phase 2 saq 3 Flashcards
first line treatment for unstable angina
GTN spray (1 mark) and either B-blocker or Calcium Channel Blocker
extra-articular manifestations of ankylosing spondylitis
5 A’s: anterior uveitis (2), autoimmune bowel disease (2), apical lung fibrosis (2), aortic regurgitation (2), amyloidosis
ankylosing spondylitis management
NSAIDS (1), Steroids during flares (1), Anti-TNF
describe moderate asthma
PEFR more than 50-75% best or predicted and normal speech, with no features of acute severe or
life-threatening asthma.
descrbe acute severe asthma
PEFR 33-50% best or predicted (less than 50% best or
predicted in children) or respiratory rate of at least 25/min in people over the age of 12 years, 30/min in children between the ages of 5-12 years, and 40/min in children between 2-5 years old, or pulse rate of at least 110/min in people over the age of 12 years, 125/min in children between the ages of 5-12 years, and 140/min in children between 2-5 years old, or inability to complete sentences in one breath, or accessory muscle use, or inability to feed (infants), with oxygen saturation of at least 92%
describe life threatning asthma
PEFR less than 33% best or predicted, or oxygen saturation of less than 92%, or altered consciousness, IorI poor respiratory effort, or silent chest, or confusion.
indications of good asthma control
No night-time symptoms
● Inhaler used no more than three times per week
● No breathing difficulties, cough or wheeze on most days
● Able to exercise without symptoms
● Normal lung function test
adrenaline mechanism of action
Stimulation / agonist (1) of beta (1) adrenergic (1) receptors
physiological responses to mediators of anaphylaxis
Vasodilation (1), Increased vascular permeability (1), tachycardia (1), hypotension (1), maximise blood glucose levels in brain
non malignant causes of lymphadenopathy
infection, sarcoidosis, phenytoin, EBV associated lymphoproliferative disease, SLE
symotoms of CLL
anorexia, weight loss, fatigue, bleedings, infections, abdominal pain
additional test to confirm CLL diagnosis
Immunophenotyping
3 treatments for CLL
- chemotherapy
- radiotherpay
- stem cell transplant
non-pharmacological management options for OA
Patient education (1), activity / exercise (1), weight loss (1), improved diet (1) - anti-inflammatory foods physiotherapy (1), occupational therapy
topical management for OA
NSAIDs (1), capsaicin
oral managemnt of OA
paracetamol (1), NSAIDs (1), opioids (1), bisphosphonates
What treatment would you prescribe Trevor to prevent stroke AFTER tia
aspirin
treatment for ischaemic total anterior circulation stroke
thrombolysis / Alteplase within 4.5 hours
chest x ray for TB
Bilateral hilar lymphadenopathy (1), ghon focus
specific signs of IBD
pyoderma gangrenosum, erythema nodosum, clubbing, arthritis
gold standard test for UC
Colonoscopy and biopsy
What marker, if raised, is definitive for diagnosing iron deficiency anaemia
in an iron profile?
ferritin
pathophysiology of bronchitis
an irritant leads to inflammation causing the epithelium to become ulcerated and
squamous epithelium replaces columnar cells when the ulcer heals, leading to
scarring and thickening of the wall
treatment for a moderate acute exacerbation of COPD caused
by a bacterial infection?
nebulisers, steroids and antibiotics
Why are diabetics a classic culprit of silent MIs?
Diabetic neuropathy so do not feel anginal pain so the diagnosis may be missed.
Patients can often die from a sudden collapse
two cells involved in acute inflammation
Neutrophils, monocytes
What does beta-naphthylamine increase the risk of ?
bladder cancer
methods of innate immunity
lysozyme in tears, skin as a physical barrier, cilia and mucus in
bronchus, vaginal flora
what two factors do TH2 cells release and what are their functions
IL-4 – induces B cell proliferation
; IL-5 – induces B cell differentiation
into plasma cells
what does F stand for in adverse drug reactions
Failure of therapy eg Failure of Oral contraceptive pill in the presence of an enzyme inducer
Which two markers would indicate a chronic infection of liver cirrhosis due to hepatits
hepatitis surface antigen
hepatitis core antibody
most common cause of spontaneous bacterial peritonitis?
E.coli
complications of CML
Myelosuppression, neutropenic sepsis, blast crisis, tumour lysis syndrome
what cancer can CLL change to
non hodghkins lymphoma
risk factors for tonic clonic seizures
Premature birth, cerebral palsy, brain tumour, meningitis,
neurofibromatosis, family history, traumatic brain injury, stroke, cocaine
use
driving rules for epilepsy
seizure
free for 12 months if this is not the patient’s first seizure
comlplication. of epilpeys
Injury, tongue biting, status epilepticus, sudden death, Todd’s paralysis,
shoulder dislocation
Which area of the brain is the primary motor cortex found
Anterior to central sulcus in the frontal lobe
investigation to diagose feltys
abdominal ultrasound
Define the Z score for DEXA scan
Number of standard deviations patient’s bone density falls below mean for their age
why does nephritis syndrome cause hameaturia
Increased permeability of glomeruli leads to red blood cells moving into the filtrate
What parasympathetic nerve is involved in micturition?
Pelvic splanchnic nerve
tests for cushings
Random plasma cortisol or overnight dexamethasone suppression test or
24 hour urinary free cortisol
two of the criteria for a screening process to be performed.
Condition should be important, recognisable latent or early symptomatic
stage, natural course of condition should be adequately understood,
suitable test, test acceptable to population
Define incidence.
= a measure of the risk of developing some new condition within
a specified period of time
Define deontology
based on the belief that we owe a duty of care to each other,
ignores the consequences.
fiest line test for stroke
non contract ct head
