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Y3 Medicine > Random 8 > Flashcards

Random 8 Flashcards

1
Q

What should you always be sure of when you are listening to murmurs?

A

Mention carotids and does it change on position?

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2
Q

What scale of consciousness should you use in an emergency?

A

ACVPU

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3
Q

What does ACVPU stand for?

A

Alert
Confusion (New)
Voice- responds to verbal stimulus
Pain
Unresponsive

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4
Q

What mnemonic can you use for the D section of the A-E assessment?

A

GATE
Glucose
ACVPU
Temp
Eyes

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5
Q

How do you remember indications for urinary catheter?

A

HOUDINI

Haematuria
Obstructed
Urological surgery
Decubitus ulcers (bed sores)
Input/output monitoring
Not for resuscitation
Immobility due to physical restraints

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6
Q

What score do you use to monitor cannulas?

A

VIP
Visual infusion phlebitis

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7
Q

What is the difference between being c.diff positive and c.diff toxin positive?

A

If you are just c.diff positive, this could be a normal commensal in the gut found in stool

If you are toxin positive, indicates damage to the gastrointestinal lining causing vomiting/diarrhoea etc.

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8
Q

What is the treatment for C.diff infection?

A

Oral vancomycin

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9
Q

What is the main cause of infective endocarditis?

A

IV drug usage

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10
Q

What is Pseudomembranous colitis?

A

The stage before a toxic megacolon. Looks like thumb printing on an abdominal X ray.

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11
Q

What are signs of SVT on an ECG?

A
  • No P waves
  • Tachycardia
  • narrow QRS waves
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12
Q

How do you treat SVT?

A

3m of Adenosine

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13
Q

What waves are seen in Wolf-Parkinson White?

A

Delta waves

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14
Q

How do you collect group and saves?

A

You need two (pink bottles) before you can cross-match. They need to be from different sites, half an hour apart.

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15
Q

What is a general rule for starting IV antibiotics?

A

If CRP is >100

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16
Q

What score on the CURB-65 would make you think about admission to ITU?

A

3

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17
Q

What do the pupils look like in an opiate overdose?

A

Pinpoint

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18
Q

What is pulmonary rehabilitation?

A

PR is an exercise and education programme designed for people with lung disease who experience symptoms of breathlessness. Part of the NHS long term plan.

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19
Q

Who is pulmonary rehabilitation targeted to?

A

Mainly patients with COPD, can also be bronchiectasis and pulmonary fibrosis.

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20
Q

What is involved in pulmonary rehabilitaiton?

A

Physical exercise (to strengthen respiratory muscles and lung capacity)

Education, breathing techniques

Psycholocial support

Nutritional advice

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21
Q

Apart from pulmonary rehabilitation, what are other non-pharmacological methods to treat chronic lung diseases?

A
  • Oxygen therapy
  • Nutritional support
  • Airway clearance techniques (chest physiotherapy)
  • Breathing techniques (purse lip breathing and diaphragmatic breathing)
  • Flu and pneumonia vaccines
22
Q

What is cor pulmonale?

A

Cor pulmonale is right heart failure secondary to chronic pulmonary arterial hypertension

23
Q

How does COPD cause Cor pulmonale?

A

Chronic inflammation and destruction of lung tissue in COPD can cause pulmonary arteries to constrict and become narrower.

This increases resistance in the pulmonary artery

24
Q

Describe in detail exercise in pulmonary rehabilitation?

A

6-8 week course
Hospital or community basis
2 supervised sessions/week
1 unsupervised/week

25
Q

How does chronic inflammation and destruction of lung tissue cause pulmonary arteries to constrict?

A
  1. Hypoxic vasoconstriction
  2. Endothelial dysfunction
  3. Smooth muscle cell proliferation
  4. Fibrosis and remodelling
26
Q

What comes under patient education in chronic lung disease?

A
  • Adherence
  • Inhaler technique
  • Trigger avoidance
  • Self-management plans
27
Q

What is included in a self-management plan?

A
  • Learn about your condition
  • How you can manage it well
  • What to do if you have an acute flare up of your symptoms.
  • Monitoring flare ups, symptoms, mood etc.
28
Q

Why is self-management important?

A

When you have a long-term condition, you might sometimes feel
you don’t have control over your health, your life and what happens
to you.
Self-managing your condition – with support from others – helps
to give you control. It helps to know all about your condition, your
symptoms, your medication and how to cope with flare-ups. It
also makes your day-to-day life easier and could reduce the risk of
needing to go into hospital.

