Misc Flashcards
most common ECG finding in PE
sinus tachycardia
3 drugs that increase affect of owarfarin
allopurinol
amiodarone
asthma
3 drugs that decrease effect of warwarrin
carbamazepine
oestrogen
progesterone
how does alcohol effect INR
chronic use decreases INR
binge causes acute liver dysfunction -> impaired warfarin metabolism -> increased INR
when do you have to start dmards in rheumatoid
ASAP!!!!!! within 3 month
medical treatment of prostate ca and MOA
gnrh analogues. modify release of LH (remember that they paradoxically decrease testosterone even tho they are analogues)
LH antagonists
peripheral androgen receptor antagonists
what symtpoms does uraemia cause
anorexia
n&v
pruritus
drowsiness, confusion, fits, coma
v v v important DDx of renal stones
AAA!!!!!!!!!
prevention of renal stones
hydration
low na diet
normal dairy intake
what to look for if DVT with no risk factors
any cancer
main causes of fever, weight loss, night sweats
lymphoma
tb
sarcoidosis
disease to think of with proximal muscle wasting
cushing’s
o2 aims in child
if ≤92%, give o2 up to 94
if on O2 at 97%, wean down
94-97% is a grey area
signs of increased work of breathing (5)
tachypnoeia sub + intercostal recession abdo breathing tracheal tug head bobbing (v worrying)
which do you treat out of umbilical and inguinal hernias and why
inguinal bc tendency to obstruct
causes of recurrent mouth ulcers
crohn’s
coeliac
b12, fe def
bad luck!
what is amitriptyline used for? (5)
abdo pain (if not responded to laxatives, loperamide or antispasmodics)
- major depressive disorder (TCA)
- neuropathic pain
- migraine prophylaxis
- tension headach prophylaxis
side effects of amitryptiline (3)
anticholinergic syndrome
drowsiness
QT interval prolongation
what class does mirtazapine belong to
NaSSA (noradrenergic and specific serotonergic antidepressant) - but dr jenny jack didn’t know this!!
why do you do an ECG if dx of HTN? what is shown on the ECG?
look for LVH -> sign of end organ damage
V2 and V6 complexes are massive
what is doxazocin used for and what is it’s MOA
HTN
BPH
(alpha 1 antagonist)
presentation of chickenpox
pyrexia then
CROPS (rather than widespread), mostly on head, neck and trunk
four risk factors for gall bladder disease
fair, fat, female, forty
investigations for angina
myoview
ECG
angiogram
exercise test
asbestosis lung change
pleural plaques, can develop to mesothelioma
when is melatonin used
> 55, persistent insomnia. max 13 weeks.
what to do if someone has insomnia
don’t drive if sleepy in day (no need to inform DVLA)
-good sleep hygine
-short course of benzo or z-drug ONLY if severe daytime impairment. max 4 weeks
CBD if persist after 2 weeks
strep and staph, gram positive cocci in what?
strep is chains
staph is clusters
why worry about mets in a long bone
fractures
short term SEs with steroids
proximal myopathy, insulin resistance (raised BMs), SLIGHT immunosuppression
what to give for fungal dermatitis
imidazole e.g. clotrimazole, miconazole, or econazole cream
hydrocort 1% if inflammation
what fungal skin infections are there?
Skin ringworm (tinea corporis) Fungal Scalp Infection (Scalp Ringworm) Athlete's Foot (Tinea Pedis) Fungal Groin Infection (Tinea Cruris) Fungal Nail Infections (Tinea Unguium).
describe fungal lesions
single/multiple red or pink, flat or slightly raised ringed patches
active red scaly advancing edge, clear central area
itchy
when to give antivirals in shingles
within 72 hours for any of: over 50 yo non-truncal involvement severe pain/rash opthalmic invovment immunocompromised
difference between cocodamol and codydramol
cocodamol = para + codeine
codidramol = paracetamol and dihydrocodeine
codeine analgesia types? 3
codeine phosphate
cocodamol
codydromol
3 things that save lives in hospital
abx, fluids, o2
what to initially worry about with flashers and floaters
retinal detachment!
when to give antiviral (valaciclovir) for genital herpes
within 72 h from onset
why do NSAIDs cause AKI
stop formation of prostaglandins (prostaglandins dilate renal afferent arteriole)
normal urine output
400-600ml per day
0.5ml/kg/hr over 6 hrs
define oliguria
<400ml per day
<0.5ml/kg/hr over 6 hrs
classification system for advanced gastric cancer
borrmann (also use tnm)
classification system for colon cancer
duke or tnm
3 different scoring systems for pancreatitis
Glasgow Prognostic Score
Ranson’s Criteria
Acute Physiology and Chronic Health Evaluation II (APACHE II) Score
what is torsailles de point
type of ventricular tachycardia
occurs in pts with long qt syndrome
rapid, irregular QRS complexes, which appear to be twisting around the ECG baseline
life threatening
cauda equina - upper or lower MN signs?
both!!!
who should you always be careful of NSAIDs in??
GORD
asthmatics!!!!!!!!!!!!!!!!!!!!!
when will a nurse escalate a NEWS score to a doctor
> =5
1 parameter = 3
when does aortic stenosis syncope occur
on exertion
what arrhythmias can cause syncope
sick sinus syndrome SVT VT long QT syndrome Brugada drug induced (malfunctioning pacemaker or ICD)
which abx can’t you have alc with
metranidazole (it is v similar to antabuse!!) so makes you really sick
never forget which side effect of beta blockers
impotence
when prescribing mirtazepine, what should you warn pts
if they get any form of acute infection (e.g. sore throat) NEED to have FBC as can cause neutropenia
what are the damn drugs (drugs that can cause AKI)
diuretics
ACEi/ARBs
metformin
NSAIDs
top 10 drugs that cause AEs that result in hospitalisation
NSAIDs incl aspirin diuretics warfarin ace and arb antidepressants incl lithium beta blockers opiates digoxin pred clopidogrel
