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year 5 flashcards HY > paeds/psych/cancer/opic/stroke/specialsenses > Flashcards

paeds/psych/cancer/opic/stroke/specialsenses Flashcards

1
Q

1st line ix for stroke

A

non contrast ct head to rule out bleed

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2
Q

What scale can be used to predict disability following stroke/ TIA?

A

The Barthel index is a scale that measures disability or dependence in activities of daily living in stroke patients

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3
Q

causes of peripheral neuropathy

A

alcohol
b12 deficiency
ckd
cancer
diabetes
vasculitis

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4
Q

what does ct head for sah show

A

hyperattenuation in the subarachnoid space
blood appears w hite; this will be m ixed in w ith the CSF. This will lie w ithin the interhem ispheric fissure, basal
cisterns and ventricles

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5
Q

what will LP show for SAH

A

increased rbc
xanthochromia- yellow colour caused by bilirubin

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6
Q

what is kernigs sign

A

when you bend the hip and knee to 90 degrees , pain on extending the knee
caused by meningeal irritation

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7
Q

what is the pterion

A

frontal
sphenoid
temporal
parietal

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8
Q

subdural haemorrhage cause & ct scan

A

high impact trauma
bridging vein
CT imaging is the first-line investigation and will show a crescentic collection, not limited by suture lines. They will appear hyperdense (bright) in comparison to the brain. Large acute subdural haematomas will push on the brain (‘mass effect’) and cause midline shift or herniation/ compression of the ventricles

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9
Q

extradural haemorrhage cause

A

middle meningeal artery
young person with trauma
lucid interval
bi convex shape on ct, limited by suture lines
rapidly declines
fracture of temporal bone

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10
Q

rf for strok

A

htn
smoker
alcohol
diabetes
hyperlipidaemia
heart disease (e.g. atrial fibrillation, valvular), peripheral
vascular disease, previous TLA, polycythaemia rubra vera, carotid
artery disease, hyperlipidaemia, clotting disorders, combined
oral contraceptive pill, excess alcohol.

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11
Q

give some metabolic causes of seizure

A
  • hypoG
  • hypoNa
  • uraemia
  • hypoCa
  • anoxia
  • water intoxication
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12
Q

what is epilepsy

A

T ran sien t occurrence o f in term itten t, abnorm al electrical activity
o f p art o f the brain. T h is tends to be stereotyped and often
m anifests itself as seizures.

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13
Q

epilepsy different types + mx

A

Absence- girls, age 3-10, stress/ hyperventilation
Ethosuximide/ sodium valproate
AVOID carbamazepine- exacerbates absence seizure

Generalised tonic clonic
1st line Sodium valproate
2nd line lamotrigine or carbamazepine

Focal
1st line Carbamazepine/ lamotrigine
2nd line levetiracetam, sodium valproate, oxcarbazepine

Myoclonic
1st line sodium valproate
2nd line clonazepam, lamotrigine

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14
Q

The cranial nerves II, III, IV and VI are involved in vision and
movement of the eye. What are the six routinely performed tests
clinically to assess these cranial nerves?

A

Visual acuity, visual fields, fundoscopy, pupillary light response
(direct and indirect), pupillary accommodation, eye movements.

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15
Q

Brown-Sequard syndrome

A
  • caused by lateral hemisection of the spinal cord
  • ipsilateral weakness below lesion
  • ipsilateral loss of proprioception and vibration sensation (dorsal column- posteriorly in spinal cord, decussates at medulla)
  • contralateral loss of pain and temperature sensation (spinothalamic tract- anterior spinal cord)
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16
Q

carpal tunnel ix

A

nerve conduction studies
electromyography
mri wrist
uss

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17
Q

Give two complications associated with long-term levodopa
treatment?

A

On-off fluctuations, dyskinesias, weaning off phenomenon

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18
Q

give 2 clinical features other than headache that can be due to raised icp

A

Vomiting, papilloedema, seizures, focal neurology, decreased
conscious level.

