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passmed notes > wednesday 17th > Flashcards

wednesday 17th Flashcards

1
Q

causes of metabolic alkalosis

A

hypokalaemia
loop diuretics
hyperaldosteronism
cushings
vomiting
liquorice

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2
Q

casues of a metabolic acidosis with raised anion gap

A

K- ketones: DKA, Alcohol
U- urate : renal failure
L - actate- sepsis, shock , hypoxia, metformin
T - toxins : salicylic,methanol

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3
Q

causes of a hyperchloreamic metabolic acidosis

A

addisons
diarrhoea
renal tubular acidosis
ureterosigmoidostomy

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4
Q

side effects of 5-ASA drugs

A

mesalazine - agranulocytosis, pancreatitis, headache
sulfa- oligospermia, headache, lung fibrosis

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5
Q

when shoudl prophylactic abx for SBP be offered? what one?

A

if ascitic protein <15g/l or had an episode of SBP
cipro

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6
Q

what neutrophil count is diagnostic of SBP

A

> 250

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7
Q

management of SBP

A

IV cefotaxime

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8
Q

symptoms of SBP

A

ascites, fever, pain

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9
Q

IX for budd chairir

A

USS with dopple flow

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10
Q

what hormones do renal cell carcinomas produce

A

EP, PTH, ACTH

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11
Q

what investigations should be done in a newly diagnosed cirrhotic patient

A

endoscopy for varices
USS for HCC(+AFP)

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12
Q

serum and urine osmolality findings in. SIADH

A

low serum osmol
high urine osmol - dumping all sodium

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13
Q

sodium high or low in diabetes insipidus

A

hypernatraemia

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14
Q

serum and urine osmolalities in SIADH vs DI

A

SIADH - low serum osmol , high urine osmol
DI- high serum osmol, low urine osmol

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15
Q

antibodies in addisons

A

anti-21-hydroxylase

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16
Q

when do you measure cortisol in a short synachten test- what is a normal result

A

before giving and after 30 mins - normally cortisol should double

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17
Q

most common cause of hyperaldosteronism

A

bilateral idiopathic adrenal hyperplasia

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18
Q

what test can differentiate between bilat idio adrenal hyperplasia and adrenal adenoma causing conns

A

adrenal venous sampling

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19
Q

first adn seconds investigatin in hyperaldosetrone

A

renin:aldosterone ration
high res CT following to find cause

20
Q

rhyme for remebering reflex spinal levels

A

1,2 buckle my shoe 3,4 kick the door 5,6 pick up sticks 7,8 shut the gate

21
Q

becks triad for cardiac tamponade

A

Distant heart sounds
Distended jugular veins
Decreased arterial pressure (low BP)

22
Q

drugs that potentiate warfarin eg. CYP450 inhib

A

ODEVICES

Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin/Cimetidine
Ethanol (acute intoxication)
Sulphonamides

23
Q

drugs that decrease warfarin activity eg CYP450 inducers

A

PC BRAS

Phenytoin
Carbamazepine
Barbiturates
Rifampicin
Alcohol (chronically)
Sulphonylureas

24
Q

what diameter is bad sign for melanoma

A

> 6mm

25
Q

treatment of mild - mod UC proctitis

A

rectal 5-asa
rectal 5-asa and oral 5asa
rectal and oral 5asa + oral steroid

26
Q

remission therapy in UC

A

5-asa either rectally or orally

27
Q

maintenance therapy in UC if >2 exacerbations in a year

A

oral mercaptpurine or azathioprine

28
Q

mangement of chrons - lifestyle, inducing remission adn maintenance

A

lifestyle - STOP SMOKING
inducing - steroids
maintain oral azathio or mercaptopurine

29
Q

what cancers are most assoc with UC and Crohns respectively

A

UC - colorectal cancer
Crohns - small bowel

30
Q

difference between low anterior resection and an abdominoperoneal resection

A

rectum removed in both anal canal left in anterior resection

31
Q

if you have a rectal cancer causing obstruction what is surgical tx

A

defunctioning loop colostomy

32
Q

treatment of colorectal caner obstruction

A

stent or resection

33
Q

lymphatic drainage above and below pectinate line

A

above - iliac
below - inguinal

34
Q

symptoms of diverticulosis

A

pr bleed
altered bowel habit
abdo pain
bloating

35
Q

abx for diverticulitis

A

co-amoxiclav

36
Q

complications of diverticulosis

A

Diverticulitis
Haemorrhage
fistula
Perforation
abscess
diverticular phlegmon

37
Q

investigations in diverticular disease

A

FBC
CRP
erect CXR
AXR
CT?

38
Q

management of thrombosed haemorrhoids

A

if <72 hrs - excise
if >72 hours - stool softeners analgesia

39
Q

initial mangement of bowel obstruction

A

NBM
IV fluids
nasogastric tube with free drainage

40
Q

what i sleft in subtotal colectomy

A

sigmoid and rectum

41
Q

what is worse with eating duodenal or gastric

A

gastric

42
Q

what inscision is used for an open cholecystectomy

A

kocher

43
Q

what inscion is used for a liver trasnplant

A

mercedes benz

44
Q

what inscions is used for a kidney transplant and where is it

A

LIF rutherford -morrison inscion

45
Q

how do you check NG placement

A

aspiration and pH

passmed notes (18 decks)

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