Past paper qs Flashcards

1
Q

Normal HB levels

A

For men, 13.5 to 17.5 grams per deciliter.

For women, 12.0 to 15.5

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2
Q

Normal MCV

A

80-100

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3
Q

Stage 1 hypertension is
Stage 2
Stage 3

A
  1. > 140/90
  2. 160/100
  3. 180/110
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4
Q

Target BP for > 80 years old

<80 years old

A

150/90

140/90

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5
Q

Target BP if pregnant (uncomplicated)

Target BP if preg with target organ damange secondary to hypertension

A

150/100

140/90

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6
Q

Step 1 Drug treatment for hypertention
Step 2
Step 3

A

1 < 55 = ACE
> 55 / black = CCB
2 ACE + CCB
3 + thiazide like diuretic

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7
Q

Normal TSH levels
T4
T3

A

TSH 0.4 to 4 (mIU/L).
T4 9.0-25.0 pmol/L
T3 3.5 - 7.8 pmol/L

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8
Q

Albumin - normal level

A

35-55

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9
Q

Surgical contamination levels

A

CLEAN - in which no inflammation is encountered and the respiratory, alimentary
or genitourinary tracts are not entered. There is no break in aseptic operating theatre
technique. (e.g. ENT)

CLEAN CONTAM - in which the respiratory, alimentary or genitourinary tracts are entered but
without significant spillage.

CONTAMINATED - Operations where acute inflammation (without pus) is encountered, or where there
is visible contamination of the wound. Examples include gross spillage from a hollow
viscus during the operation or compound/open injuries operated on within four hours.

DIRTY - Operations in the presence of pus, where there is a previously p

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10
Q

ASA levels and what do they show?

A

ASA - > 2 is increased risk of wound infection

1 A normal healthy patient
2 A patient with a mild systemic disease
3 A patient with a severe systemic disease that limits activity, but is not incapacitating
4 A patient with an incapacitating systemic disease that is a constant threat to life
5 A moribund patient not expected to survive 24 hours with or without operation

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11
Q

normal aptt

A

30-40 seconds

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12
Q

what is the effect of addisons on Na levels

A

Low

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13
Q

What is the effect of SIADH on Na

A

Low

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14
Q

Effect of lithium on electrolytes

A

all increase

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15
Q

Effect of digoxin on electrolytes

A

increase k and reduce mg

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16
Q

Effect of NSAIDs on electrolytes

A

increase k and reduce na

modulation of Renin angiotensin system

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17
Q

overactive parathyroid has what effect on calcium

A

increase

parathryoid hormone stimulates release of Ca stores from the bines

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18
Q

Risk of clozapine

A

Agranularcytosis (low neutrophils)

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19
Q

What drug has yellow vision as a side effect?

A

Dig

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20
Q

What electrolyte inbalences predispose to dig toxicity

A

Low K or Mg

21
Q

What is EDTA

A

measurement or renal funciton with radioactive traker

22
Q

NICE renal function calssificaions

A
1 >90
2 60 - 89
3A 45 -59
3B 30-44
4 15-29
5 < 15
23
Q

If converting between opiates we should reduce by …… to account for differences if metabolism

24
Q

How to interpret Volume of distribution

A

If LESS than 0.65L/kg the drug stays in the blood -> dose on IBW (e.g. Amikacin)

If MORE thank 0.65 L/kg the drug goes into the fat -> dose on Actual Weight
- IT TAKES THESE DRUGS AGES TO GET TO STEADY STATE SO THEY NEED (long half life)

25
Gamma GT indicates
most sensitive marker of hepatic disease | alcohol / drug damage
26
Alk Phos idicates
Inflammation and cholestatsis
27
Transaminiaes indicate | which is more liver specific
Dammage/death from inflammation | ALT more spec than AST
28
Bilirubin indicates
Cholestasis and synth function
29
Albumin and PT indicate what in liver impairment
Synthetic fuction - albumin long term (20 days) and PT short term (3 days)
30
Causative organisms for LRTI
Streptococcus pneumoniae, Haemophilus influenzae ATYPICALS Mycoplasma pneumoniae Chlamydophila ( Chlamydia) pneumoniae Legionnaires disease ( Legionella pneumophila)
31
What happens with atypical organisms on the gram stain
nothing - colourless | +VE purple, -ve pink
32
How does aneamia of chronic disease differ from iron deficiency
Ferritin is low in iron deficiency - trying to mobilise iron stores Ferritin is high in chronic disease - trying to store iron Iron biding capacity is always the oposite
33
Drugs that could cause a macrocytic anemia
Anything disrupting folate - phenytoin, methotrexate tc
34
Two phases of metabolism
Phase 1 - Oxidation, reduction, hydrolysis - CYP450 - Allows entry into phase 2 or excretion Phase 2 - Conjugation
35
Is phase I or II more likely to still work in liver failure
II e.g. pick lorazepam instead of chlordiazepoxide in decompensated liver failure - these enzymes are more deep in the liver and less likely to be damaged
36
What results could suggest liver failure is decompensated?
High INR | Increased ammonia
37
When do you counsider dose reduction in liver fail (5)
- narrow theraputic index - more phase 1 dependent - bili > 100 - INR > 1.3 - presence of encephalopathy or ascities
38
What is the role of calcium in high k
Calcium (either gluconate or chloride): Reduces the risk of ventricular fibrillation caused by hyperkalemia. Where as calcium resonium is used to actually reduced k
39
For asicitc drain how much fluid should be lost: per day - without odema - with odema
- without 0.5 | - with 1kg/day
40
Insulin reduces or increases potassium
reduces
41
target HbA1c
 48mmol/mol (6.5%) if diabetes is managed by lifestyle and diet OR lifestyle and diet combined with a single drug not associated with hypoglycaemia,  53mmol/mol (7.0%)
42
Cut of eGFR for metformin
45
43
Pioglitazone side effects
(heart failure, bladder cancer, bone fracture). Known risk factors for these conditions including increased age should be carefully evaluated before treatment. MHRA advise that prescribers should review treatment after 3 to 6 months and only continue if patient is deriving benefit.  Do NOT offer or continue pioglitazone if any of the following are present:  heart failure,  hepatic impairment,  diabetic ketoacidosis,  current, or history of, bladder cancer,  uninvestigated macroscopic haematuria.
44
Types of ADR ABCDE
ADRs A – Augmented – dose dependent and predictable (e.g. hypo from insulin) B – Bizarre – rare (e.g. anaphylaxis from penicillin) C – Chronic/chemical – prolonged treatment (e.g. analgesic neuropathy, paracetamol hepatotoxicity) D – Delayed – after years of treatment (e.g. antipsychotics and tardive dyskineseas) E – End of treatment – (e.g. seizures after stopping phenytoin)
45
3 types of incompatibility
physical -precipitation chemical - decomposition of the drug theraputic - antagonistic effectts
46
Factors affecting if medicines are transferred into breastmilk (4)
Size of molecule High lipid solubility Low meternal plasma protein binding Weakly acidic (milk is pH 7.2, plasma is 7.4) Usually via passive diffusion across the membrane
47
Problem excipients for children: Propylene glycol
cannot be metabolised - CNS depression
48
Problem excipients for children: sorbitol
artificial sweetener - osmotic diarrhea and GI discomfort