skin

A

Itch, rash, bruising, swellings/lumps, pigmentation changes,

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9
Q

Haem

A

Easy bruising, bleed excessively, lumps in axilla, neck groin, previous thromboses/PE, fever, night sweats, weight loss

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10
Q

MSK

A

Joint pain, stiffness, swelling, dry mouth, sore eyes, skin rash, back or neck pain, sweating, fever, autoimmune conditions

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11
Q

Mental Health

A

Anxiety, preocupations, mood, self harm, suicidal thoughts, unusual beliefs, delusions, hallucinations, memory problems/cognitive impairments, learning difficulties

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12
Q

Thyroid

A

Change in weight, appetite, voice change, bowel habit, energy level, mood, concentration, heat intolerance, change skin, hair, nails, change heart rate/rhythm, menstrual cycle

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13
Q

INR/ Warfarin

A

Recent infections, diahorroea/vomiting, blood in stool, headache, stomach ache, increased bruising, prolonged bleeding- cuts, menstrual bleeding, gums, haematuria, weakness, loss sensation, visual changes, speech changes, pain, swelling in leg, redness, heat, SOB, chest pain

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14
Q

HbA1c

A

Recent infections/illnesses, D+V(insulin requirement change, DKA/hypo, polyuria, polydipsia, weight loss, vision changes, tingling in feet, impotence

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15
Q

Peak flow/Spirometery

A

Recent illnesses/infections, SOB, exacerbating factors, wheeze, ADL effect, PND, cough, inhaler frequency

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16
Q

CRP

A

Inflammation- flare up in condition or infection

Rheumatology (RA, ankylosing spondylitis, reactive arthritis, psoriatic arthritis), Crohn’s, pancreatitis, vasculitis
Infective endocarditis, post op infection. SLE vs RA. Crohn’s vs UC.
Burns, trauma, infections (pneumonia/TB), MI, IBD, cancers

Ask all questions

17
Q

ESR

A

ESR a test which see how fast your RBCs settle in a tube

Malignancy- lymphoma, colon, breast, MM.
Haem- anaemia
Connective tissue- SLE, RA, polymyalgia rheumatica/temporal arteritis
Infection- TB, acute hepatitis, bacterial

18
Q

Albumin

A

Low- malnutrition (crohn’s, UC, coeliac), Kidney, liver (hepatitis, cirrhosis)
High- hepatitis, infections, chronic inflammatory diseases

19
Q

Liver enzymes

A

Alcohol excess, obesity, smoking, drug reaction

20
Q

ALP

A

Bile duct obstruction- obstructive liver disease, it D deficiency

21
Q

AST/ALT

A

Liver disease- drugs, toxins, viral

22
Q

GGT

A

Liver disease- drugs/alcohol

23
Q

Diabetes Risk

A

0-6 Low, 7-15 Increased, 16-24 Moderate, 25-47 High risk

Age, Male, Ethnicity, Relative with diabetes, wait measurement, BMI, HTN

Symptoms- Polyuria, polydipsia, fatigue, thrush (genital itching), weight loss

Advice- weight loss, exercise, diet- regular meals, portion size, sugar, fat, salt, alcohol

24
Q

QRISK3

A

Heart attack next 10 years risk

<10% Low Risk 10-20% Moderate risk >20% High risk

Age, Sex, Ethnicity, BMI, PMH (CARD)- CKD, AF, Rheumatoid Arthritis, Diabetes, antihypertensives, angina/MI in family under 60, smoking, cholesterol, BP

Cardiovascular and respiratory symptoms

<10%- Low risk but lifestyle advice- smoking, diet, exercise/weight loss, medication adherence

25
Q

CHA2DS2VaSc

A

Stroke in AF risk

0- No anticoag 1-consider anticoag 2+- give anticoag

Congestive heart failure, HTN, Age, Diabetes, Stroke/TIA, vascular disease, female

Check risk for bleeding, stroke like INR, clotting

Lifestyle- alcohol, smoking, diet, exercise, warfarin/DOAC advice

26
Q

FRAX

A

Spine, hip, shoulder, risk fracture in next 10 years

<10%- low 10-20%- moderate >20%- high. Low reassess in 5 years. Moderate- DEXA scan for BMD- if low treat with bisphosphonate- alendronate, denosumab. High- DEXA- ok reassess in 2 years, below-2.5 tx

Age, Sex, Weight, Height, rheumatoid arthritis, previous fractures, secondary osteoporosis conditions- kidney failure, hyperthyroidism, coeliac disease, T1DM, chronic liver disease, lithium or glucocorticoids, parental fractured hip, smoking, alcohol intake

Regular weight bearing exercise, diet high in calcium leafy green veg, if you struggle can give calcium supplements

27
Q

ABCD2

A

Risk of stroke after TIA

Up to 3 see within 7 days, 4 or 5 see within 24 hours, 6 or 7 see immediately

Age, BP, Unilateral weakness/speech without weakness, duration- 10-60 or 60+, Diabetes

TIA- how long did it last, what happened- neuro/stroke q’s, any other TIAs, other clotting questions, systemic questions

TIA treatment-
Lifestyle- diet, exercise, smoking
Antithrombotic treatment- aspirin immediatley them clopidogrel
Secondary- Control HTN, statin

Don’t drive for 1 month

28
Q

Wells’ score

A

Risk of DVT

0- Unlikely, 1,2- Moderate risk, >3 DVT likely

Recent immobilisation, tenderness along deep venous system, entire leg swollen, calf swelling >3cm compared to other leg, pitting oedema only on one leg, bedridden/surgery, active cancer, previous DVT, alternate Dx more or as likely

Ask clotting questions, SOB, cardio

D-dimer, USS doppler, CTPA if SOB
LMWH, oral warfarin/DOAC INR 2-3, compression stockings, treat/seek cause, diet, exercise, smoking cessation

29
Q

Detailed Drug History

A

“Do you know how many times you are meant to be taking ….?”
“How and when do you take it’’
“Have you missed any doses-if so, did you double the dose?’’
“Are you struggling with your current medication regime or is it okay?’’
“Any other/new medications – including over the counter

Phase 2b (7 decks)

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