Placement (additional things) Flashcards
what is the difference between HHS and DKA
HHS has no ketones and is more commonly associated with T2DM
DKA is more commonly associated with T1DM and has ketones
There can be an overlap between the 2
what is pathognomonic of superficial femoral artery blockage on clinical examination
black specks on the legs/soles of feet that are exquisitely painful
3 main things for neuroischaemic ulcer management
increase pressure - boots
improve blood supply - angioplasty
treat infection - deep infection with antibiotics
what is a cause of raised urea in isolation
dehydration
what is a cause of low creatinine
low muscle mass ie low body weight
especially in context of substance misuse
what are important side effects of carbimazole and PTU
agranulocytosis
liver failure
what is a side effect of nerve conduction studies
significant bruising
why do patients on long term steroids carry a steroid card
in case of an emergency
adrenal crisis
what is the function of erythropoeitin
hormone released by the kidneys that helps to make RBC in the bone marrow
what class of drug is bumetanide
diuretic
why might someone receive ‘split dose’ of LMWH
for example in someone with metallic heart valves but also a subdural haematoma
you want to find a good balance of anticoagulation that is predictable, reversible and short acting
warfarin and DOACs would not be ideal
IV heparin if administered and monitored correctly would be the most ideal option however it is a nuisance to carry out correctly
how many blood cultures do you send of for suspected IE
3
how many lumen does a central venous catheter have
4 - labelled as proximal, distal and 2 medial
for management of alcohol withdrawal, which BZD is used in hospital and in the community
hospital - diazepam
community - chlordiazepoxide
how much fluid should be prescribed in:
resuscitation
routine maintenance
resuscitation - 500ml bolus over 15 min
routine maintenance - 25-30ml/kg/day
what is the most important clue when seeing a patient on the ward
end of bed inspection - sweets, inhalers, walking stick…
oxycodone is twice as strong as morphine (PO)?
yes
oxycodone is also hepatically excreted
what is Sando K
oral potassium replacement
why might a patients with bruising / haematoma have a raised bilirubin
from breakdown of the haematoma
after taking an ascitic tap sample, who should you send it to
biochemistry - SAAG to tell you about portal HTN
cytology - malignancy
microbiology - infection /SBP
Being on steroids can mask a silent GI perforation, true or false
true
what is a VRE UTI
Vancomycin resistant enterococci UTI
what are the causes of finger clubbing
Cyanotic heart disease Lung - Abscess - Bronchiectasis - CF - Don't say COPD - Empyema - Fibrosis UC / Crohns disease Biliary cirrhosis Birth defect Infective endocarditis Neoplasm - lung cancer GI malabsorption - Coeliac disease
what is leukonychia a sign of
hypoalbuminaemia
what are causes of hypoalbuminaemia
liver disease
nephrotic syndrome
where do you palpate the brachial pulse
medial aspect of arm at antecubital fossa
ECG changes of digoxin toxicity
PR prolongation
reverse tick (ST segment)
PVC
AVN block
function of digoxin
increases cardiac contractility and controls HR
what is takotsubos cardiomyopathy
essentially HF due to a significant event such as stress, emotion, procedure, bereavement…
has a good prognosis
salbutamol can cause a raised lactate, true or false
true
if someone has a collapsed lung, what investigation is important to do and why
bronchoscopy to visualise the airways and see if there is an obstruction leading to collapse such as foreign body, sputum plug, tumour, mass
if someone has a leg amputation where do you place the ECG stickers
on the bony prominences of the hips
how much local anaesthetic can you give
3mg/kg
D.Dx for raised Hb levels
- polycythaemia rubra vera
- Secondary to: COPD, chronic hypoxia
- pseudopolycythaemia: dehydration, diuretics, obesity, alcohol
high Hb levels can do what to your blood
make it thicker and more likely to clot
on a CXR, fluid pushes the trachea away/towards the affected side
away
how to interpret a CXR
name, DOB, date of CXR projection, rotation, penetration, inspiration Striking abnormality ABCDE overall impression
what is the D sign on a CXR
empyema
what is a wedge infarct on a CXR indicative of
PE - necrosis
term for liver failure/cirrhosis/disease causing a pleural effusion?
hepatic hydrothorax
when doing an ABG, use your pinky to stretch out the skin
useful tip
what kind of vein should you aim for in cannulation
a straight vein
you can use a SAMA and LAMA at the same time, true or false
false, use one or the other
could lead to anticholinergic toxicity
what is re expansion pulmonary oedema a complication of
chest drain insertion
output of >1L over a short period of time
which antibiotic class can cause torsades de pointes
macrolides cause QT prolongation
in a collapsed lobe on a CXR, the trachea is pulled away/towards the affected side
towards
treatment of choice for ABPA
PO prednisolone
Widespread ST elevation implies a partial/complete occlusion of the affected coronary artery
complete occlusion
