random 2 Flashcards
what is target HbA1c for diabetics
1. lifestyle
2. metformin
3. otherdrugs that may cause hypo
48mmol/mol
48
53
when should sulfonyreas be avoided
pregnancy and breastfeeding
what causes long QT in terms of potassium - examples of drugs that do this
hypo
amiodarone - TCAs/SSRI, sotalol
erythromycin
haloperidol
ondanestron
management of uncomplicated angina
aspirin and a statin
bb or CCB (verapamil if mono dihydro if dual therapy)
when do you not give Iv dex in meningitis
immunosuppressed
meningococcal sepsis or septic shock
following surgery
investigation for epiddyimal orchitis and mangement for young and old man
young - first void urine NAAT
old - MSSU culture
young - IM cef + 2 weeks of Po doxy
old - quinolone for 2 weeks (prostatis)
mechnasim of action of different diabetic drugs eg sulfy, dpp4 adn pioglitazone
sulfy - increase pancreatic insulin secretion
DPP4- decrease peripheral breakdown of incretins
pioglitazone - PPAR - gamma receptor agonist - reduce peripheral insulin resitance
how should amiodarone be given
Amiodarone can lead to injection site reactions. It should be preferably given through a central line, and if peripherally should be given through a large bore cannula in a large vein (e.g. antecubital fossa).
when shoudl ACEI be avoided in Heart failure
if they have valvular disease
treatment of VF
Amiodarone
what would you see on CXR during arotic dissection
widened mediastinum
swelling between the sternocleidomastoid muscle and the pharynx
brachial cyst
what is seen on ECG in hypercalcaemia
short QT
Diagnostic test fro HIV
combination tests - HIV p24 antigen and HIV antibody
REPEATED
what is kussmauls sign and what can it be used to differentiate between
rise in JVP during inspiration
diff between cardiac tmaponade and constrictive pericarditis
present in constricitve pericarditis
which has a high TIBA iron deficiency anaemia or Anaemia of chronic disease
TIBC is high in IDA,
what is mechanism of action of orlistat
pancreatic lipase inhibitor
for insulindependent diabtetic hwo often must they check their glucose in long drives
every 2 hours
if someone with suspected acromegaly has an increase IGF-1 what should be done to confirm diagnosis
OGTT and serial GH measurements
when is growth hormone therapy given
turners
Prader willi
chronic renal insufficiency before puberty
if someone has hypothyroid features with low TSH and low T4 what should be investigated and how
MRI for pituitary insufficency
example fof alpha blocker used in phaechromocytoma
phenoxybenzamine
treatment for phaeochromocytoma
alpha blocker then beta blocker
what levels are seen for impaired fasting glucose
between 6.1 and 7
what BM levels are seen for impaired glucose tolerance
between 7.8 and 11.1
what hormone are reduced in stress response
Testosterone oestrogen and insulin
most common side effect of radioiodine therapy in hyperthyroid
hypothyroid
diagnostic fasting and random glucose levels in symtomatic diabetic patient
fasting glucose greater than or equal to 7.0 mmol/l
random glucose greater than or equal to 11.1 mmol/l
what is used to stabalise th emocardium in hyperkalames
Calcium gluconate
in DKA what rate of insulin infusion is used
0.1/kg/hr
does cushing cause acidosis or alkalosis
alkalosis hypokalaemic metablic alkalosis
what is fourniers gangrene and whta diabetic drug causes it
nec fasciitis on perineum SGLT2
what diabetic drug is contraindicated in heart failure
pioglitazone
how many units of insulin are in 1 ml of standard insulin
100 units of insulin
what is the max metformin daily dose
2g
what should be checked if usure over type 1 or 2 diabetes
c-peptide and autoantibodies
ovarian tumour assoc with meigs
fibroma
what bloods must be checked in osteoporsis in a man
testosterone
an isolated rise in bilirubin in response to physiological stress is seen in
gilberts syndrome
how long before endoscopy shoudl PPI be stopped
2 weeks
what investigations should be performed before a nissen fundoplication
oesophageal pH and manometry
culture negative casues of endocarditis
coxciella burnetti
HACEK
prev. antibitoics
management of endocarditis empirically for:
1. native valve
2. MRSA, septic or pen allergic
3. prosthetic valce
native - amox (+ poss gent)
MRSA - vanc and low dose gent
presthetic - rifampicin, gent, vanc
