Placement Flashcards by Soorya Thavaraj

What are the three main functions of the liver?

Synthesis
Excretion
Storage

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What liver function tests relate to hepatocytes?

ALT (alanine aminotransferase)

AST (aspartate aminotransferase)

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Where are Alkaline phosphatase (ALP) and y-Glutamyltransferase (GGT) usually found?

In the bile ducts of the liver

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What might raised ALP and GGT levels be indicative of?

Obstructive liver disease

GGT levels are also a potential indicator of how much alcohol a patient drinks

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What are the Vitamin K dependent clotting factors?

2
7
9
10

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What can increased ESR suggest?

Pregnancy
TB
Rheumatoid arthritis
Anaemia
Some malignancies

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What can increased neutrophils be caused by?

Infection
Ischaemic Necrosis (e.g. MI)
Metabolic disorders (e.g. diabetic acidosis)
Stress response (e.g. due to acute haemorrhage)
Inflammatory disease (e.g. rheumatic fever)

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Why might creatine be low?

It is proportional to muscle mass in the body and if the person has low muscle mass they might have low creatine

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What is refeeding?

It is the process of reintroducing food after starvation or malnourishment

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What is refeeding caused by?

Sudden shifts in the electrolytes that help your body metabolise food

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Why does refeeding syndrome occur?

When carb consumption is reduced, insulin secretion slows
The body changes to fats and proteins as sources of energy
This can deplete electrolyes levels
When food is reintroduced, there’’s an abrupt shift from fat metabolism back to carbohydrate metabolism
This causes insulin secretion to increase

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What are some of the effects of refeeding syndrome?

Hypophosphataemia
Hypomagnesaemia
Hypokalaemia
Thiamine deficiency

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Why does hypophosphataemia occur in refeeding syndrome?

Cells need electrolytes like phosphate to convert glucose to energy but phosphate is in short supply

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What is Courvoisier’s Law?

Presence of a palpably enlarged gallbladder and accompanied with mild jaundice, the cause is unlikely to be gallstones

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What is the typical presentation of pancreatic cancer?

Painless jaundice

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What type of drug is Flucloxacillin?

Antibiotic

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What are the indications of Flucloxacillin?

Infections due to beta-lactamase-producing staphylcocci
Cellulitis
Leg ulcer infection
Endocarditis

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What are the side effects for all penicillins?

Diarrhoea
Hypersensitivity
Nausea
Vomiting

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What are the side effects for Flucoxacillin other than the general side effects for penicillin?

Arthralgia
Fever
Neutropenia

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What are the side effects of Paracetamol?

Thrombocytopaenia
Rash
Paracetamol Overdose

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What type of drug is Amlodopine?

Calcium Channel Blocker

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What are the indications for Amlodipine?

Prophylaxis of angina

Hypertension

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What are the general side effects for all CCBs?

Abdominal Pain
Dizziness
Fatigue 
Nausea 
Headache 
Palpitations

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What are the specific side effects for Amlodipine?

Constipation
Muscle cramps
Dyspepsia 
Alopecia
Oedema

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What type of drug is Apixaban?

Anticoagulant

How does Apixaban work?

Direct inhibitor of activated factor X (factor Xa)

What are the indications of Apixaban?

Prophylaxis of VTE | Treatment of DVT

What are the side effects of Apixaban?

``` Anaemia Haemorrhage Nausea Skin reactions Hypotension ```

What are the side effects for Statins?

``` Dizziness Flatulence Headache Nausea Alopecia ```

What are the side effects specifically for Atorvastatin?

Hyperglycaemia Decreased appetite Chest pain Peripheral oedema

What type of antibiotic is Clarithromycin?

Macrolide antibiotics

What are the side effects for all Macrolides?

``` Appetite decreased Headache Nausea Insomnia Paraesthesia ```

What are some specific side effects to Clarithromycin?

Burping Dry Mouth Thrombocytosis Tremor

What type of drug is Clopidogrel?

Antiplatelet

What are some of the side effects for Clopidogrel?

