Random 15 Flashcards
When would you use Fosfomycin?
As of my last update, NICE recommends considering fosfomycin as an option for treating uncomplicated lower urinary tract infections (cystitis) caused by susceptible bacteria. The usual recommendation is a single-dose oral treatment. The choice of antibiotic treatment depends on various factors, including local resistance patterns, patient factors, and individual preferences.
What is Trimbow?
Trimbow is a fixed-dose combination inhaler that contains three active ingredients: beclometasone dipropionate (a corticosteroid), formoterol fumarate (a long-acting beta2-agonist), and glycopyrronium bromide (a long-acting muscarinic antagonist).
What questions should you always ask in a palpitations history?
- How long do the episodes last?
- Syncope?
- How frequent are the episodes?
- Associated chest pain
- Do they happen everyday?
- Caffine
What is a cause of painless jaundice?
Carcinoma of the head of the pancreas
Why is tuberculosis known as the great mimicker?
It can appear as lots of different diseases all over the body, not just the chest.
Explain pemberton’s sign and why it is relevant in a thyroid examination?
Pemberton’s sign is when a patient raises both of their arms up above their head and their face goes red.
If the thyroid gland is enlarged and extends into the superior mediastinum, it may compress the SVC. Raising the arms exacerbates this compression, leading to impaired venous return from the head and neck.
Why do you percuss the thyroid in an examination?
In case the thyroid has move retro-sternally. Percuss the sternum moving downwards from the sternal notch to assess for retrosternal dullness.
Retrosternal dullness may indicate a large thyroid mass extending posteroinferiorly to the manubrium.
What is agranulocytosis?
A reduction in (neutrophils, eosinophils, basophils)
What is the first line drug in hyperthyroidism in pregnancy?
PTU
Propylthiouracil (PTU):
PTU is another antithyroid drug used to treat hyperthyroidism.
Like carbimazole, PTU works by inhibiting the synthesis of thyroid hormones.
PTU is sometimes used in certain situations, such as during the first trimester of pregnancy when carbimazole may be contraindicated.
What is De Quervain’s thyroiditis?
De Quervain’s thyroiditis, also known as subacute granulomatous thyroiditis, is believed to be caused by a viral infection.
De Quervain’s thyroiditis, also known as subacute granulomatous thyroiditis, is indeed an inflammatory disorder of the thyroid gland, as you correctly stated. This condition typically presents with symptoms such as painful swelling of the thyroid gland, fever, and sometimes an elevated erythrocyte sedimentation rate (ESR).
What is a myxoedema coma?
Myxoedema coma, also known as severe decompensated hypothyroidism, is the most severe form of hypothyroidism, typically triggered by an acute event such as infection, myocardial infarction or drug use. It is a rare but life-threatening condition characterized by profound hypothermia, decreased mental status, and systemic manifestations of severe hypothyroidism.
They have not been taking their levothyroxine
What is a thyroid storm?
Thyrotoxic storm, or thyroid storm, is a life-threatening health condition that is associated with untreated or inadequately treated hyperthyroidism. The defining signs and symptoms of the condition are severe hyperthyroid symptoms such as tachycardia, fever, and altered mental status.
How do you treat a thyroid storm?
Symptom control:
IV propanolol
IV digoxin if propanolol is contraindicated (e.g. asthma, low BP)
Reduce thyroid activity:
Propylthiouracil: preferred because it inhibits peripheral thyroxine conversion
Lugol’s iodine: administered 4 hours after propylthiouracil
Methimazole/carbimazole: considered second-line treatment
IV hydrocortisone: to reduce thyroid inflammation
Treat complications (e.g. heart failure, hyperthermia)
How do you treat myxoedema coma?
ITU/HDU care
IV T3/T4
50-100mg IV hydrocortisone
Mechanical ventilation and oxygen - if hypoventilation
IV fluid - to correct hypovolaemia
Correction of hypothermia
Correction of hypoglycaemia
Treatment of any heart failure
Describe the pathophysiology of Parkinson’s disease
It is believed to result from the accumulation of “Lewy bodies”, intracellular inclusions primarily composed of misfolded alpha synuclein. These bodies form and lead to neuronal death in the dopaminergic cells of the substantia nigra of the basal ganglia, thereby causing the characteristic symptoms.
What percentage of neurones do you have to lose in Parkinson’s disease to see symptoms?
50%
What is a DaTscan?
DaTscan is a drug that is injected into the bloodstream to assess dopamine containing neurons
How is Parkinson’s diagnosed?
Clinial judgement no on investigations.
What is the one symptom that everyone with Parkinson’s disease will have?
Bradykinesia
What tremor do patients with Parkinson’s have?
Pill rolling tremor