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Explanation > MSRA > Flashcards

MSRA Flashcards

1
Q

What are the pre-op requirements for fasting?

A

6hrs pre-op = non-clear fluids and food

2hrs = clear fluid

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2
Q

What are the peri-op requirements for metformin?

A

Day before = take as normal

Day of = if OD/BD take as normal, if TDS omit lunchtime

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3
Q

What are the peri-op requirements for sulfonylureas?

A

Day before = take as normal

Day of = if OD omit, if BD & am op omit am dose, if BD and pm op omit both

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4
Q

What are the peri-op requirements for gliptins?

A

Take as normal

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5
Q

What are the peri-op requirements for GLP-1 (gliptides)?

A

Take as normal

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6
Q

What are the peri-op requirements for SLGT-2 inhibitors?

A

Day before = take as normal

Day of = omit

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7
Q

What are the peri-op requirements for insulin?

A

OD (levemir, lantus) = reduce by 20% day before & of

BD (novomix, humulin) = day before take as normal, day of 1/2 morning dose, normal evening

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8
Q

Post-bronchodilator FEV1/FVC <70% + FEV1 >80% predicted

A

Stage 1 COPD = mild

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9
Q

Post-bronchodilator FEV1/FVC <70% + FEV1 50-79% predicted

A

Stage 2 COPD = moderate

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10
Q

Post-bronchodilator FEV1/FVC <70% + FEV1 30-49% predicted

A

Stage 3 COPD = severe

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11
Q

Post-bronchodilator FEV1/FVC <70% + FEV1 <30% predicted

A

Stage 4 COPD = very severe

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12
Q

Most common type of oesophageal cancer, location, and risk factors

A

Adenocarcinoma
Location = lower 1/3
Risk factors = GORD, Barrett’s, smoking, achalasia, obesity

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13
Q

Types of sickle cell crises

A

Thrombotic = painful, initiated by dehydration/infection/deoxy

Sequestration = splenomegaly, anaemia, inc reticulocyte

Acute chest = infarct of lung parenchyma, dyspnoea, chest pain

Aplastic = parvovirus infection, sudden drop in Hb, bone marrow suppression

Haemolytic = rare, fall in Hb due to haemolysis

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14
Q

Side effects of methotrexate

A

Myelosuppression
Liver cirrhosis
Pneumonitis

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15
Q

Side effects of sulfasalazine

A

Rashes
Oligospermia
Heinz body anaemia
ILD

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16
Q

Side effects of leflunomide

A

Liver impairment
ILD
HTN

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17
Q

Side effects of hydroxychloroquine

A

Retinopathy

Corneal deposits

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18
Q

Side effects of prednisolone

A 
Cushingoid
Osteoporosis
Impaired glucose tolerance
HTN
Cataracts
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19
Q

Diagnosis of impaired glucose tolerance (IGT)

A

IGT = fasting plasma gluc <7.0 and OGTT 2hr >=7.8 but <11.1

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20
Q

Fasting glucose <6?

A

Normal

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21
Q

Fasting glucose between 6 and 7?

