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Random Stuff for 3rd Year Exam > Specialties > Flashcards

Specialties Flashcards

1
Q

Screening for BRCA1/2

A

2 yearly from 25 to 40 then yearly from 40-50

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2
Q

Screening for HNPCC

A

2 yearly from 25 to 35, then 5 yearly from 50

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3
Q

Neurofibromatosis sy

A

Macrocephaly, short stature and noonan look

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4
Q

Tuberous sclerosis sy

A

Epilepsy, learning difficulties and skin lesions

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5
Q

Myotonic dystrophy sy

A

Cataract, muscle weakness, learning difficulties

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6
Q

Amyotrophic lateral sclerosis sy

A

Muscle weakness but cognition spaired

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7
Q

Huntingtons disease sy

A

Movement disorder

Cognitive cxhanges

Personality change

Depression

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8
Q

Scottish Medicines consortium

A

Decide what drugs to use by cost-effectiveness

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9
Q

Patient access schemes assessment group

A

Decide if expensive drugs can be used on a case by case basis

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10
Q

Area Drugs and Therapeutics Committees

A

Approve drugs for local use

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11
Q

Commision on Human Medicines

A

Regulation of drugs in UK

(part of Medicines and Healthcare Products Regulatory Agency

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12
Q

Homeopathy

A

Toxin diluted and ingested

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13
Q

Aromatherapy

A

Use of concentrated oils

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14
Q

Physiology of ageing:

  • renal
  • CVS
  • lungs
A

GFR falls

Systoilic BP increases and diastolic falls

CO falls

Vital capacity decreases

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15
Q

Comprehensive geraitric history

A

Histolic approach

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16
Q

Stress incontinence mx

A

1 - pelvic floor exercises

2 - duloxetine

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17
Q

Overflow incontinence mx

A

Alpha blocker (tamsulosin)

Anti-androgen (finasteride)

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18
Q

Urge incontinence mx

A

1 - bladder retraining

2- anti-muscurinic e.g. oxybutinin

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19
Q

Delireum assessment

A

4AT

TIME

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20
Q

Pharmacokinetics

A

What body does to drug

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21
Q

Pharmacodynamics

A

What drug does to body

22
Q

Changes in pharmacokinetics with age:

  • absorption
  • distribution
  • metabolism
  • excretion
A

Absorption - delayed onset of action

Distribution - more fat and less muscle, decreased albumin, BBB increased permeability

Metabolism - hepatic slower

Excretion - decreased clearance

23
Q

Triad of anaesthesia

A

Hyponosis

Analgesia

Relaxation (of smooth muscles)

24
Q

GA mechanism

A

Open chlorine channels to hyperpolarise GABA neurons and make less likely to fire

25
Q

Physiology changes in GA

A
  • Central
    • Depress CV centre
    • Depress respiratory centre
  • Periphery
    • Vasodilation (decreased peripheral resistance)
    • Venodilation (decreased veno return, decreased CO)
    • Paralyse cilia in lungs
26
Q

Local anaesthesia mechanism

A

Block Na channels to prevent propogation

27
Q

Risk assessment

A

ASA grading

1 - healthy

2 - mild to moderate disease

3 - severe

4 - life threatening disease

5 - morbund patient

28
Q

What medications continue as normal

A
  • Most every day ones
    • Exceptions only anti-diabetic and anti-coagulant
29
Q

5 minimum standards of monitoring

A

ECG

Oxygen sats

Blood pressure

End tidal CO2 (amount of CO2 breathing out)

Airway pressure

30
Q

Drugs for:

  • onset
  • maintanence
A

Onset - IV (fast) or inhalation (slower)

Maintain - gas or IV

31
Q

When does acute pain become chronic

32
Q

Nociceptive v neuropathic pain

A
  • Nociceptive
    • Sharp or dull, well localised
    • Obvious injury
    • Physiological
  • Neuropathic
    • Burning, numbness, pins and needles, not well localised
    • Nervous system damage
33
Q

What stimulates pain receptors

A

Prostglandins and substance P released during tissue injury

34
Q

Pain travels in what kind of nerves

35
Q

Pain ascends in what tract

A

Spinothalamic, going contralateral to thalamus

36
Q

Modulation of pain

A
  • Gate theory of pain
    • Descending pathway from brain to dorsal horn decreases painsignal
    • Rubbing, massaging or heat stimulates large Aa/AB fibres that inhibit pain signal
37
Q

Pain ladder

A
  • 1 simple
    • NSAID, paracetomol
  • 2 weak opiods
    • Codeine
    • Dihydrocodeine
    • Tramadol
  • 3 strong opiods
    • Morphine
    • Oxycodone
    • Fentanyl
38
Q

RAT approach to pain

A

Recognise

Assess severity and type

Treat

39
Q

Level 1, 2 and 3 care

A

1 - ward

2 - used to be called high dependency unit, single organ support

3 - intensive care, multiorgan support

40
Q

How much oxygen can be given on ward

A

Up to 15L/min

41
Q

How much oxygen can be given in critical care

A

Up to 70L/min, 100% oxygen

42
Q

Classification of shock

A
  • Distributive - blood going wrong place
  • Hypovolemic
  • Anaphylactic
  • Neurogenic - blood vessels abnormally dilated or pump failure
  • Cardiogenic - heart failure
43
Q

What determines SV

A

Preload, contractility and afterload

44
Q

Shock mx

A

Vasopressors - increase preload (cause venoconstriction)

Inotropes - increase contractility

Fluids

45
Q

Normal plasma osmolarity

46
Q

Dairy requirement:

  • water
  • sodium
  • potasium
A

Water 30ml/kg

Na and K 1mmol/kg

47
Q

Cell in hypertonic solution

A

Water leaks so shrinks

48
Q

Cell in hypotonic solution

A

Water enters so bursts

49
Q

Never give more than what amount of fluid per hour

A

>100ml/kg/hour

50
Q

Fluid for maintanence

A

0.18%NaCl/4% glucose/0.3%KCl

If K already >5 then dont give K

51
Q

Fluid to give for replacement

A

Plamalyte

If upper GI bleed give 0.9%NaCl with KCl

52
Q

Fluid for resuscitation

A

Plasmalyte 148/colloid/blood

Random Stuff for 3rd Year Exam (96 decks)

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