Vol 3 Flashcards by Jack Wildman

What is normal urine output? (Range)

1ml/kg/hour - between 0.5-2

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What goes in the grey blood bottle?

Glucose

Lactate

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Below what urine output should an AKI be considered?

<0.5ml/kg/hour

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DANISH PT of cerebellar dysfunction?

Dysdiadochokinesia
Ataxia
Nystagmus
Intention tremor
Speech (slurring/scanning)
Hypotonia
Past pointing
Tremor at rest

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What is Kernig’s sign?

Meningism

Flex hip and knee to 90 degrees, subsequent extension is painful

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What are the 6 intrinsic features of benzodiazepines?

Anxiolytic
Anterograde amnesic
Antiemetic
Anticonvulsant
Sedative
Muscle relaxant

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3 diagnostic criteria for AKI?

Serum creatinine rise of >26micromol/L in 48 hours
Serum creatinine rise by 50% in 7 days
Urine output falls 6 hours

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Main causes of a normovolaemic hyponatraemia?

Someone who’s had D+V then water

Diuretics or ACEi

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Causes of hyponatraemia + dehydration?

Addison’s disease

Diarrhoea

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4 causes of hyperkalaemia?

Addison’s disease
Kidney failure
K+ sparing diuretics and ACEi

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If someone takes in 2L of water in 24 hours, what is their expected urine output over 24 hours?

800ml-2L

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What are polyuria, oliguria and anuria?

Polyuria >3L
Oliguria <50ml
(all in 24 hours)

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Medical management of migraines?

Paracetamol and NSAIDs
B blockers
Triptans (5-HT)
Anti-emetics

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What medications are given for status migrainosus?

Ergotamines

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What is exenatide?

A GLP-1 agonist

Adjunct for glycaemic control in DM2

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What is Brudzinski’s sign?

Meningism

Passive flexion of hip causes reflex flexion of contralateral hip

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What goes in the yellow blood bottle?

Biochemistry

Us and Es, LFTs, CRP, amylase, bone profile, thyroid, Trop/CK, vitamins

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What goes in the pink blood bottle?

Group and save

Cross match

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What product is in blood bottles to prevent clotting for analysis of the blood cells present?

EDTA

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What is the Reiter’s syndrome triad?

Can’t see (uveitis, conjunctivitis)
Can’t pee (circinate balanitis, urethritis)
Can’t climb a tree (plantar fasciitis, keratoderma blenorrhagica)

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What goes in the purple blood bottle?

Blood stuff - FBC, WCC, ESR, HbA1C, blood films (spherocytosis, malaria)

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What is a fibroadenoma?

Breast mice
Smooth, rubbery, mobile
Typically younger women

5 major complications of Cushing’s Syndrome?

DM2 
Hypertension
Weight gain 
Immunosuppression
Osteoporosis

What are irritative LUTS? (5)

Frequency
Urge incontinence
Hesitance 
Dysuria
Nocturia

4 indications for catheterisation?

Immobility Incontinence Needing to monitor UO (sepsis, AKI) Relieve acute urinary retention

What findings on exam indicate breast cancer?

Solid, irregular mass that is fixed in place | Dimpling on surface, nipple changes, peau d'orange

What are obstructive LUTS?

``` Weak flow Hesitancy Intermittency Dribbling Overflow incontinence Incomplete voiding ```

How does the dexamethasone suppression test for Cushing's work?

Give dexamethasone overnight - cortisol should be low in the morning. If not = Cushing's syndrome Then look at ACTH levels - if high = disease

What findings are suggestive of fibrocystic changes on breast exam?

Typically UO quadrant, often bilateral Firm and rubbery, mobile Often cyclical and related to menstrual cycle

What findings on exam are suggestive of breast abscess?

Red, swollen, hot and painful. May have systemic signs. | Often breastfeeding

What is the genetic background link to ankylosing spondylitis?

HLA B27

What is the course of ankylosing spondylitis?

Inflammatory LBP and sacroiliacitis | Disc fusion and syndesmophytes

What bloods are useful in diagnosing rheumatoid arthritis?

(Rheumatoid factor, CRP/ESR) | AntiCCP

What investigations are done via the light blue blood bottle?

Coag screen - PT (INR), APTT, fibrinogen, D dimer

What product is present in the light blue blood bottle?

Sodium citrate

What findings on exam suggest fat necrosis in breast?

Often history of trauma, may cause dimpling and inflammatory signs

What conditions are aminosalicylates used for? Examples?

Ulcerative colitis 5-ASA (mesalazine) Sulfasalazine

What is characteristic of type 2 respiratory failure?

Raised CO2, V is wrong with V/Q (damage to lungs or respiratory drive)

5 causes of type 2 respiratory failure?

``` COPD Asthma Neuromuscular dysfunction Brainstem lesion Chest wall deformities ```

What is an alternative name for collapsing pulse and what is it characteristic of?

Watsons waterhammer pulse | Hyperdynamic circulation - aortic regurge

What are the main causes of oedema with hyponatraemia? | Think transudative pleural effusion but with systemic capillaries

Congestive heart failure Liver failure Nephrotic syndrome

What is Charcot's Triad for acute cholangitis?

Jaundice, fever and RUQ pain

What is McBurney's point and what is its clinical significance?

Point where appendicitis tenderness eventually localises to after migrating from middle Located 2/3 laterally between umbilicus and right ASIS

What is the sepsis six?

``` High flow O2 IVT IV antibiotics Lactate and FBC Blood cultures Catheter to monitor UO ```

What is donepezil?

Achesterase inhibitor for Alzheimer's dementia

What ECG findings are suggestive of ischaemia?

ST elevation and/or reciprocal depression T wave changes Poor PR progression through chest leads Pathological Q waves

What is Cullen's sign?

Periumbilical ecchymosis - acute pancreatitis

What is Rovsing's sign?

Pushing LLQ elicits pain in RLQ - acute appendicitis

What is Kehr's sign?

Ruptured spleen -> L shoulder tip pain

Normal medical treatment for UTIs?

Trimethoprim for 3 days | Alternatively sulfamethoxazole/ TMP-SMX

Medical treatments for severe UTIs?

IV tazocin, amoxicillin or co-amoxyclav

What is Grey-Turners sign?

Acute pancreatitis causing flank ecchymosis

What is Troisier's sign?

Gastric cancer - Virchow's node lymphadenopathy (left subclavian region)