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19
Q

Give two examples of space-occupying lesions which may be
causing the raised intracranial pressure

A

Neoplasm, haematoma, abscess, granuloma, aneurysm

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20
Q

cushings triad in raised icp

A

widening pulse pressure
bradycardia
irregular breathing

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21
Q

idiopathic intracranial htn mx

A

weight loss
diuretics e.g. acetazolamide
topiramate is also used, and has the added benefit of causing weight loss in most patients
repeated lumbar puncture may be used as a temporary measure but is not suitable for longer-term management
surgery: optic nerve sheath decompression and fenestration may be needed to prevent damage to the optic nerve. A lumboperitoneal or ventriculoperitoneal shunt may also be performed to reduce intracranial pressure

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22
Q

why fbc in epistaxis

A

low plts- can be cause of epistaxis
low hb- anaemia due to bleed

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23
Q

other blood tests for epistaxis

A

INR as she is on warfarin, LFTs as deranged liver function may
lead to insufficient synthesis of clotting factors, group and save in
case transfusion is necessary

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24
Q

ddx for sore throat in child

A

tonsillitis
scarlet fever
infectious mononucleosis
agranulocytosis
malignancy
diphtheria

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25
Q

tonsillitis- why is penicillin V given as opposed
to am oxicillin?

A

Am oxicillin will cause a maculopapular rash if the cause of the
symptoms is infectious mononucleosis instead o f acute tonsillitis.

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26
Q

recurrent laryngeal nerve- which cranial nerve is it a branch of, which side is RLN palsy commoner on and why, give 2 causes of RLN palsy and symptoms of vocal cord palsy other than hoarseness

A
  • vagus nerve
  • left- longer than right
  • thyroid surgery, thyroid malignancy, idiopathic
  • hoarseness, low voice volume, voice fatigue, SoB, cough
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27
Q

How can you discriminate an upper motor neurone lesion from a
lower motor neurone lesion affecting the face?

A

umn- forehead sparing- suspect stroke
lmn- doesnt spare forehead- less urgetn

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28
Q

mx & long term consequences of bells palsy

A
  • lmn palsy- forehead not spared
  • within 72hrs presentation- give pred 5-10 days 50-60mg
  • Damage to the eye - consequence of reduced lacrimation and inability to close eye; altered taste; psychological impact.
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29
Q

Describe the pathogenesis of BPPV

A

T h e re is displacement of an otolith or otoconia within the
semicircular canals. The heavier otolith causes abnormal
movement of the endolymph within the canal, giving the
sensation of vertigo.

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30
Q

causes for vertigo besides bppv

A

Meniere’s disease, vestibular neuronitis, acoustic neuroma,
multiple sclerosis, cholesteatoma, trauma, drugs (gentamicin,
diuretics, metronidazole, among others).
also posterior circulation stroke

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31
Q

difference between childrens ET to adults

A

Shorter, narrower and more horizontal - poor drainage, more
likely to suffer middle ear infections.

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32
Q

name 2 portions of eardrum

A

pars flaccida
pars tensa (main middle bit)

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33
Q

otitis media eardrum otoscopy findings

A

Bulging eardrum, reddening or dull appearance, prominent blood
vessels, (+/- perforation).

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34
Q

describe eczema rash

A

. Erythematous, scaly, excoriations, lichenification, crust and
weeping if infected.
typically symmetrical flexural distribution

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35
Q

eczema herpaticum

A

Eczema herpeticum describes a severe primary infection of the skin by herpes simplex virus 1 or 2.

It is more commonly seen in children with atopic eczema and often presents as a rapidly progressing painful rash.

On examination, monomorphic punched-out erosions (circular, depressed, ulcerated lesions) usually 1–3 mm in diameter are typically seen.

As it is potentially life-threatening children should be admitted for IV aciclovir.

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36
Q

classical signs of psoriasis

A

well demarcated, red, scaly

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37
Q

plaque psoriasis- where to examine

A

extensor surfaces, sacrum and scalp
nails

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38
Q

complications psoriasis

A

psoriatic arthropathy (around 10%)
increased incidence of metabolic syndrome
increased incidence of cardiovascular disease
increased incidence of venous thromboembolism
psychological distress

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39
Q

types of malignant melanoma

A

Superficial spreading
Nodular
Lentigo maligna
Acral lentiginous

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40
Q

RF MM

A

sun exposure
fair skin
fhx
sunburn
lentigo maligna

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41
Q

malignant melanoma prognosis

A

breslow thickness
thickness of the lesion correlates mortality

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42
Q

characteristic appearance BCC

A

many types of BCC are described. The most common type is nodular BCC, which is described here
sun-exposed sites, especially the head and neck account for the majority of lesions
initially a pearly, flesh-coloured papule with telangiectasia
may later ulcerate leaving a central ‘crater’

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42
Q

characteristic appearance BCC

A

many types of BCC are described. The most common type is nodular BCC, which is described here
sun-exposed sites, especially the head and neck account for the majority of lesions
initially a pearly, flesh-coloured papule with telangiectasia
may later ulcerate leaving a central ‘crater’

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43
Q

bcc mx

A

Mohs micrographic surgery.
surgical removal
curettage
cryotherapy
topical cream: imiquimod, fluorouracil
radiotherapy

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44
Q

actinic keratoses

A

small, crusty or scaly, lesions
may be pink, red, brown or the same colour as the skin
multiple lesioms may be present
premalignant
sun exposure
fluororacil
topical diclofenac if mild AKs

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45
Q

pathophys acne

A

Increased production of sebum. Pilosebaceous follicles become
blocked and infected.