``` Diarrhoea Haemorrhage Dizziness Headahe Nausea ```

What are the two parts of Co-amoxiclav?

Amoxicillin | Clavulanic acid

Why do we use Co-amoxiclav?

Fights antibiotic resistance | Clavulanic acid is a beta-lactamase inhibitor so prevents breakdown of amoxicillin by beta-lactamases

What are the side effects for Co-Amoxiclav?

Increased risk of infection Dizziness Dyspepsia Headache

How does Denosumab work?

It is a human monoclonal antibody that inhibits osteoclast formation, function, and survival, thereby decreasing bone resorption

What is the main indication for Denosumab?

Osteoporosis

What are the side effects for Denosumab?

``` Cataract Constipation Hypocalcaemia Sciatica Increased risk of infection ```

What type of drug is Dexamethasone?

Steroid (corticosteroid)

What are some of the side effects for all corticosteroids?

``` Fatigue Headache Hirsuitism Hypertension Peptic Ulcer Weight gain ```

What type of drug is GTN spray?

Nitrate

What are the side effects for all nitrates?

``` Arrhythmias Dizziness Headache Hypotension Nausea ```

What does SSRI stand for?

Selective Serotonin Reuptake Inhibitor

What are SSRIs mainly used for?

As an antidepressant

What does SNRI stand for?

Serotonin-noradrenaline reuptake inhibitor

What does PRN mean in a medical context?

Stands for pro re nata | Means the medication is not scheduled and it is taken as needed

What are the most common causes of Anaemia?

``` Loss of blood Nutritional Deficiency Bone marrow problems Chemotherapy Kidney Failure Sickle Cell Thalassaemia ```

What are some of the ways loss of blood can occur?

``` Traumatic injury Surgery Bleeding Colon Cancer Stomach ulcer ```

What nutritional deficiency can lead to anaemia?

Iron Vitamin B12 Folate

What patients might have a high Hb level?

``` People living in high altitudes People who smoke Advanced lung disease Polycythemia rubra vera Abuse of the erythropoietin (Epogen) by athletes for blood doping ```

What might give a false high Hb level?

Dehydration produces a falsely high Hb measurement that disappears when proper fluid balance is restored

What are the causes of neutropenia?

``` Infections Chemotherapy (most common cause) Cancer Deficiencies Autoimmune diseases ```

What infections can cause Neutropenia?

Hepatitis Tb Sepsis

What deficiencies can cause Neutropenia?

B12 Folate Copper

What autoimmune diseases can cause neutropenia?

Crohn's Disease Lupus Rheumatoid arthritis

What conditions can cause lymphocytopenia?

``` Infectious diseases Autoimmune disorders Steroid therapy Blood diseases Radiation and Chemotherapy ```

What infectious diseases can cause lymphocytopenia?

``` AIDS Viral Hepatitis TB Covid Typhoid fever ```

What is an example of an autoimmune disorder that can cause lymphocytopenia?

Lupus

What blood diseases can cause lymphocytopenia?

Hodgkin's disease | Aplastic anaemia

What are the two main aetiologies of thrombocytopenia?

Decreased production of platelets | Increased breakdown of platelets

What can cause decreased production of platelets?

``` Leukaemia and other cancers Some types of anaemia Viral infections (Hep C or HIV) Chemotherapy drugs Heavy alcohol consumption ```

What can cause increased breakdown of platelets?

Pregnancy Autoimmune diseases Medications

What medications can cause increased breakdown of platelets?

Heparin Quinine Other antibiotics Anticonvulsants

What can cause an increased platelet count (thrombocytosis)?

``` Acute bleeding and blood loss Cancer Iron Defiency Splenectomy Inflammatory Disorders ```

What inflammatory disorders can cause thrombocytosis?

Rheumatoid arthritis Sarcoidosis Inflammatory bowel disease