PSA Medicine Flashcards
TSH results in hypothyroidism
- TSH high = because T4/3 are low thyroid being stimulated to produce
- T3/4 are low
- no negative feedback therefore increased TSH production
what to do if TSH result is high in hypo
- If TSH too high this means the levothyroxine is too low
- T3/4 still too low so no negative feedback so still increased TSH production
- Increase the dose
what to do if TSH result is low on levothyroxine
- levothyroxine is too high so need to reduce dose
How to take thyroxine and monitoring
- empty stomach in morning
- check tsh 3m
- once stable check annually
hyperthyroid blood results
- low TSH high T3/4
Mx hyperthyroid
- carbimazole
- once level can either titrate or levothyroxine added
what can carbimazole increase risk of
- pancreatitis
- agranulocytosis
NSTEMI mx
Aspirin 300mg
Ticagrelor 180mg stat dose
Morphine
Antithrombin therapy with fondaparinux
Nitrates
community mx paeds meningitis
IM benzylpenicillin
- 1m - 11m 300mg
- age 1-9y 600mg
- age 10-17y 1.2g
Cefotaxime if allergy
mx meningitis hospital paeds
- 1 - 3m cefotaxime and amoxicillin
- 3m - 18y = cefotaxime
dexamethasone
what causes rheumatic fever
- group a strep
s+s rheumatic fever
- fever
- joint pain
- rash
- sob
- chorea
- nodules
abx for rheumatic fever
phenoxymethylpenicllin 10 days
kawasaki S+S
- strawberry tongue
- cracked lips
- cervican ln
- bilateral conjunctivitis
mx kawasaki
- high dose aspirin
- ivig
s+s GAS scarlet fever
- sandpaper rash blanches
- strawberry tongue
- sore throat, fever, headache
mx phenoxymethylpenicllin 10 days
croup mx
- dexamethasone oral
- oxygen
- nebulised budenoside
- nebulised adrenaline
mx epiglottitis
- IV abx ceftriaxime
- Steroids = dex
mx whooping cough
macrolides
- azithromycin, erythromycin, clarithromycin
acute asthma adults mx
- Oxygen
- Salbutamol = 5mg nebs
- Hydrocortisone 100mg 6hrly/pred (40mg for 5 days)
- Ipratropium
- T
- Magnesium sulfate
asthma mx adult
- SABA = salbutamol, terbutaline
- ICS = beclametasone, budenoside, ciclesonide
- LTRA = montelukast
- LABA = salmeterol
- MART
asthma mx 5-16yrs
- SABA
- ICS
- LTRA
- LABA
- MART
PCI in STEMI
- if within 12 hours sx onset and 2 hours of hospital
- Prasugrel and aspirin
NSTEMI Mx
BATMAN
- Base of GRACE score
- Aspirin 300mg
- Ticagrelor 180mg stat (clopi of bleed, pras if angiog)
- Morphine
- Antithrombin = fondaparinux
= Nitrates
secondary prevention ACS
- ACEi
- BB
- Dual antiplatelet = 12m but aspirin indefinite
- Statin
uninvestigated dyspepsia mx
- PPI 4 weeks
- H pylori testing
Funcitonal dyspepsia
- PPI and H P tx
COPD initial mx
- SABA
- SAMA = ipratropium
COPD mx no asthmatic/steroid response
- LABA
- LAMA
COPD mx there are asthatic/steroid response
- LABA
- ICS
Acute COPD mx
- Pred 30mg OD 5 days
- Abx if infection
T2DM mx
- Metformin
- ## If Chronic HF or cvd= SGLT-2 inhibitor (empagliflozin)
1st line insulin in DM1
- basal bolus regimens
- twice daily insulin detemir for long acting
Hypocalcaemia
- Convulsions Arrythmias Tetany Numb
- ECG = prolonged QT
- Calcium gluconate 10% 10ml 10mins
Hypercalcaemia
- Stones bones moans groans
- ECG = shortened QT
- 0.9% NaCl 1000ml 4hrs
Hypokalaemia
- ECG = long PR and long QT
- 0.3% KCL 1000ml 4hrs
Hyperkalaemia
- Calcium gluconate 10% 30ml 10mins
DVT Mx
- Initial = rivaroxaban (DOAC)
- Long term = DOAC, warfarin, LMWH
DVT prophylaxins and renal impairement
unfractioned heparin
short duration constipation
- bulk forming 1st
- osmotic laxative
- stimulant laxative
opioid induced constipation
- osmotic and stimulant 1st
faecal impaction
- oral macrogol
- stimulant