Management of Chronic disease

Question 1

What is INR?

Answer 1

Measure of how likely blood is to clot, High number is likely to bleed more

Question 2

What does INR stand for/

Answer 2

International normalised ratio

Question 3

What is important to tell patient about Warfarin dose?

Answer 3

Should take same time every day

Question 4

What can increase INR?

Answer 4

Too much warfarin, Aspirin, NSAIDs antibiotics omeprasol, liver failure, bleeding disorders decreased vitamin K intake, Alcohol, Smoking

Question 5

What are symptoms of high INR?

Answer 5

Headache, stomach ache, bruising, bleeding, blood in urine, bloody or dark stool increased mentrual bleeding

Question 6

What advice should you give for high INR?

Answer 6

Cheack INR more regularly, Take medication properly, Limit alcohol, Dont smoke keep Vit K levels similar as possible

Question 7

What to ask about to find out why INR is going wrong?

Answer 7

Have they been ill recently, new medications, any symptoms of high or low INR missing doses taking it at same time every day, any changes to diet ask abot foods rich in Vit K,

Question 8

What are symtoms of low INR?

Answer 8

Stroke MI symptoms sudden weakness numbnes tingling vision changes Speech disturbance New pain Sweling New SOB chest pain

Question 9

What is advice for low INR?

Answer 9

Have INR measured more regularly, take Warfarin regularly keep Vit K same

Question 10

What can decrease INR?

Answer 10

Vit K supplements/ Increase VitK intake Oestrogen (HRT the pill)

Question 11

What is high HbA1c?

Answer 11

more than 42 mmol/L

Question 12

What is pre diabetes HbA1c?

Answer 12

42-47mmol/L

Question 13

What is diabetes HbA1c?

Answer 13

48mm/L and above

Question 14

What does HbA1c show?

Answer 14

Glucose control over 2-3 months

Question 15

What should you ask a diabetic patient/

Answer 15

How long have they had it how well are they managing it, do they know what HbA1c is and what problems with beinghigh are

Question 16

What are main diabetic complications?

Answer 16

Diabetic retinopathy (visual problems), Diabetic neuropathy (numbness or tingling in glove and stockings distribution), MI/Stroke risk, diabetic nephropathy (kidney issues), diabetic foot related issues, Impotence

Question 17

What to ask in diabetic check up?

Answer 17

How are feeling, recent illsnesses, polydipsia weight loss polyuria visual changes, tinging numbness impotence, ask how control is, ask about medications or insulin, are they checkin it are they rotting injection sites, exercise smoking alcohol, mood/sleep been

Question 18

What are symptoms of asthma to ask about?

Answer 18

Wheeze cough breathlessness chest tightness. Diurnal variation worse at night often, ask if wakes up in night,

Question 19

What to ask abot generally in asthma history?

Answer 19

What meds so far, correct usage of med and technique, impact of condition, severity of asthma including hospital admissions, triggers

Question 20

What are triggers for asthms>

Answer 20

time of day, Pets, Travel, Housing damp, working environment, hay fever smoking including passive

Question 21

What can cause Raised CRP?

Answer 21

Infections, MI/VTE, trauma Burns chronic inflammatory diseases IBD certain cancers

Question 22

What can cause raised ESR?

Answer 22

Malignant Lymphoma, carcinomas of colon and breast, Heaotological diseases anaeamic of chronic disease, multiple myeloma, SLE RA PMR GCA TB acute hepatatis

Question 23

What to ask about with LFT problems/

Answer 23

Liver symptoms ascities, Itch, Yellowing, fever, Urine stool colour RUQ pain, Liver gall bladder disease, obesity, Foreign travel, Tattos, Unprotected sex, Alcohol, IVDU/ Illicit substance use, Diet