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Y3 Medicine > Random 7 > Flashcards

Random 7 Flashcards

1
Q

What two additional measures can we use to estimate GFR?

A

Chromium 51 and EDTA

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2
Q

What does an egfr <60 tell you?

A

Chronic kidney disease

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3
Q

What are some examples of post-renal AKI?

A
  • Enlarged prostate
  • Cancer
  • Kidney stone
  • Strictures
  • Pus/blood clots
  • Retroperitoneal fibrosis (actually encases the ureters so CT scan not ultrasound)
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4
Q

What type of tumor is found in the ureter?

A

Transitional cell

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5
Q

What is the immediate action for post-renal AKI?

A

Imaging! Ultrasound

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6
Q

What causes HUS?

A

The majority of HUS cases are caused by infection with certain strains of Escherichia coli (E. coli) bacteria, particularly the strain known as E. coli O157:H7.

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7
Q

What are some causes of pre-renal AKI?

A
  • Sepsis
  • Heart failure
  • GI vomiting/diarrhoea
  • Shock, hemorrhage
  • Fracture
  • Burns
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8
Q

What is the immediate action of pre-renal AKI?

A

Fluids!

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9
Q

What are some causes of renal AKI?

A
  • Acute tubular necrosis
  • Glomerulonehpritis
  • Vascular
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10
Q

What is the immediate action of renal AKI?

A

Urine dip

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11
Q

How do you check fluid status? (not how much fluid has been given or peed out)

A
  • JVP
  • Oedema
  • Weight
  • Skin turgor
  • Mucus membranes
  • Pulmonary oedema
  • Fontanelle pressure (peds)
  • Lying and standing blood pressure
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12
Q

What medication do you give for trigeminal neuralgia?

A

Carbamazepine

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13
Q

What is an important investigation to do in a patient with ehlers-danlos?

A

Echo for aortic root dilation

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14
Q

How do you diagnose SLE and what mnemonic can you use to help?

A

4/11 criteria have to be present

A RASH POINTS AN MD

Arthritis
Renal disorder
ANA
Serositis
Haematological
Photosensitivity
Oral ulcers
Immunological disorders
Neurological disorders
Malar
Discoid rash

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15
Q

What particular weakness is present in polymyalgia rheumatica?

A

Proximal weakness for example brushing hair or getting out of the chair

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16
Q

What are side effects of corticosteroids?

A

CORTICOSTEROIDS (mnemonic)

Cushing’s
Osteoporosis
Retardation of growth
Thinning of skin
Immunosuppression
Cataracts and glaucoma
Oedema

Suppression of the immune system
Teratogenic
Emotional disturbances
Raised blood pressure and right and left heart failure
Obesity
Increased body hair growth
Diabetes
Striae

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17
Q

What are some symptoms/signs of GPA?

A
  • Otitis media
  • Sensoneurial loss
  • Epistaxis
  • Facial pain
  • Oral ulceration
  • Stridor
  • Scleritis
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18
Q

What three rheumatological conditions are more common in men?

A
  • Gout
  • Ankylosing spondylitis
  • GPA
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19
Q

What is the pulse like in Takasayu arteritis?

A

Absent

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20
Q

What is ESR and it’s significance?

A

ESR stands for Erythrocyte Sedimentation Rate. It is a blood test that measures how quickly red blood cells settle at the bottom of a tube in an hour’s time

When there is inflammation in the body, certain proteins (acute-phase reactants) cause red blood cells to clump together and settle more quickly.

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21
Q

What specific antibodies are associated with SLE?

A

Anti-Smith antibodies, also known as anti-Sm antibodies, are specific antibodies that are often associated with systemic lupus erythematosus (SLE)

22
Q

What drugs can induce SLE?

A
  • Isoniazid
  • Hydralazine
  • Quinidine

It is associated with anti-histone antibodies

23
Q

What are features of severe flares of SLE?

A
  • Nephritis
  • Haemolytic anaemia
  • Severe pericarditis
  • CNS disease
24
Q

How should you treat an acute flare up of SLE?

A

Cyclophosphamide and high dose prednisolone

25
Q

What is Sodium zirconium cyclosilicate, marketed under the brand name Lokelma

A

Used to treat hyperkalaemia. It secretes potassium from the body.

26
Q

What is Lercanidipine?

A

Lercanidipine is a dihydropyridine calcium-channel blocker used to treat hypertension.

27
Q

What are some differentials for postural hypotension?

