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med 5 > Special topics in lecture week > Flashcards

Special topics in lecture week Flashcards

1
Q

Advance care planning in end of life

A

1) Finalizing social and financial matters
2) Acute care resuscitation plan( can be used as a temp. advanced health care directive) and discussion of CPR
3) EPoA
4) Advanced health care directive(AHD)

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2
Q

PREPARED is for palliative care

A

NOT FOR BREAKING BAD NEWS

Prepare for the discussion 
Relate to the person 
Elicit patient and caregiver preferences
Provide information 
Acknowledge emotions and concerns
Realistic hope 
Encourage questions 
Document and debrief
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3
Q

Tea colour urine or coca-cola urine

A

PSGN

Supportive treatment- prognosis is really good
symptomatic management- like HTN

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4
Q

What rate control drug can be used in AF in a patient with heart failure

A

NOT beta blocker

Calcium channel blockers

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5
Q

After cardioversion during AF how long do you anticoagulant them for

A

4 weeks at least

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6
Q

Haemodynamically unstable patient with AF presents to ED. What do you do next

A

Cardioversion

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7
Q

3 most common cause of aortic stenosis

A

1) age-related progressive calcification
2) Rheumatic aoritc stenosis( in ATSI)
3) congenital bicuspid aortic valve

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8
Q

3 classically symptoms of aortic stenosis

A

Syncope
Angina
Dyspnoea(SOB)

Angina need to ddx for chest pain- not just MI

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9
Q

4 most common features of Aortic stenosis murmur

A

Ejection systolic murmur
Loudest in the aortic region(base of the heart)
Radiating to the carotids
Loss of A2(2nd heart sound)

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10
Q

Management of aortic stenosis

A

1) TAVR

2) surgical replacement of Aoritc valve

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11
Q

Urea: creatinine- Urea will be high

A

This look like an Upper GI bleed

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12
Q

Having 3-4 normal vomits first and then having a vomit is

A

Mallory Weiss tear

not oesophageal bleeding

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13
Q

Hep B tablets

A

tenofovir

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14
Q

Smudge cells in

A

CLL

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15
Q

HACEK organisms seen in

A
  • minority of IE cases
  • gram negative anaerobes common in normal human flora
  • setting of poor dentition/ periodontal infection
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16
Q

Which medication can aide in kidney stone passage?

A

Tamsulosin: alpha-1 antagonist that relaxes the ureteral muscle, decreases intraureteral pressure

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17
Q

a classic finding in ankylosing spondylitis

A

low back pain that classically improves with activity

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18
Q

Stroke score

A

NIH Stroke Scale/Score (NIHSS)

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19
Q

tPA therapeutic window for stroke

A

Time of symptom onset <4.5 hours

20
Q

SMART-COP is the best why

A

superior in predicting the need for mechanical ventilation/inotropic support

21
Q

Management of CF

A

• CF-bronchiectasis
- Chest physiotherapy, bronchodilator, pulmozyme, hypertonic saline,
antibiotics (nebulised tobramycin, azithromycin)
- Lung transplantation

• Pancreatic insufficiency

  • Nutritional supplement & vitamin supplement (ADECK)
  • Pancreatic enzyme replacement therapy (Creon)
  • Insulin replacement therapy
  • Hepatobiliary disease
  • Infertility
22
Q

Medications for CFTR

A

CFTR modulators

23
Q

Queensland pneumonia

A

Burkholderia pseudomallei

Acinetobacter baumannii

24
Q

nec fasc organisms is

A

Clostridium perfringes

25
Q

Most common virus that cause Meningitis/ encephalitis

A

Viruses: Enterovirus (most common), HSV, arbovirus

26
Q

Do not treat asymptomatic bacteriuria!!!! unless?

A

(unless undergoing elective urological procedure, or

pregnant)

27
Q

Native valve triple therapy for IE

A

BFG- big friendly giant

Native valve: Benzylpenicillin + flucloxacillin + gentamicin

28
Q

Prosthetic valve triple therapy for IE

A

Prosthetic valve: fluclox, vancomycin, gentamicin

29
Q

Medial malleolus ulcer is always….

