Phase 3B 2014 Flashcards
Risk factors for a VTE
Previous VTE Family history Thrombophilia Active cancer Immobility Pregnancy/ Postnatal period HRT/COCP Obesity Antiphospholipid syndrome
VTE prevention in hospitals
Ted stocking Low molecular weight heparin Early mobilisation following surgery Leg elevation Flow throm boot IVC filter
Test to do before prescribing LMWH
Renal function, U&Es especially potassium Weight Liver function tests FBC (look at platelets) HASBLED score
Name and list the mechanism of action of one DOAC
Apixiban
Factor Xa inhibitor
Risk factors for gout
Obesity
Diet high in purines
Reduce excretion due to renal impairment
Tumour lysis syndrome
Increased cell turnover (leukaemia, lymphoma)
EtOH excess
What precipitates a server gout attack
Infection Starting allopurinol Chemo Joint injury Binger drinking Dehydration
Management of acute gout
NSAIDs: ibuprofen,
Colchicine: alkaloid drug
Steriods: prednislone
How does allopurinol act
Xanthine oxidase inhibitor, prevents the production of uric acid, reducing the levels of urate in the blood
Reduce urate in the blood, preventing the formation of urate crystals
Why does gout favour distal joints
Cooler temperature at distal joints, crystals more likely to precited
List the risk factors for melanoma
Sun exposure Pale/Fair skin Immunocompromised Increased number of moles (> 50 melanocytic navei) History of sunburn Increase age \+ve family history
How do you stage melanoma
Breslows depth (>5mm deep bad prognostic indicator)
- Clarks
- Tumour marker is S-100
TNM based on Breslows thickness
Risk factors for being vitamin D deficiency
Institusationiled Pigmented skin Concealing clothes Sunscreen Poor diet/ Malabsorption Anti-convulsant
Action of Vitamin D on the bone
Improves the bone density
Stimulates the osteoblast to activate RANK ligand to absorb the bone
Prophylaxis for malaria
Malarone
Doxycycline
Prochloroquine
Why would malaria prophylaxis fail
Compliance
Malabsorption
Resistance
Prophylaxis
Diagnostic test for malaria
Serial thick and thin blood films (GIEMSA)
Where is transitional cell carcinomas found
Ureter
Renal pelvis
Urethra
Bladder cancer
Signs of cauda equine in three specific locations
Sphincter: Decreased anal tone, incontinence or retention of
Lower limb: Bilateral sciatic, foot drop,
Perianal tissue: Saddle paraesthesia, decreased pinprick and decreased light touch
What test should be performed prior to starting lithium
U&Es
TFTs
LFTs
ECG
Symptoms of hypothyroidism
Tired Sleepy Cold Depression Increased weight Dry thin hair Coarse skin Puffy round face Non-pitting oedema Slow reflexes Goitre Bradycardia
Signs of lithium toxicity
Tremor Nausea Vomiting Drowsy Ataxia Confusion Coma Sedation Dysarthria
Features of down syndrome on a neonatal exam
Flat nasal bridge Epicanthic folds Sandal gap Flat occiput Small mouth/ protruding tongue Single palmer crease Hypotonia Up slanting eye Round face Brush filed spots on iris Abundant neck Pelvis dyplasia
GI abnormalites in Down’s
Moscism
Non dysjunction
Robertsonian translocation
Balanced translocation
Define health economics
Assessment of efficiency, in other words it’s the comparative study of the cost and effectiveness/benefits of a health care intervention
Define a QUALY
Estimate of the years of life remaining for a patient following a treatment or intervention. Weighing each year of life lived with a QUALY life scale
Two things to make an economic evaluation: cost and effectiveness
Types of Economic evaluation
Cost benefit analysis
Cost utility analysis
Cost effectiness
Cost minimisation analysis
Define opportunity cost
Opportunity cost: to spend resources on one activity means a sacrifice in terms of lost opportunity elsewhere
Define efficiency
When resources are allocated between activates in such a way as to maximize benefits for a given budget
Features of bulbar palsy
Dysathria Dysphagia Nasal regurgitation Weak tongue Wasted tongue Fasciculations Hypersalivation
