Night before flashcards

Question 1

What are the causes of a normal anion gap metabolic acidosis?

Answer 1

Causes of a normal anion gap or hyperchloraemic metabolic acidosis

gastrointestinal bicarbonate loss: diarrhoea, ureterosigmoidostomy, fistula
renal tubular acidosis
drugs: e.g. acetazolamide
ammonium chloride injection
Addison’s disease

Question 2

What are the causes of a raised anion gap metabolic acidosis?

Answer 2

Causes of a raised anion gap metabolic acidosis

lactate: shock, hypoxia
ketones: diabetic ketoacidosis, alcohol
urate: renal failure
acid poisoning: salicylates, methanol
5-oxoproline: chronic paracetamol use

Question 3

What are the important interactions of CYP3A4?

Answer 3

Substrates:
-Macrolides
-Antiretrovirals
-CCBs

Inhibitors
-Macrolides
-Protease inhibitors (including ritonavir)
-Imidazoles

Inducers
-Carbamazepine
-Phenytoin
-Phenobarbitone
-Rifampicin
-St John’s Wort

Question 4

What are the inducers of the P450 system?

Answer 4

Inducers of the P450 system include
-antiepileptics: phenytoin, carbamazepine
-barbiturates: phenobarbitone
-rifampicin
-St John’s Wort
-chronic alcohol intake
-griseofulvin
-smoking (affects CYP1A2, reason why smokers require more aminophylline)

Question 5

What are the inhibitors of the P450 system?

Answer 5

-antibiotics: ciprofloxacin, erythromycin
-isoniazid
-cimetidine,omeprazole
-amiodarone
-allopurinol
-imidazoles: ketoconazole, fluconazole
-SSRIs: fluoxetine, sertraline
-ritonavir
-sodium valproate
-acute alcohol intake
-quinupristin

Question 6

What is the treatment escalation for asthma?

Answer 6

SABA

SABA and low dose ICS
-Not controlled or newly diagnosed with symptoms >/= 3/ week or night time waking

SABA + low dose ICS + LRTA

SABA + low dose ICS + LABA
-Continue LRTA depending on response

Switch ICS/LABA for a maintenance and reliever therapy (MART), inc low dose ICS

Moderate dose ICS in MART

Question 7

What is the T staging for lung cancer?

Answer 7

T1 = Tumour >/=3cm
-T1a = </=1cm
T1b = 1-2
T1c = 2-3

T2 = 3-5 OR tumour of any size that
-Invades the visceral pleura
-Involves main bronchus, but not the carina
-Shows an atelectasis or obstructive pneumonitis that extends to the hilum

T3 = 5-7cm
-Pancoast that involves thoracic routes T1 and T2 only
-Tumour of any size that
–Invades the chest wall
–Invades the pericardium
–Invades the phrenic nerve
–Shows one or more satellite nodules in the same lobe

T4 = >7cm
-Pancoast that involves C8 or higher nerve roots, brachial plexus, subclavian vessels or spine
-Tumour of any size that
–Invades mediastinal fat or structures
–Invades the diaphragm
–Involves the carina
–Shows one or more satellite nodules in another lobe on the ipsilateral side