A

Venous ulcer

30
Q

Which organisms cause bacterial vaginosis(spelt it right)

A

Gardnerella vaginalis

31
Q

What is included in the Amsel’s criteria

A

3/4

1) Presence of white/grey discharge
2) Positive whiff test
3) PH>4.5(alkaline)
4) presence of clue cells under microscopy

32
Q

BANDAID2- systolic heart failure

A

Beta blocker

ACEI

Neprilysin

Diuretics

Aldosterone-antagonist

Ivabradine

Devices(Implantable cardiac defibrillator (ICD)- prevent sudden cardiac death and Cardiac resynchronization therapy (biventricular pacemaker)- improves cardiac symptoms

Digoxin

33
Q

Chronic Management - HFrEF (EF <40%)

A
  • Treat ALL patients with HFrEF with ACE-I + Beta Blockers unless contraindications. PLUS consider aldosterone antagonist (spironolactone) in all patients.
    1. ACE or ARB- Aids in remodelling
    2. B blockers- Use long-acting- Bisoprolol-Reduces cardiac demand
    3. Diuretics - Spironolactone (aldosterone antagonist)
34
Q

Chronic compensated CHF

A

clinically compensated CHF; the patient has signs of CHF on echocardiography but is asymptomatic or symptomatic and stable

35
Q

Acute decompensated CHF

A

the sudden deterioration of CHF or new onset of severe CHF due to an acute cardiac condition (e.g., myocardial infarction)

36
Q

Management of ADHF can be remembered with “LMNOP”:

which drug is NEVER given in decompensated heart failure–> beta blockers

A

L = Lasix (furosemide), M = Morphine, N = Nitrates, O= Oxygen, P = Position (with elevated upper body).

Beta blockers must be used cautiously in decompensated heart failure!

37
Q

Noncardiogenic pulmonary edema causes

A

Noncardiogenic pulmonary edema due to

  1. ARDS
  2. pulmonary embolism(PE)
  3. transfusion-related acute lung injury
  4. high altitude
38
Q

The equation to calculate # of standard alcohol drinks

A

Amount of drink in litres (the volume of the container) x percent by volume of alcohol (%) x
0.789

39
Q

How to calculate pack-years of smoking

A

Number of pack-years = (packs smoked per day) × (years as a smoker)

40
Q

In Belly’s palsy–>

A

The whole face side of the face is affected(peripheral facial nerve palsy)

vs

in the central facial nerve palsy - there is forehead sparing

41
Q

Any geriatric patient who is inpatient needs a

A

Comprehensive geriatric assessment

42
Q

Mini-Mental State Examination (MMSE) cateogories

what is the max score possible

  • mild
  • moderate
  • severe
A 
Attention
Language
Orientation
Retention(short term) 
Recall( short term)

A maximum of 30 points is possible

LESS THAN 24–> dementia

20–24 points: mild dementia
13–20 points: moderate dementia
< 13 points: advanced dementia

43
Q

All dementia patient get what blood test and imaging

A

In all patients: screening for vitamin B12 deficiency (cobalamin) and hypothyroidism

In all patients: noncontrast head CT or MRI

44
Q

Treatment of dementia

-what is the side effect of the drug

A

Memory training

Pharmacotherapy
1 )Drugs: donepezil, rivastigmine, galantamine
Effect: Reversible cholinesterase inhibition leads to increased acetylcholine (ACh) concentration and can thus improve symptoms of some types of dementia.
Adverse side effects: (see symptoms of cholinergic crisis)

2) Memantine

In general, anticholinergic substances (e.g., tricyclic antidepressants) should be avoided, as they may lead to further deterioration in cognitive functioning!

Drugs with anticholinergic properties:

1) Tricyclic antidepressives (predominantly doxepin, amitriptyline, imipramine, and trimipramine)
2) Antipsychotics (e.g., clozapine, quetiapine)
3) First-generation antihistamines (e.g., promethazine, dimenhydrinate)

45
Q

What are the 2 categories of symptoms seen in Alzheimer’s disease

A

Cognitive and non-cognitive

med 5 (23 decks)

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