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46
Q

s/e oral isotretinoin

A

dry skin, dry lips, dry eyes
depression
muscle aches
migraine
teratogenic- need effective contraception

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47
Q

scc of skin- worse prognosis site? risk factors?

A

ear and lip
sun exposure, age, renal transplant & immunosuppression

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48
Q

bowens disease

A

precursor for scc
may sometimes be diagnosed and managed in primary care if clear diagnosis or repeat episode
topical 5-fluorouracil
typically used twice daily for 4 weeks
often results in significant inflammation/erythema. Topical steroids are often given to control this
cryotherapy
excision

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49
Q

what virus causes shingles

A

herpes simplex virus 3

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50
Q

what is the characteristic appearance of shingles

A

vesicles
crusting
erythematous
swollen plaques
dermatome
NEVER crosses midline !

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51
Q

commonest chronic complication of shingles

A

post herpetic neuralgia
most commonly resolves with 6 months but may last longer

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52
Q

RF for developing pressure sores

A

stroke
Elderly, cardiovascular disease, obesity, poor nutrition, immobility,
smoking, neurologically impaired, faecal incontinence, urinary
incontinence

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53
Q

what are the 4 grades of pressure sore

A
  1. erythema nonblanchable, skin intact
  2. partial thickness skin loss
  3. full thickness skin loss
  4. full thickness tissue loss, exposed bone
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54
Q

what to address in mx of pressure ulcer

A

Nutrition, antibiotics if infected, regular dressings, need for
debridement, pain relief, patient positioning, tissue viability
referral, pressure relieving mattress/chair.

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55
Q

lichen sclerosus clinical features, mx

A

itch, pain during sex, dysuria, constipation
mx- topical steroids and emollients

56
Q

coeliac disease skin association

A

dermatitis herpatiformis

57
Q

Dermatofibroma

A

Dermatofibromas (also known as histiocytomas) are common benign fibrous skin lesions. They are caused by the abnormal growth of dermal dendritic histiocyte cells, often following a precipitating injury. Common areas include the arms and legs.

Features
solitary firm papule or nodule, typically on a limb
typically around 5-10mm in size
overlying skin dimples on pinching the lesion

58
Q

fungal nail infection mx

A

if due to dermatophyte
amorolfine 5% nail lacquer
fingernail- 6 months
toenails- 9-12 months

if more extensive dermatophyte infection
oral terbinafine
fingernail- 6wks-3months
toenail- 6 months

if due to candida
oral itraconazole

59
Q

impetigo- cause & mx

A
  • cause- staph aureus, strep pyogenes
  • mx- not systemic disease: topical hydrogen peroxide cream 1%
  • otherwise- topical abx = topical fusidic acid
  • or oral abx- fluclox, alt eryth if allergic
  • 48hrs school exclusion after starting abx
60
Q

stuck on appearance mole in elderly…

A

Seborrhoeic keratoses
large variation in colour from flesh to light-brown to black
have a ‘stuck-on’ appearance
keratotic plugs may be seen on the surface

reassurance about the benign nature of the lesion is an option
options for removal include curettage, cryosurgery and shave biopsy

61
Q

shin lesions ddx

A

erythema - strep infection, IBD, sarcoid
pretibial myxoedema- graves
pyoderma gangrenosum- idiopathic, IBD
necrobiosis lipoidica diabeticorum

62
Q

breast cancer screening programme

A

50-70 mammogram evry 3 yrs
can have it after but make ur own app

63
Q

who gets hormonal therapy in breast cancer and side effects

A

oestrogen receptor positive tumours
pre/peri menopause- tamoxifen- risk of VTE, endo cancer, menopausal sx
post menopause- letronozole or anastrozole (aromatase inhibitor)

64
Q

RF cerebral palsy

A

antenatal factors:
* preterm birth (with risk increasing with decreasing gestational age)[1],[2]
* chorioamnionitis
* maternal respiratory tract or genito-urinary infection treated in hospital

perinatal factors:
* low birth weight
* chorioamnionitis
* neonatal encephalopathy
* neonatal sepsis (particularly with a birth weight below 1.5 kg)
* maternal respiratory tract or genito-urinary infection treated in hospital

postnatal factors:
* meningitis.

