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MBBS IV > Management > Flashcards

Management Flashcards

1
Q

ACS DDx

A 
AMI
Angina
Pericarditis
Myocarditis
GORD
PUD
COPD
Aortic Dissection
Pneumothorax
PE
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2
Q

ACS Ix

A

Bloods - FBC, UEC, LFT, Troponin, VBG
CXR
ECG (consider stress test)

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3
Q

ACS Mx

A 
Morphine IV 5mg
Oxygen if <94%
GTN 500mcg x2 every 5 mins for up to 20 mins
Aspirin 300mg
2 x IV access
Involve senior staff early
Telemetry
CVD risk assessment
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4
Q

AMI Ix

A

Bloods - FBC, UEC, LFT, Troponin, VBG
CXR
CT angio if considering invasive Mx
ECG

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5
Q

AMI Mx

A

As per ACS plus
PCI - clopidogrel 600mg (managed by cardio)
Fibrinolytic - clopidogrel 300mg

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6
Q

CHF DDx

A 
Renal disease
Liver disease
Sepsis
Meds
Venous Insufficiency
PE
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7
Q

CHF Ix

A 
FBC
UEC
LFT
BNP
ABG
INR
TFT
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8
Q

CHF Mx

A

Treat underlying cause
Refer to cardiologist
If HFrEF - ACEI, B blocker, loop (in acute fluid overload), spironolactone (in most), add digoxin if not well Mx

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9
Q

Systolic heart murmur causes

A

aortic stenosis
pulmonary stenosis
mitral regurg
tricuspid regurg

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10
Q

Diastolic heart murmur causes

A

aortic regurg
mitral stenosis
tricuspid regurg

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11
Q

HTN Mx

A

SNAP
1st line - ACEI, ARB, thiazide diuretic, VS-CCB
2nd line - CS-CCB, b blocker, a1 antagonist
3rd line - a2 agonist

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12
Q

IE Ix

A

Bloods - FBC, UEC, LFT, CRP, Blood culture
TOE
CXR
ECG

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13
Q

IE Mx

A

Benpen
Fluclox
Gent

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14
Q

Pneumonia Ix

A

Bloods - FBC, UEC, ABG + culture (if unwell)
CXR
ECG
Sputum culture

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15
Q

CAP Mx

A

Mild: amoxicillin
Moderate: benpen
Severe: ceftriaxone + azithromycin

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16
Q

PE Ix

A 
Bloods - ABG, FBC, UEC, Coags, LFT, D-Dimer
CXR
V/Q or CTA chest
Venous compression US
ECG
b-hCG
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17
Q

PE Mx

A

3/12 of anticoagulants

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18
Q

VE prophylaxis

A

Mechanical - TEDS, SCUDS

Pharm - enoxaparin 40mg subcut daily

19
Q

Asthma (adult) Mx

A 
As needed SABA
\+ low dose ICS
\+ low dose combination (ICS/LABA)
\+ high dose combination (ICS/LABA)
\+ add on specialist treatment
20
Q

COPD Ix

A 
Bloods - FBC, UEC, LFT, ABG
CXR
CT chest if indicated
ECG
Spirometry
21
Q

COPD Mx

A 
SMOKING CESSATION
Lifestyle intervention
All: SABA/SAMA
\+ LAMA/LABA
\+ ICS
\+ theophylline
22
Q

Lung cancer Ix

A

Bloods - FBC, UEC, LFT, consider tumour markers
CT chest/CXR
Biopsy
Spirometry if indicated

23
Q

TB Ix

A 
FBC
QF gold
CXR
Sputum MCS + AFB
Biopsy
24
Q

TB Mx

A 
Contact tracing
6-12 months treatment
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
25
Q

OSA Mx

A

CPAP
Lifestyle intervention - weight reduction
CVD risk assessment
Surgical correction of airway abnormality

26
Q

T2DM Ix

A

Bloods - FBC, UEC, Fasting BSL, HbA1c

27
Q

T2DM Mx

A 
Lifestyle intervention (SNAP)
Metformin
Sulfonylureas
SGLT2 inhibitors
GLP-1 agonist
DPP4 inhibitors
Insulin
CVD risk assessment
Yearly podiatry, optometry, UEC, fasting lipids
3 monthly HbA1c
28
Q

Cushings Ix

A 
FBC, UEC
Cortisol - morning, 24hr urine
CT adrenal
Dex suppression test
ACTH
29
Q

Cushings Mx

A

treat underlying cause, generally with surgery

may require steroid replacement after surgery

30
Q

Conns Ix

A

UEC
Serum aldosterone to renin ratio
CT adrenal
ECG

31
Q

Conns Mx

A

treat underlying cause

spironolactone until definitive management

32
Q

Define Conn’s, Addison’s and Cushing’s

A

Conn’s - hyperaldosteronism
Addison’s - adrenal insufficiency (hypoaldosteronism and hypocortisol)
Cushings - excess cortisol

33
Q

Addisons Ddx

A 
Renal dysfunction
Anorexia Nervosa
Pituitary or hypothalamic lesion
Haemochromatosis
Peutz-Jegher syndrome
Hyperthyroidism
34
Q

Addisons Ix

A 
FBC
UEC
Iron studies
CT adrenal
ACTH challenge
35
Q

Addison’s Mx

A

steroid replacement therapy (hydrocortisone)
sick days - 3 days of double dosing
if sick >3 days –> GP or ED

36
Q

Hyperthyroidism Ix

A 
Bloods - FBC, UEC, LFT
TSH &amp; T3/T4
TRAb (Graves)
Tc scan if Abs negative
ECG
FNA (biopsy)
37
Q

Hyperthyroidism Mx

A

treat underlying cause
surgical removal
Radioablation
thyroid suppression therapy - carbimazole

38
Q

Hypothyroidism Ix

A

FBC
UEC
TSH & T3/T4
TPO Ab

39
Q

Hypothyroidism Mx

A

thyroid replacement therapy - levothyroxine

treat underlying cause if present

40
Q

PUD Ix

A 
FBC
UEC
Urea breath test
Stool antigen test
Gastroscopy
Biopsy
41
Q

H. pylori Mx

A

triple therapy for 7 days
esomeprazole
amoxicillin
clarithromycin

42
Q

Biliary colic Ix

A 
FBC
UEC
LFT
CRP
USS gallbladder/ducts
MRCP/ERCP
43
Q

Biliary colic Mx

A

Conservative
ERCP
Cholecystectomy

MBBS IV (2 decks)

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