Module 1 COTE Notes Flashcards

1
Q

ALP raised in isolation?

A

Vitamin D deficiency

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2
Q

Side effect of doxycycline

A

Stomach irritation

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3
Q

anticholinergic burden

A

Drugs affecting nicotinic and muscarinic receptors and result in cognitive decline, hallucinations, speech issues, vision issues, memory issues, confusion (brain fog), irritability (and other delirium associated symptoms, poor co-ordination, dementia, dry mouth, anhydrosis, pupil dilation, increased heart rate etc

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4
Q

Hypokalaemia ECG

A

U-wave and T-wave inversion

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5
Q

Hyperkalaemia

A

Tented T-wave

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6
Q

Side effect of promorphine

A

leg swelling

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7
Q

Verification of death

A
Any doctor can do, signed by consultant
Pupil reflex - in both eyes
Stethoscope - heart and lungs for 1 min
Pulse for 1 min
Speak to patient as normal throughout
Push on chest - pain stimulus
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8
Q

Diastolic heart failure ejection fraction is…

A

Preserved

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9
Q

HFpEF - Heart failure with preserved ejection fraction

A

Approx half of HF patients, abnormal diastolic function, increased risk of AF and PHTN
Similar presentation to those with HFrEF

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10
Q

Charles Bonnet syndrome

A

Hallucinations and pseaudo-hallucinations due to poor vision function, for instance seeing shadows as being people etc

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11
Q

Opiate overdose signs

A

Pinpoint pupils
Decreased resp rate
Limpness
Pale/Clammy

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12
Q

Withdrawal of treatment law

A

Seen the same as with holding treatment in the first place

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13
Q

Basic care which must always be offered

A

Oral food and fluid
Other forms of food/fluid are not basic care and thus can be withdrawn if considered to be in the best interest of the patient

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14
Q

Mental Capacity Act

A

assume a person has the capacity to make a decision themselves, unless it’s proved otherwise

wherever possible, help people to make their own decisions

don’t treat a person as lacking the capacity to make a decision just because they make an unwise decision

if you make a decision for someone who doesn’t have capacity, it must be in their best interests

treatment and care provided to someone who lacks capacity should be the least restrictive of their basic rights and freedoms

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15
Q

Capacity

A

understand the information relevant to the decision

retain that information

use or weigh up that information as part of the process of making the decision

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16
Q

DOLS Acid Test

A

Is the person subject to continuous supervision and control? and
Is the person free to leave?

17
Q

How long does DOLS last

A

Up to 12 months

18
Q

Malnutrition screening tool

A

MUST - Malnutrition Universal Screening Tool

19
Q

Gold standard for checking NG position

A

Gold standard is to check pH aspirate to confirm position (aim <5.5)

Second line is Xray

30 day use

20
Q

NJ tube check

A

X ray not pH - 60 day use

21
Q

Treating refeeding syndrome

A

IV thiamine, Vitamin B complex for first 10 days prior to feeding, low calorie intake

Daily monitoring of Refeeding bloods including U&Es/PO4/Mg and correct as necessary until stable

22
Q

What are the geriatric giants?

A

The 4 I’s:

Instability (falls)

Immobility

Intellectual impairment (confusion)

Incontinence

23
Q
What class of drug is normally combined with
L-dopa therapy to prevent peripheral side-effects?
A

Carbidopa – a dopa-decarboxylase inhibitor

24
Q

complications of L-dopa therapy?

A

Development of choreiform movements (L-dopa induced dyskinesia)

Become tolerant to the medication – even if the dose is increased the
effect will become less

Confusion

Hallucinations

Postural hypotension on starting treatment

25
What ABCD2 score is considered “high risk” | for a stroke and what should be done?
≥ 4 = high risk Aspirin – 300mg daily – started immediately Specialist referral within 24 hours of onset of symptoms Secondary prevention measures (statins, antihypertensives) ``` Crescendo TIAs (two or more episodes in a week) should be treated as high risk, regardless of ABCD2 score ```
26
What should be done for someone with an | ABCD2 score of ≤ 3?
Specialist referral within 1 week of symptom onset, including decision or brain imaging If vascular territory or pathology is uncertain – refer for brain imaging
27
Alzheimer’s
Agnosia, Apraxia, Amnesia, Aphasia
28
Vascular dementia
stepwise progression of symptoms following | ischaemic brain injury
29
Lewy body dementia
sleep behaviour disorder, falls, impaired | consciousness, visual hallucinations, Parkinsonism
30
Frontotemporal dementia–
memory fairly preserved, extreme | personality changes and disinhibition
31
to treat Alzheimer’s
Acetylcholinesterase inhibitor Donepezil NMDA-receptor antagonist – blocks glutamate (memantine)
32
List 3 adverse effects of bisphosphonates?
Oesophagitis Osteonecrosis of the jaw Increased risk of atypical stress fractures of the proximal femoral shaft in patients taking alendronate
33
How are DEXA scan scores interpreted?
- 1 to +1 = healthy - 1 to -2.5 = osteopenia ≤ -2.5 = osteoporosis ≤ 2.5 and a current fragility fracture = severe osteoporosis
34
FRAX scoring | system?
Parent hip fracture Height and weight (BMI) Smoking Alcohol >3 units a day Steroids Previous hip fracture Femoral neck bone mineral density Female gender Age RA Secondary osteoporosis
35
How is malnutrition diagnosed?
BMI < 18.5 kg/m2 Unintentional weight loss >10% in the last 3-6 months BMI < 20kg/m2 plus unintentional weight loss >5% within the last 3-6months
36
postural | hypotension?
of >20/10 mmHg within 3 minutes of standing