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Year 4 General Medicine > Placement (additional things) > Flashcards

Placement (additional things) Flashcards

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1
Q

what is the difference between HHS and DKA

A

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

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2
Q

what is pathognomonic of superficial femoral artery blockage on clinical examination

A

black specks on the legs/soles of feet that are exquisitely painful

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3
Q

3 main things for neuroischaemic ulcer management

A

increase pressure - boots
improve blood supply - angioplasty
treat infection - deep infection with antibiotics

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4
Q

what is a cause of raised urea in isolation

A

dehydration

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5
Q

what is a cause of low creatinine

A

low muscle mass ie low body weight

especially in context of substance misuse

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6
Q

what are important side effects of carbimazole and PTU

A

agranulocytosis

liver failure

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7
Q

what is a side effect of nerve conduction studies

A

significant bruising

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8
Q

why do patients on long term steroids carry a steroid card

A

in case of an emergency

adrenal crisis

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9
Q

what is the function of erythropoeitin

A

hormone released by the kidneys that helps to make RBC in the bone marrow

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10
Q

what class of drug is bumetanide

A

diuretic

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11
Q

why might someone receive ‘split dose’ of LMWH

A

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

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12
Q

how many blood cultures do you send of for suspected IE

A

3

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13
Q

how many lumen does a central venous catheter have

A

4 - labelled as proximal, distal and 2 medial

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14
Q

for management of alcohol withdrawal, which BZD is used in hospital and in the community

A

hospital - diazepam

community - chlordiazepoxide

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15
Q

how much fluid should be prescribed in:
resuscitation
routine maintenance

A

resuscitation - 500ml bolus over 15 min

routine maintenance - 25-30ml/kg/day

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16
Q

what is the most important clue when seeing a patient on the ward

A

end of bed inspection - sweets, inhalers, walking stick…

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17
Q

oxycodone is twice as strong as morphine (PO)?

A

yes

oxycodone is also hepatically excreted

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18
Q

what is Sando K

A

oral potassium replacement

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19
Q

why might a patients with bruising / haematoma have a raised bilirubin

A

from breakdown of the haematoma

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20
Q

after taking an ascitic tap sample, who should you send it to

A

biochemistry - SAAG to tell you about portal HTN
cytology - malignancy
microbiology - infection /SBP

21
Q

Being on steroids can mask a silent GI perforation, true or false

A

true

22
Q

what is a VRE UTI

A

Vancomycin resistant enterococci UTI

23
Q

what are the causes of finger clubbing

A 
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
24
Q

what is leukonychia a sign of

A

hypoalbuminaemia

25
Q

what are causes of hypoalbuminaemia

A

liver disease

nephrotic syndrome

26
Q

where do you palpate the brachial pulse

A

medial aspect of arm at antecubital fossa

27
Q

ECG changes of digoxin toxicity

A

PR prolongation
reverse tick (ST segment)
PVC
AVN block

28
Q

function of digoxin

A

increases cardiac contractility and controls HR

29
Q

what is takotsubos cardiomyopathy

A

essentially HF due to a significant event such as stress, emotion, procedure, bereavement…
has a good prognosis

30
Q

salbutamol can cause a raised lactate, true or false

A

true

31
Q

if someone has a collapsed lung, what investigation is important to do and why

A

bronchoscopy to visualise the airways and see if there is an obstruction leading to collapse such as foreign body, sputum plug, tumour, mass

32
Q

if someone has a leg amputation where do you place the ECG stickers

A

on the bony prominences of the hips

33
Q

how much local anaesthetic can you give

A

3mg/kg

34
Q

D.Dx for raised Hb levels

A
  1. polycythaemia rubra vera
  2. Secondary to: COPD, chronic hypoxia
  3. pseudopolycythaemia: dehydration, diuretics, obesity, alcohol
35
Q

high Hb levels can do what to your blood

A

make it thicker and more likely to clot

36
Q

on a CXR, fluid pushes the trachea away/towards the affected side

A

away

37
Q

how to interpret a CXR

A 
name, DOB, date of CXR 
projection, rotation, penetration, inspiration 
Striking abnormality 
ABCDE 
overall impression
38
Q

what is the D sign on a CXR

A

empyema

39
Q

what is a wedge infarct on a CXR indicative of

A

PE - necrosis

40
Q

term for liver failure/cirrhosis/disease causing a pleural effusion?

A

hepatic hydrothorax

41
Q

when doing an ABG, use your pinky to stretch out the skin

A

useful tip

42
Q

what kind of vein should you aim for in cannulation

A

a straight vein

43
Q

you can use a SAMA and LAMA at the same time, true or false

A

false, use one or the other

could lead to anticholinergic toxicity

44
Q

what is re expansion pulmonary oedema a complication of

A

chest drain insertion

output of >1L over a short period of time

45
Q

which antibiotic class can cause torsades de pointes

A

macrolides cause QT prolongation

46
Q

in a collapsed lobe on a CXR, the trachea is pulled away/towards the affected side

A

towards

47
Q

treatment of choice for ABPA

A

PO prednisolone

48
Q

Widespread ST elevation implies a partial/complete occlusion of the affected coronary artery

A

complete occlusion

Year 4 General Medicine (16 decks)

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