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BPT annoying facts > Miscellanous 1 > Flashcards

Miscellanous 1 Flashcards

1
Q

Inotropes versus vasopressors?

A

Inotropes = increases contractility rate
-Adrenaline and Dobutamine ( B -receptor)

Vasopressors = Vasoconstriction

  • Noradrenaline and Metaraminol ( A-receptor)
  • use for septic shock
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2
Q

What is Dopamine?

A

DA/ B receptor

-use for cardiorenal syndrome - but have tachyarrhythmias

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3
Q

Ventilation mode - PEEP causes what?

Why it causes that?

A

Cardiac MI
Barotrauma ( intrinsic peep)

Cardiac MI - increases stroke volume
Barotrauma - blocks exhalation - gas-trapping - increases FRC

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4
Q

In pregnancy - what must be given with anti-convulsants?

A

Folic acid

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5
Q

OGTT best performed when in pregnancy?

A

24 weeks ( end of 2nd trimester)

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6
Q

intrahepatic cholestasis in pregnancy - when and invx, treatment?

A

3rd trimester
Free bile acid increases
Ursodeoxycholic acid

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7
Q

Acute fatty liver of pregnancy - clinical features?

A

Severe RUQ pain - mitochondrial LCFA metabolism defect

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8
Q

Noradrenaline converted to adrenaline via?

A

phenyl-ethanolamine N methyl

-stimulated by stress/cortisol from amygdala

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9
Q

HELLP pathogenesis?

A

Fibrin deposits in hepatic sinusoids - hemorrhage + necrosis

=DIC

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10
Q

Best painkillers in palliation - TCA class?

SNRI - duloxetine has what side effects?

A

Amitryptyline

SNRI - cholinergic side effects

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11
Q

Spinal cord compression - veterbrae mets into which epidural space region first?

A

Thoracic!

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12
Q

Nausea receptors in which site of brain and the triggers + receptors involved?

A

Vestibular nuclei - Movement triggers it
ACH + H1

Cerebral cortex - Emotion/ICP/ hyponatremia triggers it
GABA + 5HT2

Postrema region - CTZone
5HT3 = chemotherapy/uremia - triggers it
D2 = morphine/uremia - triggers it

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13
Q

Treatment for nausea according to site and triggering factor?

A

Vestibular nuclei (movement) = Largactil, cyclizine, promethazine

Cerebral cortex - Benzodiazepines, Cyczline if raised ICP

CTZone
5HT3 - ondansetron
D2 - metoclopramide/Haloperidol

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14
Q

Nausea receptors in which site of gut and triggers + receptors involved

A 
Vagal and splanchnic receptors
5HT3 - ondansetron
D2 - Domperidone
5HT4 (prokinetic) - metoclopramide
Anti-inflammatory - dexamethasone
Anti-secretory - hyoscine/ glycopyronnium (anti-muscarinic)/ocreotide
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15
Q

Myotonia a/w what channels and exercises causes what?

Paramyotonia a/w what channels and exercises cause what?

A

Myotonia - Sodium chloride (NACI) channel
Exercise improve it

Paramyotonia - Sodium (NA) channel
Exercise worsens it

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16
Q

High intensity exercise causes what myopathy?

A

Glycogen storage - McCardle phosphorylase deficiency

17
Q

Moderate intensity exercise/ fasting causes what
myopathy?

histology of it?

A

Lipid storage - Carnitine palmitoyl transferase II deficiency

Type IIb atrophy - moth eaten fibres

18
Q

Highest affinity towards 5HT3 receptor - what drug?

A

Palonosetron (2nd generation)

19
Q

Cyanide intoxication/poisoning - antidote?

A

Hydroxocobalamin binds to cyanide to form cyanobalamin - excrete in urine

20
Q

Gastric emptying in critically ill patients - why and treament?

A

Impaired stomach and pylorus function

IV erythromycin and Metoclopramide - helps

21
Q

Which HAART drug is contraindicated in prgnancy?

A

Efavirenz

22
Q

CCR5 D32 mutation means what in HIV?

A

slower progression to aids

23
Q

Memory T cells express CD what?

A

CD45

24
Q

ARDS - what method improve oxygenation ONLY - not mortality?

A
  1. Nitric oxide therapy
  2. Muscle relaxant infusion for 48 hours
  3. Fluid conservative therapy due to aspiration/pneumonia/inhalation injury
25
Q

Commonest cause of shock in ICU?

Least common shock in ICU?

A

Distributive shock - sepsis/anaphylaxis

Least common - obstructive

26
Q

Intra-aortic balloon pump indications?

Low Output Bridge to ASMRec

A

Severe AS
Mechanical complications + cardiogenic shock ( severe MR, ventricular or papillary muscle rupture)
Low Cardiac output post CABG
Bridge to definitive treatment

27
Q

Types of necrotising fasciitis?

A

Type 1 = polymicrobial
Type 2 = Group A streptococcal
type 3 = Gas gangrene/clostridial myonecrosis

28
Q

Serial measure of CVP using CVC recommended in septic shock?

A

No role, just aim MAP > 65 mmHG

29
Q

Milrinone mechanism of action?

A

Phosphodiesterase III inhibitor - decrease cAMP ( prevents vasodilatation)

30
Q

Phenylepherine mechanism of action?

A

pure A1 agonist

31
Q

In VT due to hyperkalemia - give what?

Any role of calcium chloride in VF?

A

Calcium chloride because 3x more calcium and no need to be metabolised by liver

Calcium chloride - NO ROLE

BPT annoying facts (62 decks)

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