A

Impaired fasting glucose

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22
Q

Fasting glucose >7

A

Diabetes

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23
Q

HbA1c diagnostic for diabetes

A

> 48mmol/L

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24
Q

Normal HbA1c

25
When should COCP be stopped before major elective surgery?
Stop 4wks prior | Can be restarted when mobilising
26
Medications for Heart Failure
1) ACEi & B-block (1st line) 2) Aldosterone antagonist - e.g. spironolactone (monitor K+ with ACEi) 3) Specialist-initiated
27
Timing and components of antenatal booking visit
8-12wks - general info, BP, urine, BMI - bloods -> iron, antibodies
28
Timing and components of antenatal early scan
10-13+6 wks - confirm dates - excl multiple
29
Timing of antenatal Down's screening
11 - 13+6
30
Timing of antenatal anomaly scan
18 - 20+6
31
Timing of anti-D prophylaxis
1st - 28wks | 2nd - 34wks
32
Features and management of herpes simplex keratitis
Red, painful eye Photophobia Dec visual acuity Epithelial ulcer on fluorescein Treat = refer to ophthal, topical aciclovir
33
Outline COPD management
1) SABA or SAMA PRN 2) If asthmatic features -> SABA or SAMA PRN, add LABA + ICS regular No asthmatic features -> SABA PRN, add LABA + LAMA regular 3) SABA PRN, LABA + LAMA + ICS regular
34
Contraindications to HRT
Current/past breast Ca Any oestrogen-sensitive Ca Undiagnosed vaginal bleeding Untreated endometrial hyperplasia
35
3rd trimester, itchy, no rash, raised bilirubin
Intrahepatic cholestasis of pregnancy
36
Features and management of intrahepatic cholestasis of pregnancy
Features - pruritis, no rash, raised bilirubin | Management - ursodeoxycholic acid, weekly LFT, induce at 37wks
37
3rd trimester, abdo pain, N+v, headache, jaundice
Acute fatty liver of pregnancy
38
Features and management of acute fatty liver of pregnancy
Features - abdo pain, n+v, headache, jaundice, hypoglycaemia | Management - delivery
39
3rd trimester, malaise, headaches, vomiting, HTN, raised liver enzymes
HELLP H - haemolysis EL - elevated liver enzymes LP - low platelets
40
Features and management of idiopathic thrombocytopenic purpura
Features - may be incidental, or may have petechae/purpura, bleeding Management - prednisolone
41
Hx autoimmune disorders, raised LFTs, SNT abdo, fatigue, pruiritis. Diagnosis and management
``` Primary biliary cholangitis Treatment: 1st line ursodeoxycholic acid - slows progression. For pruritis - cholestyramine If bilirubin >100 -> transplant ```
42
Pt advice for metronidazole
Avoid alcohol - disulfiram-like reaction | Inc effect of warfarin
43
Calculation of morphine dose for breakthrough pain
1/6th of total daily morphine e.g. 90mg BD Breakthrough = 90x2/6 = 30mg oral morphine
44
Features of acoustic neuroma
Dependent on nerve involved. CN8 - vertigo, unilat sensorineural HL, tinnitus CN5 - absent corneal reflex CN7 - facial palsy
45
Lacunar stroke features
Purely motor Purely sensory Mixed
46
Type of stroke: purely numbness
Lacunar
47
Management of T2DM
First-line is metformin. (If high-risk/established CVD - metformin + SGLT-2 inhib) Second-line -> add DPP-4i, pioglitazone, SU, SGLT-2i Third-line -> Add third drug OR start insulin If HbA1c >58 then move to next line
48
Management of MS
Acute relapse - pred (5d) DMARD - natalizumab Fatigue - amantadine Spasticity - baclofen and gabapentin
49
Palpable purpuric rash + abdo pain + arthritis + haematuria
Henoch-Schonlein purpura
50
Cause of Henoch-Schonlein purpura
IgA mediated small vessel vasculitis
51
Features of Henoch-Schonlein purpura
Palpable purpuric rash over buttocks and extensor surfaces of arms and legs Abdo pain Polyarthritis May have features of IgA nephropathy (haematuria)
52
Management of HTN in <55yo (or T2DM)
1) A 2) A+C or A+D 3) A+C+D 4) If K+ <4.5, +spirololactone. If K+ >4.5 +alpha/beta block ``` A = ACEi or ARB C = CCB D = thiazide-like diuretic ```
53
Management of HTN in >55yo or African-Caribbean descent
1) C 2) C+A or C+D 3) A+C+D 4) If K+ <4.5, +spirololactone. If K+ >4.5 +alpha/beta block ``` A = ACEi or ARB C = CCB D = thiazide-like diuretic ```
54
Organism in ieCOPD
Haemophilus influenzae
55
Diabetes drug contraindicated in heart failure
Pioglitazone (thiazolidinediones)
56
Converting oral to sc morphine
Total daily oral morphine / 2 -> sc syringe driver
57
Diarrhoea in HIV+ patient
Cryptosporidium
58
2nd line angina management
If not controlled with B-block, add CCB (nifedipine)

Explanation (1 decks)

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