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MBBS > TONKA TRUCK > Flashcards

TONKA TRUCK Flashcards

1
Q

For a rhythm arising above a functional AV node, the rate is limited to ___bpm

A

150bpm

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2
Q

Usual rate for rhythms originating in the AV node?

A

140-220

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3
Q

What is the limit for the rate of ventricular originating rhythms?

A

THERE IS NO LIMIT

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4
Q

MoA of DIgoxin?

A

Inhibits NaKATPase, increases refractory period, slow conduction through AV node

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5
Q

Lignocaine Route of administration and considerations/side effects

A

IV only for arrhythmias
pro-arrythmogenic
tremor, confusion, seizures

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6
Q

Amiodarone side effects?

A

Thyroid (hyper or hypo)
Interstitial lung disease
corneal microdeposits
skin discolouration (blue/grey - light sensitive)

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7
Q

Criteria for capacity?

A

Understand, retain and believe information, then weight that information foreseeing consequences and balancing risks.

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8
Q

Age when kids can consent to medical treatment as adults?

A

16

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9
Q

Criteria for emergency treatment without consent?

A

1) Patient incapable of consenting
2) Treatment will prevent imminent risk to life or health, supported by another medical practitioner in writing
3) Patient has not refused treatment to the best of the practitioners knowledge

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10
Q

Which drug needs to be administered with Levodopa and why?

A

A peripheral dopa decarboxylase inhibitor (carbidopa)
Because dopamine can’t cross the BBB, the prodrug levodopa is given, the DDC inhibitor cannot cross the BBB so prevents activation of dopamine outside the CNS

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11
Q

Indications for dopamine agonists in Parkinson’s?

A

Younger patients - L-dopa sparing
Late stage disease in combination with L-dopa
(longer duration than L-dopa)

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12
Q

How to treat nausea in Parkinson’s?

A

Dopamine antagonist that doesn’t cross the BBB (e.g. domperidone)

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13
Q

Mechanisms of anti-Parkinsonian drugs? (4)

A 
Replace dopamine (Levodopa)
agonise dopamine receptors (D2 agonists - Cabergoline, bromocriptine)
Delay dopamine breakdown (COMT inhibitor - entacapone, Monoamine oxidase B inhibitors - Selegiline)
Inhibit acetylcholine (Anti-cholinergics - benztropine)
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14
Q

Non-motor symptoms of Parkinsons?

A 
Orthostatic hypotension
Constipation
Neurogenic bladder
Sexual dysfunction
Depression
Dementia
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15
Q

Problems late in parkinson’s treatment?

A

Wearing off, freezing

On-off motor fluctuations

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16
Q

Treatment of Parkinson’s disease no longer controlled on L-dopa/carbidopa?

A

More frequent dosing, longer acting formulations
Add COMT inhibitor, anti-cholinergic
Deep brain stimulation

17
Q

Prevalence of epilepsy?

A

1 in 150

18
Q

Consequences of Status epilepticus?

A 
Hypoxia
Hypercapnoea
Acidosis
Brain damage
Death
19
Q

Features of Absence seizure?

A

Lack of awareness to surroundings, blinking maintained
usually lasts <10seconds
No post-ictal changes

20
Q

Why is it important to determine whether a seizure had a focal onset?

A

High likelihood of a focal brain lesion

- abscess, tumour, AVM, stroke

21
Q

Drugs which lower the seizure threshold?

A

TCAs, Quinolones, Lithium, ecstasy, cocaine, amphetamines

22
Q

Drugs for generalized seizures

A

First line: Carbemazepine, Sodium Valproate

Second line: Lamotrigine, Phenytoin

23
Q

Drugs for partial/focal seizures

A

First line: carbemazepine

Second line: Sodium Valproate, phenytoin, lamotrigine, gabapentin

24
Q

Drugs for absence seizures

A

First line: Sodium Valproate, ethosuxamide

25
Q

Mechanism of anticonvulsants?

A

Sodium channel blockade: Carbemazepine, Lamotrigine, Phenytoin, Sodium Valproate
Increased GABA concentration; Gabapentin.
Increased activity of GABA; Benzodiazepines

26
Q

Side effects of Phenytoin

A

Ataxia, Gum hypertrophy, hirsuitism, acne

27
Q

Side effects of carbemazepine

A

Ataxia, lethargy, SIADH, hepatotoxicity, aplastic anaemia

28
Q

Side effects of Sodium Valproate

A

Weight gain, hair loss, severe hepatotoxicity in children

29
Q

Side effects of Lamotrigine

A

Ataxia, diplopia, drowsiness, Stevens-Johnson Syndrome

30
Q

Side effects of Gabapentin

A

sedation, tremor, amnesia

31
Q

Anticonvulsants which are enzyme inducers

A

Carbemazepine, Phenytoin

32
Q

Anticonvulsants which are enzyme inhibitors

A

Sodium valproate

MBBS (13 decks)

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