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Y3 Clinical Case Revision > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

indications for nutritional support

A

BMI < 18.5 kg/m^2
unintentional weight loss of > 10% in 3-6 months
BMI of < 20 kg/m^2 + unintentional weight loss of greater than 5% in 3-6 months

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2
Q

refeeding syndrome definition

A

potentially fatal shifts in electrolytes following feeding in malnourished individuals (^ protein intake than before)

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3
Q

refeeding syndrome predispositions

A 
low energy diet
obese + sudden, profound weight loss
stress
malabsoptive syndrome (IBD / pancreatitis)
anorexia
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4
Q

how can refeeding syndrome be prevented?

A

prophylactic vitamin B + thiamine

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5
Q

complications of blood transfusions

A

clotting abnormalities
electrolyte abnormalities
acute haemolytic reaction
transfusion associated circulatory overload
transfusion related acute lung injury (acute respiratory distress syndrome)

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6
Q

what are respiratory and physiological post-operative complications

A 
DVT / PE
pressure ulcers
XS fluid production (mediastinal surgeries) > acute respiratory distress syndrome 
inflammation
infection 
compartment syndrome
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7
Q

vitamin B12 anaemia picture

A

microcytic anaemia

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8
Q

erythromycin effect on other drugs

A

potent hepatic enzyme inhibitor > drug toxicity

eg. digoxin, phenytoin, lithium, warfarin and theophylline

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9
Q

warfarin route of administration

A

oral

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10
Q

warfarin moa

A

vitamin K antagonist

acts on extrinsic clotting pathway

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11
Q

warfarin effect on renal function

A

no effect

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12
Q

warfarin indications

A

DVT / PE treatment
stroke prevention in AF
prevention of recurrent TIA / stroke
VTE prevention post prosthetic heart valve

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13
Q

assessment of pancreatic function

A

clinical judgement

faecal elastase

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14
Q

raised faecal calprotein

A

gastrointestinal inflammation

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15
Q

perforations causing retroperitoneal free air

A

3rd part of duodenum
ascending colon
descending colon

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16
Q

sepsis definition

A

life threatening organ dysfunction caused by abnormal and uncontrolled host response to an infection

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17
Q

septic shock definition

A

sepsis with hypotension despite aggressive fluid resuscitation

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18
Q

first line antibiotic in MRSA infection

A

vacomycin

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19
Q

first line antibiotic in ? sepsis

A

meropenem

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20
Q

first line antibiotic in acute bacterial prostatitis

A

ciprofloxacin

penetrates prostate well

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21
Q

causes of post operative fever

A 
wind 
water
wound 
walking 
wonder drugs
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22
Q