A
  • Dehydration
  • Addison’s disease
  • Parkinson’s disease
  • Medications (antihypertensives, diuretics, alpha blockers, and some antidepressants)
  • Anaemia
  • Bradycardia, valve pathologies
28
Q

What is Pregabalin used for and how does it work?

A

Used for seizures and anxiety

Pregabalin binds to the alpha2-delta site of voltage-gated calcium channels in the central nervous system (CNS) tissues. This calcium channel modulation may reduce the release of many neurotransmitters.

29
Q

What is Prochlorperazine used for and how does it work?

A

Used for Schizophrenia and anxiety

As a first-generation antipsychotic, prochlorperazine mainly blocks D2 dopamine receptors in the brain.

30
Q

What is Methyldopa used for and how does it work?

A

Used for hypertension

Alpha agonist

31
Q

What is Betahistine used for and how does it work?

A

Used for Menieres disease

H3 antagonist. Improves blood flow to the ear

32
Q

What is Carvedilol and how does it work?

A

Used for hypertension and angina

Beta blocker

33
Q

What lung emergency should you always think about in asthma patients?

A

Pneumothorax

34
Q

What are the four things that cause pulmonary oedema?

A
  1. Increase in LA pressure
  2. Increase in pre-load
  3. Decrease in oncotic pressure
  4. Endothelial injury
35
Q

If someone has been ventilated for more than 3 days, what should you do to prevent pulmonary oedema?

A

NG tube straight away to keep oncotic pressure up.

36
Q

What is released in surgery/trauma that keeps your blood pressure high?

A

ADH

37
Q

What are the 10 things that increase LA pressure that leads to pulmonary oedema?

A
  1. Diastolic failure
  2. Hypertension
  3. Left ventricular systolic failure
  4. Aortic stenosis
  5. Mitral regurgitation
  6. Aortic regurgitation
  7. Mitral stenosis
  8. Restrictive cardiomyopathy
  9. Myoxoma
  10. Atrial fibrillation
38
Q

What is the cause of mitral regurgitation?

A

Infective endocarditis. Papillary muscle damage means chordae tendinae don’t hold up the mitral valve.

39
Q

What is Barlow syndrome?

A

Mitral valve prolapse, also known as click-murmur syndrome, Barlow’s syndrome, balloon mitral valve, or floppy valve syndrome, is the bulging of one or both of the mitral valve flaps (leaflets) into the left atrium during the contraction of the heart.

40
Q

What happens to a pregnant woman with mitral stenosis.

A

She will die

41
Q

What causes restrictive cardiomyopathy?

A
  • Haemochromatosis
  • Sarcoidosis granuloma
  • Amyloid
  • Lurfur’s eosinophilic
  • B cell lymphoma
42
Q

What are causes of secondary hypertension?

A
  • Phaechromocytoma
  • Cushing
  • Conn’s
  • Coarctation of the aorta
43
Q

What is the difference between type A and type B aortic dissection?

A

Type A involves the ascending aorta and type B involves the descending aorta.

44
Q

What should you do with an atrial myoxoma?

A

Operate the next day.
Fragile and thrombogenic, rare but can cause an ischaemic limb if you get an embolus.

45
Q

What is the procedure used to treat an aortic stenosis?

A

TAVI
TAVI stands for Transcatheter Aortic Valve Implantation. It is a minimally invasive procedure used to treat aortic stenosis

46
Q

What is malignant hypertension?

A

Severe elevation of arterial blood pressure leading to end-organ damage.

47
Q

What causes malignant hypertension and how do you treat it?

A

Uncontrolled hypertension, phaechromocytoma, genetic factors

Gradual blood pressure reduction to about 160/100mmHg over 24 hours.
Oral medication (e.g., amlodipine or nifedipine) preferred unless complications like encephalopathy, heart failure, or aortic dissection are present.

48
Q

What signs will you see if a patient has LVSF- pulmonary oedema

A
  • Accessory muscles in use, tripodding on the bed
  • HR increases
  • BP increases
  • Pale
  • Clammy
  • Very distressed
49
Q

How do you treat LVSF

A
  1. O2 60% high flow
  2. Very strong vasodilators like diamorphine or morphine
  3. Cyclizine and Metoclopramide
  4. IV furosemide
    5.Nitrates- GTN infusion
  5. CPAP
50
Q

What contra-indications are there to vasodilation if a patient has LVSF?

A

Aortic stenosis. If you vasodilate you will kill them.

Y3 Medicine (17 decks)

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