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Last min Flashcards

1
Q

Symptoms of depression

A 
DEAD SWAMP
D - depression (low mood) 
E - energy loss
A -Anhedonia
D - death thoughts
S - sleep disturbance
W - worthlessness 
A - appetite change/ weight loss
M - mentation decreased (decreased concentration)
P - psychomotor agitation or retardation
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2
Q

Pansystolic murmur

A

Ventral septal defect

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3
Q

Ejection systolic murmur

A

Harsh (cyanosis) - Tetralogy of fallot or atrial septal defect

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4
Q

Machinery murmur

A

Patent ductus arteriosus

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5
Q

Murmur between scapula

A

Coarctation of the aorta

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6
Q

Fluid management

A

0.9% NaCl solution + 5% glucose +/- KCL
1st 10kg - 100mls/kg/day
2nd 10kg - 50mls/kg/day
>20 kg - 20mls/kg/day

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7
Q

Neonatal fluid requirements

A

Day 1 - 60mls/kg/day
Day 2 - 90mls/kg/day
Day 3 - 120mls/kg/day
Day 4 - 150mls/kg/day

Na 3mmol/day
K 2mmol/day
Ca 1mmol/day

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8
Q

Fluid bolus

A

20mls/kg

Trauma or DKA - 10ml/kg

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9
Q

Fluid deficit

A

deficit% x 10 x weight (kg)= over 24 or 48hrs

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10
Q

When do you over ECV

A

At 36 weeks Nulliparous or 37 for multiparous

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11
Q

Risk factors for pre-eclampsia

A 
PMHx of pre-eclampsia
Nulliparous 
>35 BMI
Maternal age >40
Family history
pregnancy interval >10 years
Multi pregnancy 
High risk:
Chronic HTN
Pre-existing CKD
Autoimmune disease
Diabetes
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12
Q

Symptoms of pre-eclampsia

A 
HTN
Proteinuria
Papilloedema
Headaches
Visual disturbance 
epigastric pain 
Hyper-reflexia
oedema
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13
Q

Cessation of seizures in pregnancy

A

Magnesium sulphate

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14
Q

Side effects of Lithium

A

LITHIUM CON

L - Leukocytosis
I - Increased weight
T - Tremor (fine  coarse)
H - Hydration decreases (dry mouth)
I - Increased GI (N+V, diarrhoea/constipation, abdo pain)
U - Underactive thyroid (hypothyroidism)
M - Mum’s beware (teratogenic)
C - Cardiac
O - Oedema
N - Nephro/Neurotoxic
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15
Q

First rank symptoms of schizophrenia

A 
PHDT
Passivity phenomena
Hallucinations (3rd person auditory) 
Delusions
Thought alienation
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16
Q

Triggers of Lithium toxicity

A

MR BAD

M - Metronidazole
R - Renal failure
B - Bendroflumethiazide (diuretics)
A - ACE-i/ARB
D - Dehydration
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17
Q

Symptoms of mania

A

I DIG FASTER

I - Irritability
D - Distractibility
I - Inhibition loss
G - Grandiosity
F - Flight of ideas
A - Activity increased
S - Sleep not needed
T - Talkative
E - Elevated mood
R - Reduced concentration
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18
Q

Symptoms of alcohol withdrawal

A

6-12 hrs: tremor, sweating, tachycardia, anxiety, malaise, nausea, insomnia
peak incidence of seizures - 36 hrs

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19
Q

Delirium tremens symtoms

A

48-72hrs: coarse tremor, confusion, delusions, auditory and visual hallucinations, fever, tachycardia

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20
Q

Treatment of alcohol withdrawal

A

Benzodiazepines - Diazepam or chlordiazepoxide (lorazepam if hepatic failure)
Carbamazepine for seizures

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21
Q

Alcohol misuse relapse prevention

A

disulfiram - intolerance to ethanol
Acamprosate - Anti-craving medication
Naltrexone - relapse prevention (for opioids too)

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22
Q

Wernicke’s Encephalopathy

A

Ataxia, ophalmoplegia and confusion

Treat with benzo’s and IV Pabrinex (thiamine)

