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Y5 OSCE > Knowledge revision - Medicine > Flashcards

Knowledge revision - Medicine Flashcards

1
Q

Which investigation is essential after first seizure?

A

ECG

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2
Q

What are the first-line options for gen tonic-clonic epilepsy?

A

Lamotrigine, valproate (not if woman), carbamazepine

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3
Q

What are the first-line options for focal epilepsy?

A

Lamotrigine or carbamazepine

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4
Q

What are the first line options for absence seizures?

A

Valproate or ethosuximide

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5
Q

Which AEDs are enzyme inducers?

A

Phenytoin, carbamazepine and topiramate

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6
Q

Which methods of contraception can be used in women taking enzyme-inducing AEDs?

A

Mirena IUS/Copper IUD
Barrier methods
NO systemic hormonal contraception - reduced efficacy

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7
Q

Which common medications can lower seizure threshold?

A

Penicillins, quinolones, antipsychotics, chloroquines

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8
Q

Which clinical scoring system is used in ACS?

A

GRACE

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9
Q

Which scoring system is used in CAP?

A

CURB65

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10
Q

Which scoring system is used for VTE?

A

Wells’ score

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11
Q

Which scoring system is used to calculate the risk of stroke in AF?

A

CHADSVASC

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12
Q

Which scoring system is used to calculate the risk of stroke in AF?

A

CHADSVASC

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13
Q

Which scoring system is used to calculate bleeding risk in patients on anticoagulation?

A

HASBLED

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14
Q

Which scoring system is used in assessing severity of heart failure?

A

NYHA

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15
Q

Which scoring system predicts prognosis in chronic liver disease?

A

Child-Pugh score

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16
Q

Which scoring tool is used to predict risk of cardiovascular disease?

A

QRISK

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17
Q

Which scoring system is used to assess risk pre-endoscopy in UGIB?

A

Glasgow-Blatchford

18
Q

Which scoring system is used to assess risk post-intervention in UGIB?

A

Rockall

19
Q

What does CURB65 stand for?

A

 Confusion
 Urea > 7
 RR > 30
 BP < 90 / 60
 > 65

20
Q

What symptoms may be present in patients with CKD?

A

Itching, loss of appetite, oedema, nausea, fatigue

21
Q

Which patients with CKD should be referred to a specialist?

A

o eGFR < 30 or ACR > 70
o Accelerated progression
o Unable to control BP despite 4 anti-hypertensives

22
Q

What are the cornerstones of management of CKD?

A

Treat underlying causes
Optimise CVD risk - ACEI and primary prevention with atorvastatin
Treat complications eg. renal anaemia, bone disease etc
ESRD - dialsysis/transplant

23
Q

What is the Hb target in CKD?

A

100-120

24
Q

What does the renal diet include?

A
  • Often fluid restriction
  • Low salt
  • Low potassium – no bananas, cooked greens/spinach, oranges
  • Low phosphorous – greens/mushrooms, certain cereals, soft drinks like diet coke
25
Q

When should patients with CKD start preparing for the possibility of requiring RRT?

A

eGFR < 30

26
Q

Which patient group should not receive morphine?

A

reduced renal function

27
Q

Which analgesics could you consider if pain persisting despite paracetamol?

A

Weak opioids eg. codeine, DHC, tramadal

28
Q

What is the usual dose of codeine?

A

30-60mg every 4 hours if req

29
Q

What is the usual dose of Morphine?

A

10mg up to 4-hourly initially

30
Q

How do you convert from PO to SC Morphine?

A

Half the dose

31
Q

How is heart failure managed?

A

o Refer to cardiology
o Advice re condition
o Medical treatments
 ACEI & beta-blocker
 Can add aldosterone antagonist
 Loop diuretics if severe oedema
o Flu, COVID and pneumococcal vaccines

32
Q

Which CXR findings are consistent with CCF?

A

A - Alveolar oedema (bat wings)
B - Kerley B lines (interstitial oedema)
C - Cardiomegaly
D - Dilated upper lobe vessels
E - Effusion (pleural)

33
Q

What initial management can be started in DKA?

A

IV Fluids and 6 units/h Actrapid

34
Q

What is the most sensitive marker of hepatocellular damage?

A

ALT

35
Q

What fold increase in ALT suggests hepatocellular damage?

A

> 10

36
Q

What fold increase in ALP suggests cholestasis?

A

> 3

37
Q

Give causes of isolated hyperbilirubinaemia.

A

Gilbert’s syndrome/haemolysis

38
Q

ALT > AST suggests…

A

Chronic LD

39
Q

AST > ALT suggests…

A

Acute LD

40
Q

What is the first-line treatment for stable angina?

A

PRN short-acting nitrate + beta-blocker and/or dihydropyridine CCB (Nifedipine, Amlodipine or Felodipine)

41
Q

Give examples of antiemetics that could be prescribed

A

Cyclizine 50mg PO
Prochlorperazine buccal 3mg

Y5 OSCE (7 decks)

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