Peer teaching mock - stuff I didn't know Flashcards
HTN in <55 yrs OR T2DM
ACEI - ramipril
ACEI + CCB (amlodipine)
ACEI + CCB + Thiazide-like diuretic (Indapamide)
HTN in >55yrs or black African / African-caribbean
CCB
CCB + ACEI or ARB (candesartan) or thiazide-like
CCB + ACEI + Thiazide like
when does CGD delay present
Slow growth from 3/6 mnths to 2/3 yrs
Puberty in girls
BOOBS, PUBES, GROW, FLOW
Breast buds (9-11)
Pubes
Growth
Period
Puberty in boys
GRAPES, DRAPES, SPURT, SQUIRT
Balls
Pubes
Growth
Ejaculation
Tanners puberty stages for boys
- Prepubertal (Increase in GnRH, FHS and LH)
- Genital growth (testicles and scrotum, pubes and under arm, growth spirt.
- Genital growth, Wet dreams, darkening of hair, more sweating, vocal changes
- Penis growth, acne, peak height
- Pubic hair growth to thighs and bellybutton
Early puberty in boys
<9 : hypothyroid, tumour on adrenal gland, pituitary pathology
Tanners stages for girls
- Prepubertal
- Breast buds, pubic hair, height
- Further breast budding, underarm growth and pubic hair continued growth, acne
- Protruding nipples
- Period
Simple febrile seizure
- Generalised tonic clonic
- <15 mins
- Occur ONCE during febrile illness
Complex febrile seizures
Partial of focal
>15 mins
MULTIPLE in same febrile illness
Metabolic alkalosis w/ partial compensation
- Raised pH (alkalosis)
- Raised bicarb (metabolic alkalosis)
- Elevated CO2 but still raised pH (partial compensation)
UTI management in a man
- Nitrofurantoin : 7 days
UTI management in a female (not pregnant and no haematuria)
- Nitrofurantoin : 3 days
Asymptomatic bacteraemia management in pregnant women.
- Nitrofuratoin (avoid at term)
- Amoxacillin (if culture results available(
- Cefalexin
Folic acid in pregnancy
- If on anti-epileptics, coeliac disease, BMI >30 or neural tube defect risk = 5mg UNTIL 12 wks
- None of the above : 400 micrograms until 12 wks
Idiopathic intracranial hypertension mx
- weight loss
- Diuretics (acetazolamide)
Idiopathic intracranial HTN RF and presentation
- RF : obesity, female, pregnancy and drugs (COCP, steroids tetracyclines, vit A and lithium)
- Presentation : headache, blurred vision, papilloedema, enlarged blind spot and sixth nerve palsy
Method for working out percentage risk of being a carrier
- If the PT DOES not have the disease and the disease is autosommal recessive
- DISCOUNT THE NON DISEASE THIRD = 67% chance
Pt in community, presenting with psychotic sx + no previous history. Not resistant. What section
2
Pt 65 or older OR with previous fragility fracture starting on long term steroids
Alendronate without DEXA
Pt under 65 starting on long term steroids
DEXA :
0 to -1.5 = repeat in 1-3 yrs
less than -1.5 = alendronate
pt 75 or older with fragility fracture
presumed osteoporosis with treatment without DEXA
pt under 75 with fragility fracture
DEXA
pt under 75 with fragility fracture
DEXA
Wenicke’s and korsakoff’s
- Severe thiamine (B1) deficiency (usually alcoholics)
- Wernicke’s : ataxia, opthalmaplegia and nystagmus
- Korsakoff’s : confabulation and amnesia (anterograde and retrograde)
Delerium management
- Verbal de-escalation techniques !!!!!
- Non verbal de-escalation techniques
- Haloperidol 0.5-1mg PO/IM (unless LBD or PD = lorazepam 0.1-1mg PO/IM)
Bradford-hill criteria for causality
S : strength of association
T : temporality (exposure before outcome)
D : dose response
S : specificity
R : reversibility (removal of cause, decreases effect)
C : consistency
C : coherence
R
A : analogy
P : plausibility (biological)
Green nipple discharge
Duct ectasia
1st step management of cord prolapse
all 4’s position
elderly, fall, not found for hours, dark brown urine, reduced skin tugor and dry mucous membranes
Rhabdomyolysis : AKI (raised creatinine) + elevated CK
GAD management if sertraline doesn’t work
- Offer alternative SSRI or SNRI
Pregnant woman + doubt of whether she’s ever had chickenpox
CHECK varicella IgG
Pregnant woman <20wks and NEVER had chickenpox
VZIG - varicella zoster immunoglobulin ASAP
Pregnancy woman >20 wks and NEVER had chicken pox
VZIG or aciclovir 7-14 days after exposure
Pregnant, chickenpox exposure + rash + >20 wks
Oral aciclovir
Disadvantage of RCT
Unethical to withhold Tx you deem to be effects
T2DM diagnosis !
- Symptoms + fasting >=7.0 and random >=11.1
- Asymptomatic : need above levels of 2 different occassions
Impaire fasting glucose
> =6.1 but less than 7.0
Impaired glucose tolerance
- Fasting of less than 7.0 but OGTT value >=7.8 but less than 11.1
pt presents to A&E, psychotic and KNOWN to mental health services
Section 3
A&E still counts as community and so 5s wouldn’t be used
Status epilepticus management in hospital
- 4mg IV lorazepam
- After 10 mins = another 4mg IV lorazepam
- Phenytoin, SV, levetiracetam
- Phenobarbital or GA
Status epilepticus community
- Buccal midazolam or rectal diazepam
- Call 999
Diagnostic Ix for heart failure
- Echo
- 1st line : BNP
Management of worms
Household mebendazole