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23
Q

Korsakoff’s syndrome

A

Antero and retrograde amnesia, confabulation, loss of insight

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24
Q

Hallucination of tiny people

A

Lilliputian

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25
What is given to prevent extra-pyramidal side effects of anti-psychotics?
Procyclidine
26
Benzodiazepine mechanism of action
facilitating the binding of the inhibitory neurotransmitter GABA
27
Donepezil
binds to acetylcholinesterase and inhibits the hydrolysis of acetylcholine
28
haloperidol
block postsynaptic dopamine (D2) receptors in the mesolimbic system of the brain
29
Side effect of SSRIs
Hyponatremia
30
Mirtazapine side effects
Weight gain and drowsiness
31
MHA Section 2
28 days assessment and treatment
32
MHA Section 3
6 months treatment
33
MHA Section 4
72 hr emergency assessment
34
MHA Section 5 (2)
72hrs
35
MHA Section 5 (4)
Nurse 6hrs
36
MHA section 135
House to place of safety
37
MHA section 136
Public to place of safety
38
Normal Pressure Hydrocephalus (NPH) triad
Urinary incontinence, dementia, gait disturbance
39
Parkinson's triad
Bradykinesia, pill rolling tremor, postural instability
40
Serotonin syndrome triad
Neuromuscular abnormalities, Altered mental state, Autonomic dysfunction. Tachycardia, hypertension, agitation, flushed skin, Muscle rigidity, fever, tremor, Tx - supportive to cyproheptadine
41
Causes of delirium
PINCH ME P - Pain ie post-op I - Infection N- Nutrition C - Constipation- if giving codeine always give senna H - Hydration (hypovolaemic), hypoxia, hypercapnia - C C - co2 retainer M - Medication/ metabolic E - Environment- how would you help their environment? Put them by the window, give them a clock, allow visiting, have pictures by the bed, have a routine It is possible to have both hyper and hypo active delirium.
42
Alzheimer's Dementia symptoms
neurofibrillary tau tangles, beta amyloid plaques. 4As: Amnesia, aphasia, agnosia, apraxia
43
Lewy body dementia symptoms
fluctuating cognition, visual hallucinations, REM sleep disorder
44
Fronto-temporal dementia
under 65s, behavioural disturbance ie gambling addiction, sexual addiction
45
Vascular dementia
stepwise pattern of decline, associated with low mood and depression, focal changes
46
Stress incontinence treatment
Pelvic floor exercise, surgical retropubic tape, Duloxetine (for those that refuse surgery)
47
Urge incontinence treatment
Urodynamic studies, Bladder training, OXYBUTYNIN | Surgery GOLD STANDARD
48
Causes of osteoporotic fracture?
``` SHATTERED S - Steroid use H - Hyperthyroid A - Alcohol and tobacco use T - Thin T - Testosterone (LOW) E - Early menopause R - Renal or liver failure E - Erosive and inflammatory bone disease- Myeloma/RA D - Dietary- poor calcium absorption, T1DM ```
49
Pressure ulcer classification
Waterlow System Grade 1: intact skin with non-blanching redness over bony prominence Grade 2: partial loss of dermis with a shallow open ulcer Grade 3: full thickness tissue loss with slough present Grade 4: sore is full thickness involving muscle tendons or visible bone Deep tissue injury = purple localized area of discolouration over bony prominence Regular turns (4hr), air mattress, dressing, debridement
50
Screening and investigation of malnutrition in the elderly
MUST (malnutrition universal screening tool) FBC (anaemia) Folate, B12 TFTs Calcium, phosphate, zinc Vitamin levels Albumin & cholesterol levels (evidence of malnutrition in elderly) May have coexisting dehydration, anaemia, infection, hypoglycaemia
51
ADHD treatment
Methylphenidate - first line | Lisdexamphetamine
52
Lithium toxicity treatment
Stop lithium, Supportive monitor levels and renal func, IV fluids
53
Neuroepileptic malignant syndrome
Tremor, muscle cramps, fever, autonomic instability, delirium Raised CK can progress to rhabdomyolysis Slower onset. Idiosyncratic (increased risk in dementia with lewy body) Treated with DA agonists (Bromocriptine)
54
Most common site for ectopic pregnancy
Ampulla
55
Gestational diabetes fasting glucose
Fasting: < 5.6 mmol/l At 2 hours: < 7.8 mmol/l 5-6-7-8
56
Kawasaki symptoms
``` CRASH and BURN C - conjunctivitis R - rash maculopapular A - adenopathy S - strawberry tongue H - hands (palmar erythema, swelling) BURN - fever > 5 days ```
57
Risk factors for placental abruption
ABRUPTION: A - Abruption previously; B - Blood pressure (i.e. hypertension or pre-eclampsia); R - Ruptured membranes, either premature or prolonged; U - Uterine injury (i.e. trauma to the abdomen); P - Polyhydramnios; T - Twins or multiple gestation; I - Infection in the uterus, especially chorioamnionitis; O - Older age (i.e. aged over 35 years old); N - Narcotic use (i.e. cocaine and amphetamines, as well as smoking)
58
Target sign
Intussusception
59
whirlpool sign
ovarian torsion
60
Snow storm sign
Multidiform
61
TORCH infections
Toxoplasmosis, other (syphilis, paroviris, varicella zoster), rubella, CMV, herpes/hepatitis
62
Drugs that induce psychosis
Metoclopramide, alcohol, cocaine, amphetamine, MDMA, cannabis, mephedrone, LSD, ketamine
63
Emergency contraception
Levonelle - 72hrs Ulipristal acetate (Ellaone) - 120hrs Copper coil - 120hrs

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