wc 30/12 Flashcards
how do calcium levels differ in acute vs chronic CKD
if chronic they are low (due to low vit D)
how is diabetic nephropathy screened for annual
morning urine albumin: creatinine
causes of normal anion gap metab acidosis
ABCD
addisons
bicarb loss (diarrhoea)
chloride
drugs
what cause of nephrotic syndrome is associated with malignancy
membranous nephropathy
normal anion gap
10-18
what degree of stenosis is carotid endarterectomy considered
> 50%
within what timeframe of stroke onset can fibrinolysis be given
4.5 hrs
within what timeframe of stroke can thrombectomy be done
6 hrs
how does ulnar nerve lesion affect hand movements and muscles
weakness of finger abduction
weakness of finger adduction
wasting of thenar eminence
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
how does radial nerve lesion affect hand movements and muscles
wrist drop (inability to extend wrist)
to diagnose rhabdomyolysis how much should CK be raised
5x normal
increase in creatinine for AKI
50% in past 7 days
>26 in past 48 hrs
how long does it take an AV fistula to develop
6-8 weeks
how to differentiate brain abscess from meningitis
neurology is likely to be focal in abscess
cushings triad
bradycardia
irregular breathing
wide pulse pressure
common peroneal nerve injury causes
foot drop
weakness of foot dorsiflexion
weakness of foot eversion
colles fracture causes injury to what nerve
median
what artery is affected by atherosclerosis causing amaurosis fugax
internal carotid
it will be ipsilateral to the visual loss
where is the lesion in a homonymous hemianopia
the contrateral optic radiation or occipital cortex
where is the lesion in an isolated hemianopia
the contralateral optic tract
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
first line diagnostic tests for asthma
FeNO or eosinophils
allergic bronchopulmonary aspergillosis mx
oral prednisolone
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
anterior
most common shoulder dislocation
anterior
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
