wc 30/12 Flashcards by Aaska Banthiya

how do calcium levels differ in acute vs chronic CKD

if chronic they are low (due to low vit D)

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how is diabetic nephropathy screened for annual

morning urine albumin: creatinine

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causes of normal anion gap metab acidosis

ABCD

addisons
bicarb loss (diarrhoea)
chloride
drugs

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what cause of nephrotic syndrome is associated with malignancy

membranous nephropathy

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normal anion gap

10-18

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what degree of stenosis is carotid endarterectomy considered

> 50%

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within what timeframe of stroke onset can fibrinolysis be given

4.5 hrs

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within what timeframe of stroke can thrombectomy be done

6 hrs

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how does ulnar nerve lesion affect hand movements and muscles

weakness of finger abduction
weakness of finger adduction
wasting of thenar eminence

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how does median nerve lesion affect hand movements and muscles

weakness of wrist flexion
inability to pronate arm and wrist
loss of sensation of lateral 3.5 digits

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how does radial nerve lesion affect hand movements and muscles

wrist drop (inability to extend wrist)

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to diagnose rhabdomyolysis how much should CK be raised

5x normal

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increase in creatinine for AKI

50% in past 7 days
>26 in past 48 hrs

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how long does it take an AV fistula to develop

6-8 weeks

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how to differentiate brain abscess from meningitis

neurology is likely to be focal in abscess

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cushings triad

bradycardia
irregular breathing
wide pulse pressure

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common peroneal nerve injury causes

foot drop
weakness of foot dorsiflexion
weakness of foot eversion

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colles fracture causes injury to what nerve

median

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what artery is affected by atherosclerosis causing amaurosis fugax

internal carotid

it will be ipsilateral to the visual loss

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where is the lesion in a homonymous hemianopia

the contrateral optic radiation or occipital cortex

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where is the lesion in an isolated hemianopia

the contralateral optic tract

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adult asthma guidelines

start low dose ICS and SABA
if v symptomatic start with MART
add low dose MART
moderate dose MART
measure FeNO and eosinophils
if high refer to specialist
if normal start LAMA or LTRA in addition to mod dose MART
if not controlled try the other one out of LAMA or LTRA
refer to specialist

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first line diagnostic tests for asthma

FeNO or eosinophils

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allergic bronchopulmonary aspergillosis mx

oral prednisolone

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FVC in pulmonary fibrosis

decreased

infective exacerbation of COPD abx

amox or doxy or clarith

when is PPI given in GI bleed

after endoscopy

whats given before procedure in a variceal bleed

terlipressin and abx

what blood test determines severity of c diff

WCC

what is pulses paradoxus and what cause it

drop in bp by 10mmhg on inspirationw

what is seen on barium enema in UC

leadpipe colon= loss of haustra

what is leadpipe colon

loss of haustra

plummer vinson syndrome triad

IDA dysphagia atrophic glossitis

diagnostic ix for pancreatic cancer

high resolution CT

sx acute mesenteric ischaemia

sudden onset abdo pain blood in stools rf increasing clotting

first line ix for acute mesenteric ischaemia

lactate- will be raised

what is nissen fundoplication and whats it done for

chronic GORD- involves tightening of the lower oesophageal sphincter

what antiemetic is avoided in bowel obstruction

metaclopramide

loperamide moa

acts on opiod receptors to slow gut movements

what is intestinal angina

chronic mesenteric ischaemia sx include pain after eating, weight loss and an abdominla bruit

what does TIPs procedure connect

hepatic vein to portal vein

metaclopramide acts on what receptors

dopamine D2

statin primary and secondary prevention dose

primary= 20mg secondary= 80mg

mx if someone has a massive PE and hypotension

thrombolyse

r waves in what leads in inferior MI

V1-V2

fondaparinux moa

activates antithrombin III

most common organism causing infective endocarditis after valve replacement

staph epidermis

how is carotid artery stenosis diagnosed

duplex ultrasound

what oxygen therapy is used for OSA

biPAP

how is insulin given to newly diagnosed T1DM

twice daily basal insulin bolus insulin with meals

how to differentiate BPH and prostate cancer on examination

cancer= irregular prostate and blood in urine BPH= even enlargement

is CT KUB usually done with or without contrast

without

what should be checked for all men with erectile dysfunction

testosterone

BPH first line medication and moa

tamsulosin alpha 1 antagonist

what type of cancer is prostate cancer most commonly

adenocarcinoma

in staghorn calculus UTI what is the common causative organism

proteus mirabilis

after ultrasound what imaging is used to confirm a kidney stone

non contrats CT

what size stone is percutaneous nephrolithotomy indicated

>20mm

what size stone is shock wave lithotripsy done

>5mm <20 mm

what kidney stones are radio lucent

xanthine urate

what kidney stones are semi opaque

cystine

most common organic cause of erectile dysfunction

vascular

what class of drugs are used for overactive bladder, given an example

antimuscarinic oxybutynin

first line ix for suspected prostate cancer

multiparametric MRI

what ix is gold standard for suspected bladder cancer

cystoscopy

reed stenberg cells

hodgkins lymphoma

in what differential for AKI and haemoptysis do you get sinusitis

granulomatosis with polyangitis

VT drug therapy

amiodarone lidocaine- not in LV impairment

what suggests cholangiocarcinoma

painless jaundice and a palpable gallbladder

what nerve is at risk in neck of humerus fracture

axillary

what drug is given for symptoms of gastric paresis in T1DM

metaclopramide

what type of renal cancer is most common

renal cell carcinoma

what nerve is responsible for the cremasteric reflex

genitofemoral

how are stones that are >5mm and <20mm removed in pregnant women

ureteroscopy

if diclofenac cant be given in renal stones what should be given instead

IV paracetamol

normal post void residual volume <65 and >65

<65= 50ml >65= 100ml

what is seen on ECG in cardiac tamponade

electrical alternans- the QRS complexes alternate in height as the heart swings in a fluid filled sac

in infective endocarditis do you prioritise giving abx or blood cultures

blood cultures if the patient is haemodynamically stable- complete taking them then start abx

what is the definitive mx for biliary colic

elective lap chole

what does apple core on barium swallow indicate

oesophageal cancer

AAA screening programme

men aged over 65 yrs get a single US

what type of shoulder dislocation does fall onto an outstretched hand cause

most common shoulder dislocation

when is someone with acne referred

after a trial of benzyl peroxide and topical abx then oral antibiotics for 3 months doesnt work

what are calcium, PTH and phosphate levels in osteogenesis imperfecta

normal