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3rd Year > Hospital Front Door > Flashcards

Hospital Front Door Flashcards

1
Q

What drugs can cause hyperglycaemia and raised uric acid (gout)

A

Diuretics

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2
Q

loss of outer eyebrows indicates problems with what

A

thyroid

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3
Q

Treatment options for fibromyalgia

A

amitriptyline/gabapentin
increase exercise
duloxetine

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4
Q

what is atypical chest pain

A

non-cardiac chest pain

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5
Q

3 conditions for typical chest pain

A
  • substernal chest discomfort of characteristic quality and duration
  • provoked by exertion or emotional stress
  • relieved by rest/GTN spray
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6
Q

What does the HASBLED score calculate the risk of

A

risk of bleeding

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7
Q

which antibiotic can cause prolonged QT interval

A

Clarithromycin

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8
Q

sign of endocarditis on echo

A

vegetation on valves

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9
Q

potassium replacement

A

SanoK

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10
Q

Dose of SandoK

A

2 tablets TDS for 3 days

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11
Q

hypokalaemia ECG findings

A

-U waves
-no (small) T-waves
-long PR
-long QT
“U have no pot(assium) or no T, but a long PR and a long QT”

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12
Q

Deficiency of vitamin D can cause an increase in what

A

Calcium

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13
Q

cause of lipodystrophy

A

injecting insulin in the same place repeatedly

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14
Q

DKA: fixed rate insulin given 1st, based on…

A

Pt’s weight

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15
Q

DKA: once pt’s ketones are , put them on a sliding scale

A

<0.6

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16
Q

DKA: what is the sliding scale based on

A

pt’s BMs

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17
Q

DKA: how long is the pt kept on a sliding scale for

A

until they can eat

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18
Q

2 causes of pseudohyponatraemia

A
  • Diabetes (hyperglycaemia)

- Hyperlipidaemia

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19
Q

If a pt on steroids is unwell, what should you do to their steroid dose

A

double it

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20
Q

Pts with what should not receive metoclopramide

A

PD

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21
Q

Metoclopramide MOA

A

dopamine antagonist

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22
Q

Hyperkalaemia ECG findings

A

tall tented T-waves,

broad PR interval

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23
Q

Hyperkalaemia treatment

A
  • Nebulised salbutamol (stabilise heart)
  • Calcium gluconate (stabilise heart)
  • Insulin with dextrose (pushes K+ out)
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24
Q

4 reasons for acute dialysis

A
  • resistant hyperkalaemia
  • asidosis
  • pulmonary oedema
  • uraemic encephalopathy
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25
Q

What other electrolyte should be checked if hypokalaemia is present

A

Mg2+ (K+ will never be corrected if Mg2+ is also low)

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26
Q

Treatment of low Mg2+

A
  • 0.5-0.7 give magnesium sulphate (sachet)

- <0.5 IV magnesium sulphate

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27
Q

Treatment of hypernatreamia

A

IV dextrose (rehydration)

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28
Q

In hypernatraemia, how much do you want it to drop per day and why?

A

drop by 10mmol/day –> risk of cerebral oedema if drops too quickly

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29
Q

What electrolyte imbalance would you see in SIADH

A

hyponatraemia

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30
Q

what is the test for SIADH

A

serum osmolality + urine osmolality

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31
Q

Treatment for severe hypocalcaemia

A

IV calcium gluconate

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32
Q

Irritability, muscle aches, confusion, hallucinations, paraesthesia and seizures can indicate

A

low phosphate

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33
Q

What inflammatory marker can also be raised in malignancy? (not just infection)

A

CRP

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34
Q

Management of acute exacerbation of COPD

A
  • Antibiotics (if infective)
  • O2
  • oral steroids (prednisolone)
  • nebulised salbutamol + ipratropium
  • Non-invasive ventilation (if type 2 respiratory failure)
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35
Q

