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Phase 3a > Last min > Flashcards

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
Q

What is given to prevent extra-pyramidal side effects of anti-psychotics?

A

Procyclidine

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26
Q

Benzodiazepine mechanism of action

A

facilitating the binding of the inhibitory neurotransmitter GABA

27
Q

Donepezil

A

binds to acetylcholinesterase and inhibits the hydrolysis of acetylcholine

28
Q

haloperidol

A

block postsynaptic dopamine (D2) receptors in the mesolimbic system of the brain

29
Q

Side effect of SSRIs

A

Hyponatremia

30
Q

Mirtazapine side effects

A

Weight gain and drowsiness

31
Q

MHA Section 2

A

28 days assessment and treatment

32
Q

MHA Section 3

A

6 months treatment

33
Q

MHA Section 4

A

72 hr emergency assessment

34
Q

MHA Section 5 (2)

A

72hrs

35
Q

MHA Section 5 (4)

A

Nurse 6hrs

36
Q

MHA section 135

A

House to place of safety

37
Q

MHA section 136

A

Public to place of safety

38
Q

Normal Pressure Hydrocephalus (NPH) triad

A

Urinary incontinence, dementia, gait disturbance

39
Q

Parkinson’s triad

A

Bradykinesia, pill rolling tremor, postural instability

40
Q

Serotonin syndrome triad

A

Neuromuscular abnormalities, Altered mental state, Autonomic dysfunction. Tachycardia, hypertension, agitation, flushed skin, Muscle rigidity, fever, tremor,

Tx - supportive to cyproheptadine

41
Q

Causes of delirium

A

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
Q

Alzheimer’s Dementia symptoms

A

neurofibrillary tau tangles, beta amyloid plaques. 4As: Amnesia, aphasia, agnosia, apraxia

43
Q

Lewy body dementia symptoms

A

fluctuating cognition, visual hallucinations, REM sleep disorder

44
Q

Fronto-temporal dementia

A

under 65s, behavioural disturbance ie gambling addiction, sexual addiction

45
Q

Vascular dementia

A

stepwise pattern of decline, associated with low mood and depression, focal changes

46
Q

Stress incontinence treatment

A

Pelvic floor exercise, surgical retropubic tape, Duloxetine (for those that refuse surgery)

47
Q

Urge incontinence treatment

A

Urodynamic studies, Bladder training, OXYBUTYNIN

Surgery GOLD STANDARD

48
Q

Causes of osteoporotic fracture?

A 
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
Q

Pressure ulcer classification

A

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
Q

Screening and investigation of malnutrition in the elderly

A

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
Q

ADHD treatment

A

Methylphenidate - first line

Lisdexamphetamine

52
Q

Lithium toxicity treatment

A

Stop lithium, Supportive monitor levels and renal func, IV fluids

53
Q

Neuroepileptic malignant syndrome

A

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
Q

Most common site for ectopic pregnancy

A

Ampulla

55
Q

Gestational diabetes fasting glucose

A

Fasting: < 5.6 mmol/l
At 2 hours: < 7.8 mmol/l

5-6-7-8

56
Q

Kawasaki symptoms

A 
CRASH and BURN 
C - conjunctivitis 
R - rash maculopapular 
A - adenopathy 
S - strawberry tongue 
H - hands (palmar erythema, swelling) 
BURN - fever > 5 days
57
Q

Risk factors for placental abruption

A

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
Q

Target sign

A

Intussusception

59
Q

whirlpool sign

A

ovarian torsion

60
Q

Snow storm sign

A

Multidiform

61
Q

TORCH infections

A

Toxoplasmosis, other (syphilis, paroviris, varicella zoster), rubella, CMV, herpes/hepatitis

62
Q

Drugs that induce psychosis

A

Metoclopramide, alcohol, cocaine, amphetamine, MDMA, cannabis, mephedrone, LSD, ketamine

63
Q

Emergency contraception

A

Levonelle - 72hrs
Ulipristal acetate (Ellaone) - 120hrs
Copper coil - 120hrs

Phase 3a (2 decks)

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