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Planning management Flashcards

1
Q

what are some adverse features of a tachycardia? and what do you do in that case?

A

shock
syncope
MI
HF

*synchronised DC shock

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2
Q

what are some examples of irregular broad complex QRS tachy?

A

AF with BBB
pre-excitation AF
Torsades

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3
Q

how do you manage torsades?

A

magnesium 2g over 10 min

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4
Q

what is a broad QRS regular tachy?

A

ventricular tachy - amiodarone
SVT with BBB

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5
Q

what are some examples of narrow QRS tachys?

A

regular - SVT
irregular - AF

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6
Q

how do you determine if you should treat pneumothorax or not?

A

secondary with lung disease always treat
- chest drain >2cm
- or if over 50, SOB, <2cm aspirate

primary
- <2cm and not SOB discharge with f/u 4w
- >2cm OR SOB then aspirate and if unsuccessful attempt again and then chest drain if unsuccessful again

tension - emergency mx then drain

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7
Q

what does CURB65 stand for?

A

Confusion
Urea >7.5
RR >30
Bp <90 systolic
65+ age

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8
Q

how do you interpret CURB65?

A

none - home tx
2+ hospital tx with oral or IV abx
3+ ITU

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9
Q

what are the 8 C’s of managing GI bleed?

A

cannulae
catheter and fluid monitoring
crystalloid bolus
crossmatching 6u
clotting abnormalities correcting
camera - endoscopy
culprit drugs stopping - NSAIDs, aspirin, warfarin, heparin
Call surgeons

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10
Q

how are you managing a seizure before medications are indicated?

A

ensure airway patency
recovery position with oxygen to prevent aspiration
perform bedside tests for triggers: blood glucose, electrolytes, drugs, sepsis

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11
Q

how is osmolality calculated?

A

(2xNa + 2xK) + urea + glucose

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12
Q

what target blood pressures are you aiming for with antihypertensives?

A

<80 patients aim for <140/90 for clinic and <135/85 at home

over 80 add 10mmHg to systolic values

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13
Q

what medications are added to CHF patient to help with mortality etc?

A

ACEI
BB
spironolactone if needed
nitrates if needed

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14
Q

what does CHA2DS2-VASc stand for?

A

stroke risk!

Ccf or LHF
Hon
Age >75 (2 points)
Dm
Stroke or TIA (2 points)
Vascular disease (PAD or IHD)
Age 65-74
Sex (female)

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15
Q

how do you interpret CHA2DS2-VASc scores?

A

0 - not require
1 - consider in men
2 or more - consider anticoagulant in men and women

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16
Q

what is HAS-BLED score?

A

risk of anticoagulation in AF

Htn - uncontrolled BP
Abnormal renal function and liver function
Stroke

Bleeding tendency or predisposition
Labile INR
Elderly >65
Drugs like aspirin or NSAIDs

17
Q

how is HAS-BLED interpreted?

A

0 - low risk, consider anticoagulant
1-2 - moderate so consider
3< - high risk, consider alternatives to anticoagulants

18
Q

In AF who is considered for rhythm control?

A

<48h since onset, young, symptomatic, first episode or due to precipitant

*cardioversion or pharmacological

19
Q

who is considered for rate control in AF?

A

> 48h presentation

20
Q

what are the aims of angina management?

A

GTN spray for sx relief
secondary prevention
anti-anginal drug - BB or CCB

21
Q

What are some contraindication for BB?

A

hypotension
bradycardia
asthma
acute HF

22
Q

what are some contraindications for CCB?

A

hypotension
bradycardia
peripheral oedema

23
Q

what does diabetic annual review include? and why?

A

albumin-creatinine ratio
- early indicator of diabetic neuropathy, CVS disease predictor indicating need for ACEi

24
Q

first line for Parkinson’s?

A

co-careldopa or co-beneldopa

very mild - dopamine agonists

25
Q

first line: myoclonic seizures?

A

valproate male
levetiracetam female

26
Q

first line: tonic?

A

valproate male
lamotrigine female

27
Q

first line: focal?

A

carbamazepine or lamotrigine

28
Q

first line: absence?

A

ethosuximide or valproate

29
Q

first line: generalised tonic clonic?

A

valproate male
lamotrigine female

30
Q

how are you inducing remission if crohns?

A

mild flare - prednisolone 20-40mg oral

severe - hydrocortisone IV

31
Q

how is crohns remission maintained?

A

azathioprine or 6-mercaptopurine

CHECK TPMT and if low start lower dose, if absent methotrexate

32
Q

what are some stool softeners?

A

docusate sodium - good for impaction, reduced gut motility

33
Q

what are some bulking agent?

A

isphagula husk - can take days and not in impaction!

34
Q

stimulant laxatives?

A

Senna and bisacodyl

not in acute abdomen, may exacerbate cramps

35
Q

osmotic laxatives?

A

lactulose, phosphate enema

enema not in acute abdomen, may exacerbate bloating

36
Q

RA during flare?

A

short term glucocorticoids IM methylpred
short term NSAIDs with PPI
DMARD restart after

PSA (9 decks)

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