Management of acute asthma exacerbation

A
  • O2
  • Nebulised salbutamol + ipratropium
  • oral cotricosteroid (prednisolone)
  • magnesium sulphate (bronchodilator)
  • aminophilline
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36
Q

When should someone have a repeat CXR after pneumonia

A

6 weeks later

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37
Q

Conditions that increase risk of pneumothorax

A

Marfans syndrome

Ehlers danlos

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38
Q

Site of needle aspiration for pneumothorax

A

2nd intercostal space, mid-clavicular line

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39
Q

5 triggers for seizures

A
  • electrolyte disturbances
  • infection
  • drugs (NSAIDs, tramadol, antibiotics)
  • photo-optic
  • post-ictal
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40
Q

what is Clobazam used for

A

Used to prevent and terminate seizures

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41
Q

What does a PESI score give

A

30 day mortality for pts with PE

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42
Q

Lactate >X is an indicator of death

A

> 4

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43
Q

What happens to urea when a pt is dehydrated

A

urea will be reabsorbed, so urea lvls will increase (greater than creatinine lvls)

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44
Q

CURB-65

A 
C = confusion
U = urea >7
R = resps >30
B = BP<90 systolic or <60 diastolic
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45
Q

high WCC, but low neutrophils and lymphocytes indicates…

A

leukaemia

46
Q

What can asbestos exposure lead to?

A

Formation of pleural plaques and mesothelioma in the lung

47
Q

Causes of pleural effusion

A
  • pneumonia
  • cardiac failure
  • malignancy
48
Q

potential SE of amiodarone

A

SOB

49
Q

Tension pneumothorax or pulmonary effusion, trachea deviates….

A

AWAY

50
Q

cancerous lung collapse, trachea deviates…

A

TOWARDS

51
Q

Big pneumothorax treatment

A

Chest drain

52
Q

Small pneumothorax treatment

A

aspirate

53
Q

Why do you give a higher dose of steroid in the morning

A

circadian rhythm

54
Q

a lupus rash is…

A

photosensitive

55
Q

3Ps in TLOC history

A
  • Posture
  • Provoking factors
  • Prodromal symptoms
56
Q

Thunderclap headache

A

subarachnoid haemorrhage

57
Q

what do delta waves on an ECG indicate

A

Wolf Parkinson White syndrome

58
Q

what are the rules for epileptics and driving

A

they must be 1.5yrs seizure free

59
Q

treatment for rhabdomyolysis

A

Fluids - flush it out the system

60
Q

what are the symptoms of idiopathic intracranial hypertension

A
  • headaches
  • pulse-synchronous tinnitus
  • visual loss
  • neck + back pain
  • diplopia
61
Q

signs of idiopathic intracranial hypertension

A

papilloedema
6th nerve paresis
(disturbances in sensory visual function?)

62
Q

causes of acute severe back pain

A 
MSK
AAA
Herniated disk
spine mets
pyelonephritis
renal stones
63
Q

What enzymes should you check in appendicitis

A

amylase

lipase

64
Q

Causes of pancreatitis

A

GET SMASHED

65
Q

What can cause raised WCC with normal CRP

A

seizure

66
Q

2 complications of pancreatitis

A

pancreatic necrosis

pancreatic abscess

67
Q

Why does pain radiate to the back in pancreatitis

A

retroperitoneal organ

68
Q

What can inhalation of anaesthetic gases cause

A

pancreatitis

69
Q

What is the procalcitonin

A

an infection marker more sensitive than CRP

70
Q

what is peritonism

A

inflammation of 1 area

71
Q

What is peritonitis

A

inflammation of the whole area

72
Q

Causes of RUQ pain

A

cholecytitis, biliary colic, hepatitis, pancreatitis, renal stones, pneumonia, PE, MI, peptic ulcer disease

73
Q

Causes of LUQ pain

A

gastritis, pancreatitis, pneumonia, PE, MI

74
Q

Causes of iliac fossa pain

A

renal stone, ovarian cyst, torsion, diverticulitis (LIF), appendicitis (RIF), ectopic pregnancy

