sunday 21st Flashcards
what would characteriscally casue loss of DCML eg vibration first
b12 deficiency
what tumour is caused by secondary hyperparathyroid
browns tumour of the bone
management of bone disease in CKD
- reduce phosphate intake
- phophate binders - calcium carbonate/sevelamar
- vit D supps
anamia in CKD predisposes to what heart pathology
lv hypertrophy
test used for proteinuria in daibetics
ACR
hypertension management in CKD
ACEI
Furosemide
examples of potassium sparing diuretics
eplerenone spironolactone
treatment of preotienuria in CKD
ACEI
SGLT-2
treatment of arotic stenosis
symptomatic = valve replacement
asymptomatic but valvular gradient > 40 mmHg and with features such as lV dysfunction then consider surgery
is fasiculations an UMN or LMN sign
LMN
how to work out serum osmolality
2x sodium + glucose+urea
what is seen in HHS - symps and findings
polyuria, polydipsia, confusion, dehydrated , lethargy, N&V
hyerglycaemia >30
serum osmol>320
hypovolaemia
complications of HHS
hyperviscosity therefor MI and stroke give VTE prophylaxis
rescue therpay for exacerbations of neuropathic pain
tramadol
criteria for liver trasnplant post paracetamol overdose
Arterial pH < 7.3, 24 hours after ingestion
or all of the following:
prothrombin time > 100 seconds
creatinine > 300 µmol/l
grade III or IV encephalopathy
management of torsades
iv mag sulphate
treatment of barrets oseophagus
high dose PPI
if dysplasia 1st line - radiofrequency ablation
Symptoms of ADPKD
loin pain
haematuria
palpable masses
HTN
recurrent UTI
renal stones
first investigation in acute limb ischaemia
handheld dopller
medications for individuals with PAD
Clopidogrel and atorvastaton
investigations for varicose veins
venous duplex ultrasound: this will demonstrate retrograde venous flow
treatment of varcisoe veins
compression stockings
endothermal ablation:
foam sclerotherapy:
surgery: ligation or stripping
management of takayasu
steroids
types of gastric adenocarcinoma and associations
intestinal - angry ulcer
diffuse - dignet ring type
tx of gatroparesis
metroclopamide - pro-kinetic
dyspahgia to both liquids and solids
achalasia
treatment of achalasia
pneumatic balloon dilatation
heller myomectomy
investigation of ahcalsia
oesophageal manometry
h.pylori type of bug e.g gram stain
gram neg curvillinear rod
screening test for latent TB
mantoux test
diagnosis of TB including first line and gold standard
CXR
Sputum smear (i.i zheils neelsen) - need 3
Sputum culture - gold standard
prophylaxis of peripheral neuropathy in wilson adn with isonizaid
pyridoxine
retinopathy is hydroxychloroquine adn ethambutol
HCQ- bulls eye retinooathy
ethambutol - opttic neurtitis
tb drugs and side effects
rifampicin - orange secretions , hepatitis
isonizaid- periph neuro
pyrazinamide 0 gout, arthralgia, heaptitis
ethambutol- optic neuritis
where doe sTB reaction generally occur in lung
apex
treatemtn of latent TB
3 months of Rifampicin and isonizaid
OR
6 month isonaizde
what is given in sus meningitis if in GP
IM Benpen
sign of raised ICP
focal neurological signs
papilloedema
continuous or uncontrolled seizures
GCS ≤ 12
when should LP be delayed in meningitis
signs of sepsis or rash
severe resp or cardio compromise
significant bleeding risk
signs of rasied ICP
management of suspected meningitis
IV access - bloods and culture
LP
IV ABX
< 3 months: cefotaxime + amoxicillin (or ampicillin)
3 months - 50 years: cefotaxime (or ceftriaxone)
> 50 years: cefotaxime (or ceftriaxone) + amoxicillin (or ampicillin) for adults
IV dexamethasone - dont give if rash/septic or <3 months
when shoudl dexamethasone be avoided in meningitis
in septic shock, meningococcal septicaemia, or if immunocompromised
prophylaxis of meningitis who its given to
ciprofloxacin or rifampicin for close contacts in the previous 7 days
how is meningitis tested for if LP contraindicated
PCR
what is seen in diff type of LP in menigitis with regards to white cells
bacteria- polymorphs
virla, Tb, fungi - lymphocytes
most common cause of bacterial meningits in over 60s
strep pneumonia
