Random Facts Flashcards
What can be given to reduce Sx of brain/spinal mets? Why?
Dexamethosone - reduces swelling around Ca
Baby has a nappy rash with central focus and satellite red lesions… likely diagnosis?
Candidiasis
What drug can be used as HRT in post-menopausal esp if they have a low mood?
Fluoxetine
General risks with HRT
Blood clots, Breast Ca
Basics cause of iron deficiency
In- diet
Absorption
Out - blood - period/gastric common
Drug for menorrhagia? What else could you consider?
Tranexamic acid
The coil
Reflux in pregnancy drug?
Omeprazol
Why is trimethoprim a CI in pregnancy ?
When else should you be careful and why?
Decreases folic acid absorption –> risk of neural tube defects.
AKI as it decreases renal function
What could be given as an alternative to trimethoprim in pregnancy?
Penicillin
What shouldn’t be given with trimethoprim and why?
Methotrexate - its a folic acid antagonist
DDs of being ‘tired all the time’
Anaemia, sleep apnea, depression/low mood, thyroid, stress/overwork, Ca
?sleep apnea - what test can you do? What do you need to do before referring to sleep studies?
Esworths sleep scale
TFT - make sure not missing hypothyroid
Rosacea. What is it? Treatment?
Flushing of the skin.
Avoid triggers (eg sunlight)
Good skin care
Metronidazole
Diagnosis of pre/diabetes ?
HbA1C 42-48 = pre diabetes
>48 + Sx (tired, drink/wee lots, infections) = diabetes
>48 but no Sx = repeat check
Who gets fasting glucose?
Women who had gestational diabetes to see if it has resolved or if they have developed diabetes
First referral for pre diabetes?
To diabetes prevention - structured lifestyle advice
What investigations for newly diagnosed diabetes?
See diabetes nurse -> education U&e / ACR - kidney function Feet - and with every review Retinopathy - screening referral Flu jab
First line treatment for diabetes? Benefit?
Metformin
Cheap , no weight gain
Side effects of metformin? Methods to avoid?
Gi - diarrhoea ->start low and titrate up / use modified release
Kidney function
How do you check kidney function with metformin ? When would you consider stopping?
GFR
<45 consider stopping
<30 stop
When would you re check hba1c with metformin?
After 3/12
2nd line treatment for diabetes. When? What?
If metformin CI
If hba1c still high -> add in
Suphonylureas (gliclazide), glyptins, flosins…
Side effects of glyclaside
Weight gain
Hypoglycaemia
Target HbA1C in diabetes ?
<48
?hypothyroid test? Cut off?
TSH >10
Treat hypothyroid? When review?
Levothyroxine - 50mg / day
Re check TSH after 6/62 -> good maintain dose and annual check
Some back pain (not bad + pregnancy), pain relief? Which not? Why?
Paracetamol
Ibuprofen -> affects ductus arteriosis closure
Pt feeling better after 3 weeks of citalopram ? What to do?
Keep them on for at least 6/12 then ween off slowly
What is a small bruise like mark on the base of a spine?
Mongolian blue spot
First line treatment for UTI
Nitrofurintoin
Resistant hypertension in hospital
Magnesium sulphate
When do you treat bronchietasis ? With what?
Always get production of sputum due to ‘little pockets’ of infection
Large amounts of sputum produced -> more infected
Doxyclyline for 14 days
Paediatric rash what important DDs
Chicken pox , measles, rubella, parvovirus
Does metformin cause a hypo? What can it cause?
No
Common is diarrhoea but important is lactic acidosis
-> need to stop in AKI /kidney jury
Characteristic presentation of Kawasaki disease
High temp >5 days with: Rash swollen glands in neck Dry cracked lips Red fingers / toes Red eyes
DDs of Kawasaki
Scarlet fever, measles, glandular fever, viral meningitis, Stevens Johnson syndrom, lupus, toxic shock syndrome
Investigations for kawasaki
urine - see if WBC
Bloods
Lumpar puncture
Usual place affected by complications of kawasaki
Heart
Tachycardia, pericardial effusion, myocarditis
Causative organism for kawasaki
unknown
Treatment for kawasaki
asprin, IV Ig, fluids
After treatment of kawasaki
Low dose aspirin,
Echocardiogram to confirm no cardiac abnormalities
Peeling of skin may occur until 4 weeks after start of disease
Why is aspirin not usually prescribed in children
risk of reye’s syndrome
Usual age for kawasaki
72% <5yr
When do you usually get Reye’s syndrome? What are the initial Sx?
A few days after a viral infection Eg flu, chicken pox
Vommiting, tiredness / lack of enthusiasm, tachypnea, seizures
Reye’s syndrome later Sx
irritability, severe anxiety (sometimes with hallucinations), Coma
Basic pathophysiology in Reye’s
Mitochondria become damaged
Which organs most serious affected in Reye’s
Liver, Brain
What happens with liver damage in Reye’s
Build up of toxic chemicals in blood -> brain swelling
DDs of Reye’s
Meningitis, encephalitis, inherited metabolic disorders
Investigations in Reye’s
Blood tests - esp bacteria + LFTs
CT Scan - brain swelling
Lumbar puncture
Liver biopsy
Management in Reye’s
Electrolytes and fluids
Diuretics - reduce brain swelling
Ammonia detoxicants
anticonvulsants
Most common cause of sight loss? Type of vision
Age related macular degeneration
Central vision loss
Type of vision in glaucoma
Tunnel
Treatment for benign idiopathic cranial hypertension
Acetazolamide
