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CC2 > Memorise For OSCE > Flashcards

Memorise For OSCE Flashcards

1
Q

Diabetes and pre diabetes HbA1c?

A

Diabetes: > 48 mmol/L
Prediabetes: 42-47 mmol/L

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2
Q

What is QRISK2?

A

Risk if developing MI/stroke in next 10 years

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3
Q

Factors for QRISK2?

A

14 things
Age, males, ethnicity, smoking, diabetes, angina/MI in 1st degree relative <60, CKD 4 or 5, AF, BP treatment, RA, cholesterol/HDL, BP, BMI, UK postcode

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4
Q

When would someone be offered a statin who has not had CHD or a stroke?

A

If QRISK more than 10%

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5
Q

What lifestyle factors are important for heart health?

A
  • healthy diet
  • physical activity
  • stopping smoking
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6
Q

What is the flow rate and percentage oxygen of nasal cannulae?

A

0.5-4L

24-36% O2

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7
Q

Considerations for nasal cannulae?

A
  • Positive: speak, eat, drink, good claustrophobic/agitated/confused
  • Negative: drying nasal mucosa/bleeding especially at higher flow rate, avoid oil creams
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8
Q

What is the flow rate & % oxygen for a Hudson mask/simple face mask?

A

30-40%

5-10L

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9
Q

What are considerations for simple face masks?

A
  • Consider humidification for long term therapy
  • latex allergies for all masks!
  • Avoid over tightening of straps
  • Do not allow tight control of FiO2
  • Risk of aspiration if patient vomits
    Straps under ears!
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10
Q

What % and flow rate of oxygen for non rebreathe mask?

A

70% and 10-15L

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11
Q

When and how is a non-rebreathe mask used?

A

Emergency therapy

Occlude valve to inflate reservoir bag before fitting on patient

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12
Q

What % and flow rate do the Venturi masks range?

A

2-15L/min

24-60%

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13
Q

What are the benefits and negatives of Venturi masks?

A
  • Can change flow rate without altering %
  • More accurate for long-standing lung disease
  • Can be noisy
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14
Q

What does the tracheostomy mask and elephant tubing need?

A

Must be humidified and can be noisy

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15
Q

Chest X-ray steps?

A
  • This is an erect chest X-ray!
  • Patient ID, date, time, previous imaging
  • RIPE: rotation, inspiration (5-6 ribs), projection, exposure (left hemidiaphragm visible to spine and vertebrae behind heart)
  • Airway: trachea deviation, can see carina & bronchi?, hilar size and symmetry?, mediastinal shift
  • Breathing: compare 3 zones - shadows and lung markings
  • Cardiac: size and heart borders
  • Diaphragm: air, costophrenic angles
  • E: mediastinal contours (aortic knuckle & aortopulmonary window), bones, soft tissue, tubes, valves, pacemaker
  • Review: lung apices, retro cardiac, behind diaphragm, peripheral lung, hilar
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16
Q

Causes of glucosurea?

A
  • diabetes mellitus
  • renal tubular disease
  • SGLT2 inhibitors
17
Q

What causes conjugated bilirubin in urine?

A

Increased serum levels

- post-hepatic: gallstones, head of pancreas cancer, cholangiocarcinoma, strictures

18
Q

What cause ketourea?

A

Increased fatty acid metabolism in starvation and DKA

19
Q

What is SG in urine analysis? What is normal range and what causes low and high?

A

Specific gravity

  • normal is between 1.02-1.035mOsm/kg
  • low: production of dilute urine = diabetes insipidus and acute tubular necrosis
  • high: dehydration, glycosuria (DM), proteinuria (nephrotic syndrome)
20
Q

What is normal pH of urine? What can cause it to change?

A

4.5-8
Low pH: starvation, DKA, metabolic acidosis (sepsis)
High pH: metabolic alkalosis (vomiting), medications (diuretics)

21
Q

What is the blood strip in urinalysis testing for specifically? What does positive indicate?

A

Red blood cells, haemoglobin, myoglobin

UTI, renal stones, injury to renal tract, rhabdomyolysis, nephritic syndrome, malignant or urinary tract

22
Q

What could cause proteinuria?

A

Nephrotic syndrome and CKD

23
Q

What could the presence of nitrites in urine suggest?

A

E. Coli (+ other gram negative) breakdown product = UTI

24
Q

What is the normal range of urobilinogen? What could high and low levels indicate?

A

Breakdown product of bilirubin (intestine)

  • 0.2-1.0 mg/dL
  • increased: haemolysis (haemolytic anaemia, malaria)
  • decreased: biliary obstruction
25
Q

What is leukocyte esterase?

A

Enzyme produced by neutrophils and indicates presence of white cells in urine
Positive: UTI, haematuria (renal stones, injury to tract, rhabdomyolysis, nephritic syndrome, malignancy of urinary tract)

26
Q

What does presence of leukocytes and nitrites in urine suggest? What further tests?

A

UTI

Microscopy and culture

27
Q

What does presence of glucose in urine suggest? What further tests?

A

DM - blood glucose and HbA1C

28
Q

Prediabetes blood glucose and HbA1C range?

A

5.5-6.9 mmol/L fasting
7.8-11.0 mmol/L 2 hour post prandial
HbA1C: 42-47mmol/mol (6-6.4%)

29
Q

Diabetes blood glucose and HbA1C?

A

11.1 mmol/L or more random
7.0 mmol/L fasting
11.1 mmol/L 2 hour post prandial
HbA1C: 48 mmol/mol (6-6.4%)

30
Q

What is glucosurea, ketourea and low urinary pH indicative of? What further tests?

A

DKA
Urgent admission, serum blood glucose, VBG
Treat: insulin, glucose and potassium infusion

31
Q

What is raised specific gravity and proteinuria indicative of? What further tests?

A

Nephrotic syndrome

UEs, microscopy and culture (rule out UTI)

32
Q

Further investigations for haematuria on urinalysis?

A 
Microscopy & culture - UTI 
FBC 
UEs - glomerulonephritis 
CT KUB - renal calculi 
Cystoscopy - bladder malignancy
33
Q

What is the normal reference range for sodium?

A

133-146 mmol/L

34
Q

What is the normal reference range for potassium?

A

3.5-5.3 mmol/L

35
Q

Reference ranges for haemoglobin?

A

Male: 130-180g/L
Female: 115-165g/L

36
Q

White cell count normal range?

A

3.6-11.0 x10^9

37
Q

Platelet normal reference ranges?

A

140-400 x10^9

CC2 (7 decks)

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