Hospital Front Door Flashcards
1
Q
What drugs can cause hyperglycaemia and raised uric acid (gout)
A
Diuretics
2
Q
loss of outer eyebrows indicates problems with what
A
thyroid
3
Q
Treatment options for fibromyalgia
A
amitriptyline/gabapentin
increase exercise
duloxetine
4
Q
what is atypical chest pain
A
non-cardiac chest pain
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
6
Q
What does the HASBLED score calculate the risk of
A
risk of bleeding
7
Q
which antibiotic can cause prolonged QT interval
A
Clarithromycin
8
Q
sign of endocarditis on echo
A
vegetation on valves
9
Q
potassium replacement
A
SanoK
10
Q
Dose of SandoK
A
2 tablets TDS for 3 days
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”
12
Q
Deficiency of vitamin D can cause an increase in what
A
Calcium
13
Q
cause of lipodystrophy
A
injecting insulin in the same place repeatedly
14
Q
DKA: fixed rate insulin given 1st, based on…
A
Pt’s weight
15
Q
DKA: once pt’s ketones are , put them on a sliding scale
A
<0.6
16
Q
DKA: what is the sliding scale based on
A
pt’s BMs
17
Q
DKA: how long is the pt kept on a sliding scale for
A
until they can eat
18
Q
2 causes of pseudohyponatraemia
A
- Diabetes (hyperglycaemia)
- Hyperlipidaemia
19
Q
If a pt on steroids is unwell, what should you do to their steroid dose
A
double it
20
Q
Pts with what should not receive metoclopramide
A
PD
21
Q
Metoclopramide MOA
A
dopamine antagonist
22
Q
Hyperkalaemia ECG findings
A
tall tented T-waves,
broad PR interval
23
Q
Hyperkalaemia treatment
A
- Nebulised salbutamol (stabilise heart)
- Calcium gluconate (stabilise heart)
- Insulin with dextrose (pushes K+ out)
24
Q
4 reasons for acute dialysis
A
- resistant hyperkalaemia
- asidosis
- pulmonary oedema
- uraemic encephalopathy
25
What other electrolyte should be checked if hypokalaemia is present
Mg2+ (K+ will never be corrected if Mg2+ is also low)
26
Treatment of low Mg2+
- 0.5-0.7 give magnesium sulphate (sachet)
| - <0.5 IV magnesium sulphate
27
Treatment of hypernatreamia
IV dextrose (rehydration)
28
In hypernatraemia, how much do you want it to drop per day and why?
drop by 10mmol/day --> risk of cerebral oedema if drops too quickly
29
What electrolyte imbalance would you see in SIADH
hyponatraemia
30
what is the test for SIADH
serum osmolality + urine osmolality
31
Treatment for severe hypocalcaemia
IV calcium gluconate
32
Irritability, muscle aches, confusion, hallucinations, paraesthesia and seizures can indicate
low phosphate
33
What inflammatory marker can also be raised in malignancy? (not just infection)
CRP
34
Management of acute exacerbation of COPD
- Antibiotics (if infective)
- O2
- oral steroids (prednisolone)
- nebulised salbutamol + ipratropium
- Non-invasive ventilation (if type 2 respiratory failure)
35
Management of acute asthma exacerbation
- O2
- Nebulised salbutamol + ipratropium
- oral cotricosteroid (prednisolone)
- magnesium sulphate (bronchodilator)
- aminophilline
36
When should someone have a repeat CXR after pneumonia
6 weeks later
37
Conditions that increase risk of pneumothorax
Marfans syndrome
| Ehlers danlos
38
Site of needle aspiration for pneumothorax
2nd intercostal space, mid-clavicular line
39
5 triggers for seizures
- electrolyte disturbances
- infection
- drugs (NSAIDs, tramadol, antibiotics)
- photo-optic
- post-ictal
40
what is Clobazam used for
Used to prevent and terminate seizures
41
What does a PESI score give
30 day mortality for pts with PE
42
Lactate >X is an indicator of death
>4
43
What happens to urea when a pt is dehydrated
urea will be reabsorbed, so urea lvls will increase (greater than creatinine lvls)
44
CURB-65
```
C = confusion
U = urea >7
R = resps >30
B = BP<90 systolic or <60 diastolic
```
45
high WCC, but low neutrophils and lymphocytes indicates...
leukaemia
46
What can asbestos exposure lead to?
Formation of pleural plaques and mesothelioma in the lung
47
Causes of pleural effusion
- pneumonia
- cardiac failure
- malignancy
48
potential SE of amiodarone
SOB
49
Tension pneumothorax or pulmonary effusion, trachea deviates....
AWAY
50
cancerous lung collapse, trachea deviates...