75
Q

location of meckel’s diverticulum

A

wishing 2ft of the ileocaecal valve

76
Q

what is meckel’s diverticulum

A

a bulge or out pouching of the small intestine

77
Q

2 signs indicating pancreatitis

A

grey turner

cullens

78
Q

What is ARDS

A

adult respiratory distress syndrome - non-cariogenic pulmonary oedema (fluffy consolidation all over lungs on CXR)

79
Q

name of criteria for ARDS

A

berlin criteria

4 quadrant infiltrates on XR, hypoxic resp. failure, acute origin (<1wk), normal heart

80
Q

treatment of ARDS

A

supportive - ventilation, treat infection, time

81
Q

2 causes of oedema

A

hypoalbuminaemia

increased cytokines

82
Q

treatment of pancreatitis

A

fluids
NG feeding
analgesia

83
Q

At what BP does radial pulse disappear

A

systolic BP <70

84
Q

most common cause of CAP

A

Strep. pneumoniae

85
Q

Sign of DIC

A

petechia all over body

86
Q

Pathophysiology of DIC

A

clotting factors get all used up (in micro vessels) and then the blood no longer clots

87
Q

antidote for heroin OD

A

Naloxone

88
Q

what is H. pylori strongly associated with

A

duodenal ulcers

89
Q

how long after a gastric ulcer should you do another endoscopy and why?

A

8 weeks later - ensure it has healed and is not cancer (strong association)

90
Q

treatment of oesophageal varices

A
  • antibiotics (reduces mortality)
  • turlepressin (splanchnic vasoconstriction –> decreased portal pressure)
  • resuscitate
91
Q

signs of portal hypertension on bloods

A

deranged PTT + bilirubin, low platelets

92
Q

what is high urea and low Hb suggestive of

A

UGI bleed

93
Q

treatment of acute migraine

A

analgesia
triptans
metoclopramide

94
Q

prophylactic treatment of migraines

A

propanolol
topiramate
amitriptyline

95
Q

what frequency of migraines requires prophylactic treatment

A

> 1/month

96
Q

cluster headaches

A
  • Unilateral (always same side)
  • v. severe
  • last roughly 45mins
  • associated with autonomic symptoms
  • more common in men
97
Q

1st line treatment for cluster headaches

A

O2

98
Q

prophylactic treatment for cluster headaches

A

verapamil

99
Q

primary headache

A

no identifiable cause

100
Q

secondary headache

A

identifiable cause

101
Q

what would you find on lumbar puncture in a pt with SAH

A

xanthocromia - metabolised RBCs (must wait 12h post onset of symptoms)

102
Q

management of idiopathic intracranial hypertension

A
  • lumbar puncture
  • weight loss
  • medication (e.g. topiramate, drugs that decrease CSF production, diuretics)
  • VP shunt
  • bariatric surgery
103
Q

Investigations for venous sinus thrombosis

A
  • CT head
  • CT venogram
  • Lumbar puncture
104
Q

Investigations for meningitis

A
  • CT head (often NAD)
  • lumbar puncture
  • blood cultures
105
Q

Causes of pericardial effusion causing tamponade

A
  • trauma
  • cardiac free wall rupture
  • aortic dissection
  • malignancy
106
Q

CXR findings in oesophageal rupture

A

thin black lines down the mediastinum

107
Q

what happens to peripheral pulses in aortic dissection

A

weak or impalpable

108
Q

other than angina, what else can GTN spray help

A

oesophageal spasm

109
Q

2 causes of raised JVP and chest pain

A
  • cardiac tamponade

- PE

110
Q

what can deep t-wave changes indicate

A

hypertrophic cardiomyopathy

111
Q

Type A aortic dissection

A

involves aortic root/ascending aorta –> requires surgical intervention

112
Q

Type B aortic dissection

A

doesn’t involve aortic root (descending aorta) –> medical management (control BP) (only indication for treatment = pain/ishcaemia –> end-vascular stenting)

3rd Year (2 decks)

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