65
Q

other than neuro what examination for cerebral palsy do you want to do & why

A
  • MSK - contractures
  • Eyes – strabismus and visual problems
  • Ears – deafness
  • Developmental examination
  • GI – GORD (epigastric tenderness)
  • Resp – recurrent pneumonias
66
Q

what hormone is structurally similar to bhcg

A

LH

67
Q

why is pth high in chronic renal failure

A

low absorption of calcium from gut and kidneys and bones
leads to hypocalcaemia
leads to PTH secretion
= secondary hyperPTH (high PTH, low or normal Ca)
over time, the pth gland will increase (hyperplasia) in size- tertiary hyperPTH (high pth, high Ca)

68
Q

what is NIHSS

A

National Institute of health Stroke Scale
It objectively quantifies impairment caused by stroke
Measure things like LOC, horizontal eye movement, visual field defect, faacial palsy, motor arm, motor leg

69
Q

why do sca pts not exhibit sx until 6/12 of age

A

high levels of fetabl haemoglobin HbF masks the effect of the disease until 6 months when HbF declines

70
Q

rouleaux formation…

A

A ‘rouleaux formation’ is a stacking of red blood cells seen in a blood film. It is characteristic of a myeloma.

71
Q

most common malignancy associated with acanthosis nigricans

A

gastrointestinal adenocarcinaoma

72
Q

schneiders first rank sx

A
  1. delusional perception
  2. third person auditory hallucination
  3. thought disorder (withdrawal/ insertion/ broadcast)
  4. passivity phenomenon
73
Q

core sx depression

A

low mood
low energy
low interest = anhedonia

74
Q

OTHER SX OF DEPRESSION

A

cognitive- lack of concentration, negative thoughts, excessive guilt, suicidal ideation
biological- low libido, early morning awakening, diurnal variation in mood, poor appetite/weight loss, psychomotor retardation
psychotic- 2nd person auditory hallucinations, delusions (hypochondriacal/guilt/nihilistic/persecutory)

75
Q

how to avoid antidepressant discontinuation syndrome

A

switch to fluoxetine, then wean off fluoxetine
or reduce daily dose gradually

76
Q

list some rf for schizophrenia

A

fhx biggest one- twins/sibling/parent
childhood abuse
low socioeconomic status
substance misuse
cannabis
adverse life events
migrants
neurochemical- increased dopamine, reduced glutamate, serotonin, gaba

77
Q

negative sx of schizophrenia

A

avolition (reduced motivation)
asocial behaviour
anhedonia
alogia (poverty of speech)
affect blunted
attention deficit- lack of conc.

78
Q

organic differentials for anxiety

A

hyperthyroidism
anaemia
phaeochromocytoma
hypoglycaemia
caffeine/ alcohol consumption
withdrawl from drugs

79
Q

organic differentials for anxiety

A

hyperthyroidism
anaemia
phaeochromocytoma
hypoglycaemia
caffeine/ alcohol consumption
withdrawl from drugs

80
Q

difference between ptsd and adjusment disorder

A

adjustment disorder-non catastrophic event, sx within 1 month of the event
ptsd- extremlely traumatic event, sx must occur within 6months of the event

81
Q

how is dx of postural hypotension made

A

Postural hypotension may be defined as a fall of systolic blood pressure > 20 mmHg on standing.
or diastolic > 10
or systolic >30 in pts with htn
within 3 mins of standing

82
Q

what are some causes of postural hypotension

A

antihypertensives
hypovolaemia, dehydration
autonomic dysfunction- diabetes, parkinsons
alcohol

83
Q

pharmacological and non-pharmacological mx of postural hypotension

A

F ull-length compression hosiery, education on recognising
symptoms and taking action, high-salt diet, bed tilt

Fludrocortisone, midodrine.

84
Q

factors predisposing falls in elderly

A

Arthritis, reduced cognition, polypharmacy, reduced visual input,
reduced muscle strength, reduced proprioception, increased
reaction time.
postural hypotension

85
Q

how do penicillins work

A

cell wall synthesis inhibition

86
Q

how do bacteria develop penicillin resistant

A

beta lactamase production
breaks down beta lactam ring

87
Q

why are penicillins given in combo with other drugs eg co amociclav

A

the additional drugs are beta lactamase inhibitors
reduces resistance

88
Q

common reversible causes of dementia

A

b12 deificency
thiamine deficiency
normal pressure hydrocephalus
hypoglycaemia
hypothyroid
uraemia

89
Q

abnormalities on MRI scan for AD

A

Cortical atrophy, ventricular enlargement, hippocampal atrophy.