TOWARDS
51
Big pneumothorax treatment
Chest drain
52
Small pneumothorax treatment
aspirate
53
Why do you give a higher dose of steroid in the morning
circadian rhythm
54
a lupus rash is...
photosensitive
55
3Ps in TLOC history
- Posture
- Provoking factors
- Prodromal symptoms
56
Thunderclap headache
subarachnoid haemorrhage
57
what do delta waves on an ECG indicate
Wolf Parkinson White syndrome
58
what are the rules for epileptics and driving
they must be 1.5yrs seizure free
59
treatment for rhabdomyolysis
Fluids - flush it out the system
60
what are the symptoms of idiopathic intracranial hypertension
- headaches
- pulse-synchronous tinnitus
- visual loss
- neck + back pain
- diplopia
61
signs of idiopathic intracranial hypertension
papilloedema
6th nerve paresis
(disturbances in sensory visual function?)
62
causes of acute severe back pain
```
MSK
AAA
Herniated disk
spine mets
pyelonephritis
renal stones
```
63
What enzymes should you check in appendicitis
amylase
| lipase
64
Causes of pancreatitis
GET SMASHED
65
What can cause raised WCC with normal CRP
seizure
66
2 complications of pancreatitis
pancreatic necrosis
| pancreatic abscess
67
Why does pain radiate to the back in pancreatitis
retroperitoneal organ
68
What can inhalation of anaesthetic gases cause
pancreatitis
69
What is the procalcitonin
an infection marker more sensitive than CRP
70
what is peritonism
inflammation of 1 area
71
What is peritonitis
inflammation of the whole area
72
Causes of RUQ pain
cholecytitis, biliary colic, hepatitis, pancreatitis, renal stones, pneumonia, PE, MI, peptic ulcer disease
73
Causes of LUQ pain
gastritis, pancreatitis, pneumonia, PE, MI
74
Causes of iliac fossa pain
renal stone, ovarian cyst, torsion, diverticulitis (LIF), appendicitis (RIF), ectopic pregnancy
75
location of meckel's diverticulum
wishing 2ft of the ileocaecal valve
76
what is meckel's diverticulum
a bulge or out pouching of the small intestine
77
2 signs indicating pancreatitis
grey turner
| cullens
78
What is ARDS
adult respiratory distress syndrome - non-cariogenic pulmonary oedema (fluffy consolidation all over lungs on CXR)
79
name of criteria for ARDS
berlin criteria
| 4 quadrant infiltrates on XR, hypoxic resp. failure, acute origin (<1wk), normal heart
80
treatment of ARDS
supportive - ventilation, treat infection, time
81
2 causes of oedema
hypoalbuminaemia
| increased cytokines
82
treatment of pancreatitis
fluids
NG feeding
analgesia
83
At what BP does radial pulse disappear
systolic BP <70
84
most common cause of CAP
Strep. pneumoniae
85
Sign of DIC
petechia all over body
86
Pathophysiology of DIC
clotting factors get all used up (in micro vessels) and then the blood no longer clots
87
antidote for heroin OD
Naloxone
88
what is H. pylori strongly associated with
duodenal ulcers
89
how long after a gastric ulcer should you do another endoscopy and why?
8 weeks later - ensure it has healed and is not cancer (strong association)
90
treatment of oesophageal varices
- antibiotics (reduces mortality)
- turlepressin (splanchnic vasoconstriction --> decreased portal pressure)
- resuscitate
91
signs of portal hypertension on bloods
deranged PTT + bilirubin, low platelets
92
what is high urea and low Hb suggestive of
UGI bleed
93
treatment of acute migraine
analgesia
triptans
metoclopramide
94
prophylactic treatment of migraines
propanolol
topiramate
amitriptyline
95
what frequency of migraines requires prophylactic treatment
>1/month
96
cluster headaches
- Unilateral (always same side)
- v. severe
- last roughly 45mins
- associated with autonomic symptoms
- more common in men
97
1st line treatment for cluster headaches
O2
98
prophylactic treatment for cluster headaches
verapamil
99
primary headache
no identifiable cause
100
secondary headache
identifiable cause
101
what would you find on lumbar puncture in a pt with SAH
xanthocromia - metabolised RBCs (must wait 12h post onset of symptoms)
102
management of idiopathic intracranial hypertension
- lumbar puncture
- weight loss
- medication (e.g. topiramate, drugs that decrease CSF production, diuretics)
- VP shunt
- bariatric surgery
103
Investigations for venous sinus thrombosis
- CT head
- CT venogram
- Lumbar puncture
104
Investigations for meningitis
- CT head (often NAD)
- lumbar puncture
- blood cultures
105
Causes of pericardial effusion causing tamponade
- trauma
- cardiac free wall rupture
- aortic dissection
- malignancy
106
CXR findings in oesophageal rupture
thin black lines down the mediastinum
107
what happens to peripheral pulses in aortic dissection
weak or impalpable
108
other than angina, what else can GTN spray help
oesophageal spasm
109
2 causes of raised JVP and chest pain
- cardiac tamponade
| - PE
110
what can deep t-wave changes indicate
hypertrophic cardiomyopathy
111
Type A aortic dissection
involves aortic root/ascending aorta --> requires surgical intervention
112
Type B aortic dissection
doesn't involve aortic root (descending aorta) --> medical management (control BP) (only indication for treatment = pain/ishcaemia --> end-vascular stenting)