29
Q

How do you define acute respiratory failure?

A

Acute respiratory failure is a sudden onset life-threatening condition that results in abnormally low oxygen levels (hypoxia) or abnormally high carbon dioxide (CO2) levels (hypercapnia) in the blood.

30
Q

What are symptoms/signs of acute respiratory failure?

A
  • Tachycardia
  • Tachyphnea
  • Dyspnea
  • Cyanosis
  • Wheezing
31
Q

What level of glucose is classed as hypoglycemia?

A

<4mmol/L

32
Q

Discuss the pain management ladder

A

Google

33
Q

What is necrotising fasciitis?

A

Necrotising fasciitis is a severe, life-threatening infection involving the subcutaneous tissue and fascial planes, typically caused by toxin-producing bacteria.

34
Q

What are normal (fasting) glucose levels?

A

4-6mmol/L

35
Q

What is cross-matching blood?

A

Is done before a blood transfusion to ensure that the donor’s blood is compatible with the recipient’s blood.

During cross-matching, a sample of the recipient’s blood is mixed with a sample of the donor’s blood in a test tube. The compatibility is determined by observing whether there is agglutination (clumping) or hemolysis (destruction of red blood cells). If agglutination or hemolysis occurs, it indicates an incompatible match, and the transfusion cannot proceed with that particular donor’s blood.

36
Q

How do you grade diabetic foot ulcers with Wagner’s classification?

A

Grade 0: Pre- or post-ulcerative site (epithelialized wound) Grade 1: Superficial wound, not involving tendon, capsule, or bone. Grade 2: Wound is penetrating to tendon or capsule. Grade 3: Wound is penetrating bone or joint.

37
Q

What are some differences between venous and arterial ulcers?

A

Google

38
Q

Explain charcot’s foot development

A
  • Loss of sensation due to peripheral neuropathy, ischaemia due to peripheral arterial disease and microvascular disease; and immunosuppression due to poor glycemic control
  • Patients continue to weight bear exacerbating the problem
  • This leads to progressive destruction of the bones, joints and soft tissues.
39
Q

What is debridement surgery?

A

Debridement surgery is a medical procedure in which damaged, infected, or dead tissue is removed from a wound or injury site. The term “debridement” comes from the French word “débrider,” which means “to unbridle” or “to remove a bridle.”

40
Q

What medications can you use to treat diabetic foot ulcer?

A
  • Vancomycin
  • Metronidazole
  • Ceftazidime
41
Q

What is cardiac autonomic neuropathy and how can diabetes lead to it?

A

Damage to the vagus and cardiac and cardiac sympathetic nerves.

Causes orthostatic hypotension, resting tachycardia and a reduced exercise tolerance.

Diabetes can lead to cardiac autonomic neuropathy (CAN) due to the prolonged exposure of nerves to high levels of glucose in the bloodstream.

42
Q

What is the danger of CAN?

A

Cardiac autonomic neuropathy

Means patients can’t feel the normal symptoms of a heart attack.

43
Q

What are the 6ps of ischaemia?

A
  • Pallor
  • Perishing cold
  • Parasthesia
  • Paralysis
  • Pulselessness
  • Pain
44
Q

What are some drugs that can cause a high blood sugar level?

A
  • Levothyroxine
  • Anti-retrovirals for HIV
  • Anti-psychotics
  • Corticosteroids
45
Q

What are osmotic symptoms for T2DM?

A
  • Polyurea
  • Polydypsia
  • Weight loss and fatigue are usually absent
46
Q

What are other endocrinopathies that can cause T2DM?

A
  • Cushing’s
  • Acromegaly
  • Pheochromocytoma
  • Thyrotoxicosis
  • Glaucoma
47
Q

What are signs of insulin resitance?

A
  • Central obesity
  • Acanthosis nigricans
  • Hyperandrogenism in females
48
Q

What are investigations for T2DM?

A
  • HBA1c
  • Renal, liver, thyroid and lipid profile
  • B-cell antibodies, anti-GAD, anti-islet cell
  • C-peptide
49
Q

What has a stronger genetic linkage T1DM or T2DM?

A

T2DM

50
Q

What is the weight loss goal for someone with T2DM?

A

10% each year. Decrease calories by 600 each day.

Y3 Medicine (17 decks)

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