Trickies Flashcards
Cytochrome P450
- Mitochondrial proteins or in the ER.
- Involved in synthesis and breakdown of hormones.
- Major enzymes in drug metabolism; excreted and deactivated by CYP.
- Some drugs increase or decrease the activity of CYP.
CYP inhibitors
- grapefruit
- Bergamot
- St john’s wort
- Tobacco
- Valproate
- Isoniazid
- Cimetidine
- Ketoconazole
- SSRI
- Fluconazole
- Alcohol
- Chloramphenicol
- Cipro
- Erythromycin
- Amiodarone
- Omeprazole.
CYP inducers
- Carbamazepine
- Steroids
- Phenobarbital
- Phenytoin
- Rifampicin.
GCS
1) Eyes = 1-4 1 = does not open eyes 2 = open eyes to pain 3 = opens eyes to voice 4 = normal
2) Verbal = 1-5 1 = makes no sounds 2 = makes sounds 3 = words 4 = confused 5 = normal
3) Motor = 1-6 1 = make no movements 2 = extension to pain 3 = abnormal flexion away from painful stimuli 4 = withdrawal from pain 5 = localises to painful stimuli 6 = obeys commands.
MUST score
1) BMI
>20 = 0
18.5-20 = 1
<18.5 = 2
2) Unplanned weight loss in the past 3-6 months
<5% = 0
5-10% = 1
3) Patient is ill and not likely to adequately receive nutrition = 2
Low risk = 0
Medium risk = 1 (observe)
High risk = 2 0r more
Wells score
- Clinical Sx of DVT = 3
- PE most likely = 3
- HR >100 = 1.5
- Immobilization for 3 days of surgery in the previous 4 weeks = 1.5
- Previous DVT/PE = 1.5
- Haemoptysis = 1
- Malignancy = 1
PESI (PE severity index)
- age
- sex - male = 10
- Hx of cancer = 30
- HF = 10
- Chronic lung disease = 10
- HR >110 = 20
- Sys BP <100 = +30
- RR >30 = 20
- temp <36 = 20
- altered mental status = 60
- O2 saturation <90 = 20.
Frax
- Age
- sex
- BMI
- previous #
- parent # hip
- smoking
- steroids
- RA
- Osteoporosis
- Alcohol >3 units a day
- Femoral neck BMD.
CHADVASC
- Age - 65-74 = 1, >75 = 2
- Sex - female = 1
- CHF Hx - yes =1
- HTN - yes = 1
- Stroke/TIA/thrombus - yes = 2
- Vascular Hx (Mi, pvd) - yes =1
- DM - yes =1
HASBLED
1) HTN - yes =1
2) Renal disease - yes = 1
3) Liver disease - Yes =1
4) stroke Hx - yes = 1
5) prior major bleed - yes = 1
6) Labile INR - yes = 1
7) Age >65 - yes = 1
8) Medication which predispose to bleeding; NSAIDs, antiplatelet - yes = 1
9) Alcohol use >8 units/week - yes = 1.
NOF
Shortened and externally rotated leg.
When looking at a XR of a #
AABCS
- Adequacy of film
- Alignment
- Bones
- Cartilage
- Soft tissue
OLD ACID -bones
- Open vs closed
- Location, proximal, mid, distal
- Degree (complete/incomplete)
- Articular involvement
- Communion
- Intrinsic bone quality
- Displacement
Open # management
- ABCDE
- Photo
- Saline soaked gauze
- IV ABx (augmentin)
- Tenatus booster
- Analgesia
CXR interpretation
ABCDE A = airway - trachea and bronchi B = Breathing - lung fields C = Circulation - heart and aortic knuckle D = diaphragm - pnemoperitoneum E = everything else
NG tube
- Aspirate = pH <5.5 = safe to feed.
- Location check with CXR.
Pelvic XR
- 3 rings (the pelvis inlet + 2 obturator foramen)
- SI joints
- Acetabulum and lines
- Hip joint and proximal femur
Colles #
distal radius + dorsal displacement
Smiths #
Distal radius + Volar displacement.