90
Q

drugs causing urinary retneiton

A

Anticholinergics (e.g. tolterodine, oxybutynin), NSAIDs (e.g.
naproxen, diclofenac, ibuprofen).

90
Q

drugs causing urinary retneiton

A

Anticholinergics (e.g. tolterodine, oxybutynin), NSAIDs (e.g.
naproxen, diclofenac, ibuprofen).

91
Q

how does duloxetine improve stress incontinence

A

snri
more noraderenaline available
increases the tone of the internal urethral sphincter

92
Q

tia definition

A

The original definition of a TIA was time-based: a sudden onset of a focal neurologic symptom and/or sign lasting less than 24 hours, brought on by a transient decrease in blood flow. However, this has now changed as it is recognised that even short periods of ischaemia can result in pathological changes to the brain. Therefore, a new ‘tissue-based’ definition is now used: a transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischaemia, without acute infarction.

93
Q

ix of tia

A

mri head
carotid doppler
if >70% stenosis = carotid endarterectomy

94
Q

score used for determining stroke risk following tia

A

abcd2
age, bp, clinical features, diabetes,duration

95
Q

where do fragility fractures commonly occur

A

pelvis
hip
vertebrae
proximal humerus
proximal radius

96
Q

advice when taking bisphosphonate

A

Swallow whole, take in fasting state, wash down with plenty of
water, remain upright for 30 mins after taking the tablet, avoid
food and drink for 30 m inutes after taking the tablet

97
Q

bisphosphonate s/e

A

A bdo pain, dyspepsia, nausea, abdo distension,
oesophageal ulceration, upper GI bleed.

98
Q

what 2 ix for myeloma screen

A

Urinary Bence Jones protein, serum electrophoresis.

99
Q

what is seen on plain radiographs for myeloma

A

Lytic lesions

99
Q

what is seen on plain radiographs for myeloma

A

Lytic lesions

100
Q

treatment of msccc

A

dex
spinal cord decompression
rt

101
Q

treatment of msccc

A

dex
spinal cord decompression
rt

102
Q

MYELOMA COMPLICATIONS

A

renal failure
hypercalcaemia
anaemia
thrombocytopenia
neutropenia
recurrent infections
hyperviscosity

103
Q

other causes of parkinsonism

A

Drug-induced Parkinsonism (e.g. antipsychotics), Lewy body
dementia, Shy-Drager syndrome, multiple system atrophy,
vascular disease.

104
Q

why arent younger pts with parkinsons disease not commonly given levodopa

A

It becomes gradually ineffective over many years; therefore, held
until necessary

105
Q

other causes of raised psa beside prostate ca

A

Benign prostatic hypertrophy, prostatitis, post-prostatic biopsy,
post-digital rectal examination

106
Q

Name the five distressing end-of-life symptoms that the Liverpool Care Pathway
addresses, and name a drug it recommends to use for each.

A

Pain (morphine), agitation (midazolam), nausea (cyclizine),
respiratory tract secretions (hyoscine butylbromide/
hydrobromide), dyspnoea (morphine).

107
Q

causes of a urethral stricture

A

sti- gonorrhoea
idiopathic
iatrogenic- indwelling catheter trauma
lichen sclerosus
penile fracture
hypospadias

108
Q

aortic stenosis- who gets a valve replacement?

A

symptomatic
or asyptomatic and valvular gradient >40 or signs of ventricular dysfunction

109
Q

hypoglossal nerve injury

A

causes by carotid endarterectomy
paralysis of tongue muscles
“lick the lesion”- the tongue will deviate towards the side of the lesion due to the overactivity of the strong genioglossus nerve

110
Q

urticaria rash

A

pale, pink raised skin. Variously described as ‘hives’, ‘wheals’, ‘nettle rash’
pruritic

111
Q

mrsa mx

A

vancomycin

112
Q

notching of the inferior border of the ribs on cxr =

A

coarctation of aortia- collateral vessels

113
Q

how to diagnosie active tb

A

gold standard is sputum culture

sputum smear- ziehl neelson stain - 3 samples required

114
Q

inr 5-8 on warfarin, no sign of a bleed

A

Withhold 1 or 2 doses of warfarin
Reduce subsequent maintenance dose

115
Q

pressure ulcer- which member of mdt can assess it

A

district nurse

116
Q

impetigo mx

A

hydrogen peroxide 1% cream
or topical fusidic acid (abx)
or systemic disease flucoloxacillin