first line antibiotics for large anastomotic leak

A

meropenem

tazocin

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23
Q

first line antibiotic for staph aureus wound infection post operatively

A

flucloxacillin PO 500mg QDS for 5 days

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24
Q

red flags of back pain

A 
TUNAA FISH 
trauma
unexplained weight loss
neurological sx
age > 50 
fever
intravenous drug use
steroid use
hx of ca
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25
first line antibiotic for osteomyelitis
IV flucloxacillin
26
complications of osteomyelitis
sepsis recurrent infection chronic osteomyelitis growth disturbances in children
27
first line antibiotics in patient with septic arthiritis
flucloxacillin IV
28
first line antibiotics in patient with septic arthritis and first line contraindication
ie. penicillin allergy | = clindamycin
29
urinary tract tubercolosis presentation
``` travel history flank pain dysuria polyuria haematuria X renal calculi on XR KUB X pregnancy ```
30
risk factors of Forier's gangrene
``` = necrotising fasciitis of scrotum and perineal area DM alcohol XS poor nutrition steroid use malignancies trauma ```
31
most common organism in lactational mastitis
staphylococcus aureus
32
RFs of pilonidal sinus
sedentary poor hygeine obesity male
33
haemophilia A inheritance pattern
X linked recessive
34
haemophilia A diagnosis
Factor VIII assay
35
haemophilia A management
minor bleeds - desmopressin | major bleeds - recombinant factor VIII
36
haemophilia B inheritance pattern
X lined recessive
37
haemophilia B diagnosis
factor IX assay
38
reversal agent for DOAC (dabigatran)
idarucizumab
39
reversal agent for warfarin
vitamin K
40
reversal agent for heparin
protamine sulfate
41
most diagnostic test for ACL injury
Lachman's
42
ASA score of pt with uncontrolled HTN
ASA 4
43
BMI of pt with ASA score of 4
> 40
44
management of intracapsular #: independent / poorly mobilising
``` independent = total hip replacement immobile = hemiarthroplasty ```
45
nephropathic ulcer presentation
``` history of DM punched out appearache poor healing granulated base painless ```
46
venous ulcer management
ABPI (<0.8 not indicated for multilayer compression bandaging) Multilayer compression bandaging
47
Ductal papilloma presentation
UL blood stained discharge | = harmless growth behind nipple, malignant potential (tx: surgical excision)
48
duct ectasia presentation
green brown discharge access with puss discharging red swollen warm = due to duct dilation
49
menopausal breast manifestation
BL clear-white nipple discharge | due to hormonal changes
50
breast access presentation
temperature unwell red swollen sore breast
51
galactocele presentation
UL milky creamy discharge | = due to a clogged duct
52
most likely hernia in women
fermoral
53
first line investigation for biliary pathology
transabdominal USS | CT = gold standard but not first line
54
venous ulcer presentation
``` gaiter region localised swelling erythema shallow irregular borders ```
55
arterial ulcer presentation
``` small lesion well defined border necrotic base located at pressure area RFs = smokers, HTN, DM ```
56
RFs for varicose veins
prolonged standing obestiy Fx pregnancy
57
TCC haematuria
painless (without secondary infections)
58
malaria diagnosis
THREE blood films (before it can be excluded)
59
Drug induced lupus causes
``` CHIMP Carbamazepine / chlorpromazine Hydralazine Inflizimab / isoniazid Minocycline / Minoxidil Penicillamine / Procainamide / Pyrazinamide ```
60
RCC biopsy findings
clear cells (+hx of mass on L kidney)
61
immune suppression suitable in pregnancy
azathioprine hydroxychloroquine steroids
62
testing found on individuals with hepatitis vaccine
Anti HBs
63
testing found on individuals with previous hepatitis infection
Anti-HBc | Anti-HBs
64
testing found on individuals with acute hepatitis
HBsAg Anti-HBs IgM Anti-HBc
65
testing found on individual with chronic hepatitis
HBsAg | IgG Anti-HBc
66
COPD step up management
SABA / SAMA | + LABA + ICS + LAMA
67
C diff antibiotic
ORAL vancomycin QDS 125mg for 10 days
68
how many classes of NYHA
4
69
macroprolacinoma presentations
``` M > F visual field defect (enlarged pituitary gland pressing on optic chasm) decreased libido brest enlargement milky discharge from nipples ```
70
microprolacinoma presentation
F > M F: menstural disturbances, galactorrhea, infertility M: v libido, gynaecomastia, milky nipple discharge, hypogonadism
71
otitis externa most likely organism
pseudomonas aerginosa staphylococcus aureus FUNGAL = over treatment of topical Abx
72
otitis medial most likely organism
streptococcus pneumonia moraxella catarrhalis haemophillus influenzae
73
most common heart defect
VSD
74
most common heart defect associated with Down's syndrome
AVSD
75
first line contraceptive used for heavy periods
IUS
76
core sx of depression
severe low mood lack of enjoyment in any activities for the last 4 weeks lack of energy
77
criteria for referral to specialist assessment for a pt with HTN
Clinic HTN 180/120 and higher with signs of retinal haemorrhage / papilloedema OR life threatening sx (new onset confusion, chest pain, HF signs, AKI) same day specialist assessment
78
What should guide decisions regarding contraceptive prescribing
Fraser guidelines | Gillick competence
79
HbA1c target in diabetic patients
Standard: 48 mmol/mol On 1 medication that is associated with hypOglycaemia: 53 mmol/mol Nb. add second drug if it rises to 58 mmol/mol
80
Acute Gout management
NSAIDS (contraindicated in PUD) | colchicine
81
management of meningitis in primary care
IM benzylpenicillin
82
what drug commonly causes ankle oedema
amlodipine (CCB)
83
Shingles management
Sx < 3 days: aciclovir | Sx >3 days: amitriptyline
84
paracetamol overdose management
ingestion <1 hr ago AND dose > 150 mg/kg = PO charcoal OR N-acetylcysteine
85
how does a paracetamol overdose affect the liver
paracetamol undergoes hepatic sulfaten and glucuronidatoin > non-toxic metabolites being excreted in the urine > ALF ^^^ paracetamol > saturation of pathways > ^ NAPQI formation (hepatotoxic - > mitochondrial injury / hepatocyte death) v liver stores of GSH (glutathione - normally prevent ROS damage by combining with NAPQI and is renally excreted)
86
most likely organism in quinsy
strep pyogenes
87
drugs to stop pre surgery
``` CHOW clopidogrel 7 days before hypoglycaemic agents - insulins night before, metformin day of OCP 4 weeks before Warfarin 5 days before ```
88
drugs to alter pre surgery
SC insulin - to VRII | LT steroids - switch to IV hydrocortisone
89
drugs to start pre surgery
``` fluids if NBM prophylactic Abx (if breast, prosthetics ie. ortho, GI, vasc) VTE prophylaxis (TEDs, LMWH) ```
90
management of malignant hyperthermia
dantrolene | reaction to induction of anaesthetic agent

Y3 Clinical Case Revision (17 decks)

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