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AKT > Medicine > Flashcards

Medicine Flashcards

1
Q

What is the 2nd line medication to treat IBS after antispasmodics/loperamide?

A

TCAs e.g. AMT for analgesic effect

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1
Q

When to do stool microscopy for diarrhoea (child)?

A

after 7 days

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2
Q

What eGFR to use metformin
a) with caution
b) STOP altogether

A

a) 45
b)30 - STOP

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3
Q

For GAD - how long to continue medication (SSRI) for?
For Panic disorder - how long?

A

12 months once established - due to risk of relapse
6 months

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4
Q

what is buproprion used for? how does it help? contraindications?

A

for smoking cessation
reduce craving
not in eating disorders, bipolar, pregnancy, hx of seizures

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5
Q

what is disulfiram used for?how does it help? contraindications?

A

promotes abstinence from alcohol - makes you feel like shit if you drink alcohol (cause severe rxn)
inhibit acetyldehyde dehydrogenase
not in cardiac failure, coronary artery disease, history of cerebrovascular accident (CVA), hypertension, psychosis and suicide risk.

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6
Q

what is acamprosate used for? how does it help? contraindications?

A

reduces craving, a weak antagonist of NMDA receptors
not in renal iimpairment, severe hepatic impairment

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7
Q

Features of suspected malignancy in a lump?

A

malignancy in a lump include
size more than 5 cm
increasing in size and deep to the fascia
pain

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8
Q

What are the 1st and 2nd line medications for GAD?

A
  1. SSRI
  2. Venlafaxine (SNRI) or pregabalin
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9
Q

What are the 1st and 2nd line medications for panic disorder?

A
  1. SSRI
  2. TCA
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10
Q

how to treat h pylori

A

PPI + amox + clari or metronidazole
if pen allergic
PPI + clari + metronidazole

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11
Q

in management of angina, what medication should not be prescribed together with a BB?

A

verapamil - risk of complete heart block
Also don’t Rx verapamil in HF

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12
Q

Mx of angina: first 4 steps
What other preventative meds to add?

A

BB or CCP based on person/comorbidities
then monotherapy up to maximum dose
add the other med
add other meds e.g. long acting nitrate etc.
then consider Pci/cabg

add statin & aspirin for preventative

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13
Q

Mx of heart failure (HFREF)

A

ACEi+BB
Aldosterone antagonist e.g. spironolactone/eplerenone
+?SGLT2i
3rd line: initiated by specialist

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14
Q

features of WPW syndrome on ECG?

A

Wave - Delta wave
PR - short
Wide - QRS
(narrow complex tachy)

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15
Q

Where might you expect ST changes for a posterior MI? and what sort of ST changes?

A

anterolateral leads (V1-3)
ST depression

16
Q

what BP med is contraindicated in mod-severe aortic stenosis?

A

ACEi

17
Q

for management of a pt w HTN and diabetes, which meds should not be used in combination? why?

A

Thiazide & BB
The routine use of beta-blockers in uncomplicated hypertension should be avoided, particularly when given in combination with thiazides, as they may cause insulin resistance, impair insulin secretion and alter the autonomic response to hypoglycaemia.

18
Q

Poorly controlled HTN - already taking max dose ACEi and CCB. Next step? (step 3 in HTN algorithm)

A

Add thiazide-like diuretic e.g. indapamide.

19
Q

What to Rx to treat gut oedema for pt with HF?

A

bumetanide - better bioavail than furosemide

20
Q

Post splenectomy, what prophylactic abx to use?

A

Pen V 1st line for at least 2 yrs

21
Q

What does the anaemic picture look like for pt with haemoglobinopathy?

A

anaemia is normocytic with a low or normal ferritin level

22
Q

Important adverse effect of taking carbimazole?

A

agranulocytosis - fever, sore throat, mouth ulcers

23
Q

what cancers are likely to spread to bone?

A

breast, thyroid, bowel, kidney, prostate and myeloma

24
Q

A 68-year-old man is treated for a proven urinary tract infection. He has an enlarged prostate on examination.

According to the National Institute for Health and Care Excellence (NICE) guidelines, which is the MINIMUM wait, if any, before his prostate-specific antigen (PSA) should be measured?

A

6 weeks

25
Q

A 61-year-old patient presents with dysuria, urinary urgency and frequency with perineal pain radiating to the rectum and tip of the penis. Urine dipstick test is positive for nitrites and leucocytes.

A

acute bacterial prostatitis

26
Q

BP control in CKD: ACR<30 - what antihypertensive to Rx?
if ACR>30?

A

follow normal HTN guidelines
if ACR>30, ACEi/ARB first

27
Q

What is the target Hba1c for T1DM patients?

A

48

28
Q

Parameters for impaired glucose tolerance - fasting & 2hr?

A

6.1-7
7.8-11.1

29
Q

Urine ACR result to diagnose microalbumiuria?

A

> 3

30
Q

What value is fasting glucose for a diagnosis of prediabetes?

A

6.1-6.9

31
Q
A

AKT (7 decks)

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