117
Q

who to refer for bariatric surgery

A

very obese pts bmi 40-50
esp those with diabetes
rather than it being last resort

118
Q

where do venous ulcers occur

A

above ankle/ medial malleolus
painless

119
Q

how to recognise an arterial ulcer

A

Occur on the toes and heel
Typically have a ‘deep, punched-out’ appearance
Painful
There may be areas of gangrene
Cold with no palpable pulses
Low ABPI measurements (normal is 0.9-1.2, <0.9 is arterial disease, or >1.3 in diabetics too)

120
Q

autism 3 main characteristics

A
  1. social impairment/ issues with social interaction
  2. impaired communication skills/ speech delay
  3. restrictive repetitive activities/ behaviours or interests
121
Q

non medical professional who can aid diagnosis of autism

A
  • teacher
  • speech and language therapist
  • community psychiatric nurse
  • occupational therapist
  • educational psychologist
122
Q

medical conditions that are often co-morbid with autism

A
  • epilepsy
  • tuberous sclerosis
  • fragile X
  • adhd
  • dyspraxia
  • hearing impairment
  • anxiety
  • visual impairment
123
Q

what are the 2 main predictors of poor prognosis in autism

A
  1. iq < 50
  2. no communicative speech before age 5
124
Q

factors associated with elder person being a victim of abuse

A
  • social isolation
  • memory problems
  • communication problems
  • being dependent on carer
  • poor relationship with carer
  • carer has addictions eg alcohol/ drugs
  • carer relies on victim for home/ finances/ emotional support
125
Q

re-feeding syndrome biochemical abnormalities

A
  • hyperglycaemia
  • hypophosphataemia
  • hypomagnesaemia-may predispose to torsades de pointes
  • hypokalaemia
  • thiamine deficiency
126
Q

how to reduce risk of refeeding syndrome

A
  • refeed slowly- <50% energy requirements if theyve eaten little or nothing in more than 5 days or have other rf
  • checking bloods, replace electrolytes prior to starting to feed
  • replace B vitamines
127
Q

serious complicatyions of anorexia

A
  • hf
  • bradycardia, arrhythmia
  • mitral valve prolapse
  • osteoporosis
  • infertility
  • anaemia, leucopenia
  • wernickes enceph/ korsakoff
128
Q

psychological tx for anorexia nervosa

A
  • individual eating disorder focused cbt (CBT-ED)
  • MANTRA
  • specialist supportive clinical management (SSCM)
129
Q

why do pts with PD develop bradykinesia

A

neuronal degeneration in nigrostrial pathway
lead sto doapmine deficiency in the basal ganglia

130
Q

name 2 dopamine receptor agonist drugs

A
  • ropinirole
  • bromocriptine
  • pramiprexole
131
Q

why should dopamine be held off for as long as possible/ used in low dosage in youngers pts

A
  • may be neurotoxic and speed up PD progression
  • can cause dyskinesia (involuntary movements)
  • leads to motor fluctuations- on/off, freezing
  • wearing off
  • non motor s/e- nausea, hallucinations, low bp
    *
132
Q

procyclidine s/e

A

confusion, disorientation, visual hallucination
nausea
urinayr retention
visual disturbance
dry mucous membrane
constipation
impaired memory
anxiety/nervousness

133
Q

why pts with advanced PD may develop confusion, disorientation, visual hallucinations

A
  • onset of PD dementia
  • intercurrent illness eg infection
134
Q

mx of hyperCa in first 24hrs

A
  • iv normal saline
  • careful observation of fluid balance
  • stop acei

(iv bisphosp started after 24hrs)

135
Q

ct head guidelines head injury within 1 hr

A
  • GCS < 13 on initial assessment
  • GCS < 15 at 2 hours post-injury
  • suspected open or depressed skull fracture
  • any sign of basal skull fracture (haemotympanum, ‘panda’ eyes, cerebrospinal fluid leakage from the ear or nose, Battle’s sign).
  • post-traumatic seizure.
  • focal neurological deficit.
  • more than 1 episode of vomiting
136
Q

pt attends diabetic clinic, thereaftyer develops acute glasucoma, why

A

may hav used mydriatic - dilates pupil, exacerbating untreated narrow angle

year 5 flashcards HY (5 decks)

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