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120 Cards in this Set
- Front
- Back
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What can causes lower HBA1c levels |
Sickle cell anaemia G6PD hereditary spherocytosis |
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What can cause high than exprected levels of HBA1c |
Vit B12 deficiency Iron deficiency Splenectomy |
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What is the usual regime for contraceptive patch |
Change patch weekly with a week break after 3 patches |
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When will a child be able to use knife and fork |
5 years old |
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What are the risk factors Of Breast cancer |
Endogenous oestrogen exposure ie early menarche , late menopause Exogenous : HRT AND COCP Alcohol excess Radiation Benign breast lump |
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What is the recommended anti emetic therapy for hyperemeisi gravidarium |
1st line : cyclizine 50 mg IM OR IV 2nd line : metaclopramide 5-10 mg 8hrly 3rd line : corticosteroids : hydrocortisone 100mg BD |
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What are the risk factors for hyperemesis gravidarium |
First pregnancy Previous HG multiple gestation Molar pregnancy Increased placental mass |
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How do you manage HG |
Maintain hydration IV FLUIDS electrolyte monitoring potassium chloride Thiamine 100mg in 100ml of saline Enoxaparin 40mg OD anti emetic H pylori eradication |
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What is the path physiology of painful arc syndrome |
This is because the subacromial space narrows - which is where the supraspinatus muscle tendon passes. The narrowing causes irritation of the tendon resulting in a tendonitis |
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What are the risk factors of placental abruption |
Previous placental abruption Transverse lie Smoking or drug use eg cocaine Pre eclampsia and other hypertensive disorders |
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What are the types of motor neurone disease |
Most common is amyotrophic lateral sclerosis: typically LMN signs in arms and UMN signs in legs Primary lateral sclerosis : UMN signs only : very rare and progressive Progressive muscular atrophy : predominantly lower motor neuron lesion Progressive bulbar palsy : palsy of the tongue due to loss of function of the brain stem motor nuclei WORST PROGNOSIS |
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How does measles present |
Conjunctivitis Koplik spots Rash behind ears the. To the whole body |
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How does measles present |
Conjunctivitis Koplik spots Rash behind ears the. To the whole body |
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How does rubella present |
Pink maculopapular initially on face before spreading the whole body usually fades by the 3-5 days Lymphadenopathy suboccipital and postauricular |
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How does measles present |
Conjunctivitis Koplik spots Rash behind ears the. To the whole body |
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How does rubella present |
Pink maculopapular initially on face before spreading the whole body usually fades by the 3-5 days Lymphadenopathy suboccipital and postauricular |
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How does mumps present |
Fever Malaise Muscular pain Parotitis ( pain on eating ) |
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What are the adverse effects of thiazolidinediones |
Weight gain Liver impairment : monitor LFT Fluid retention Risk of bladder cancer ( pioglitazone) |
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What are some side effects sglt 2 inhibtors |
genital infection diabetic ketoacidosis |
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What are some side effects of GLP 1 mimetics |
Nausea VOmiting Pancreatitis |
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What is the criteria for early insulin treatment |
Normal BMI rapid onset of severe symptoms ketouria persistant hyperglycaemia despite treatment |
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When do you do an ECHO |
Indicated if there is high suspicion of underlying structural heart disease ( murmur ) or functional heart disease (heart failure ) If result of the ECHO would alter the subsequent managment I e the choice of antiarrhythmic |
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When do you do an ECHO |
Indicated if there is high suspicion of underlying structural heart disease ( murmur ) or functional heart disease (heart failure ) If result of the ECHO would alter the subsequent managment I e the choice of antiarrhythmic |
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What are 3 things a patient with stable angina should avoid |
Heavy meals Exposure to cold Emotional distress |
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Which cns rumours are most common in children |
Medulloblastoma - FAP Astrocytoma Ependymoma |
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What inx is available of GORD |
It is clinical mainly PH monitoring Oesophageal impedance study Endoscopy |
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What inx is available for reflux |
It is clinical mainly PH monitoring Oesophageal impedance study Endoscopy |
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How do you mnx reflux |
Reassurance Alginates - makes feeds thicker Thick milk - carabel Medical 1st ranitidine h2 antagonist 2nd PPI pro-kinetic ( domperidone ) Surgical Laparoscopic nissen fundoplication Jejunal feeds |
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What are the complication of reflux |
Recurrent aspiration Wheeze Apnoea Dental erosions |
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What is recommended daily intake |
150mls/kg/day |
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What is recommended daily intake |
150mls/kg/day |
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What are the features of infant colic |
Ddx of exclusion Inconsolable crying May draw up knees Excessive flatus Symptoms take place several times of the day Can be caused by GORD and cow milk protein intolerance |
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What is recommended daily intake |
150mls/kg/day |
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What are the features of infant colic |
Ddx of exclusion Inconsolable crying May draw up knees Excessive flatus Symptoms take place several times of the day Can be caused by GORD and cow milk protein intolerance |
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How does CMP intolerance present |
Vomiting Diarrhoea blood sometimes Wheeze Uticarial rash |
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What is recommended daily intake |
150mls/kg/day |
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What are the features of infant colic |
Ddx of exclusion Inconsolable crying May draw up knees Excessive flatus Symptoms take place several times of the day Can be caused by GORD and cow milk protein intolerance |
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How does CMP intolerance present |
Vomiting Diarrhoea blood sometimes Wheeze Uticarial rash |
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How do you mnx cow milk protein intolerance |
Milk exclusion from moms diet Hydrolysed formula ( aa based formula) Minimum 2-4 week trial No soya < 6 months Early weaning |
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What is recommended daily intake |
150mls/kg/day |
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What are the features of infant colic |
Ddx of exclusion Inconsolable crying May draw up knees Excessive flatus Symptoms take place several times of the day Can be caused by GORD and cow milk protein intolerance |
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How does CMP intolerance present |
Vomiting Diarrhoea blood sometimes Wheeze Uticarial rash |
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How do you mnx cow milk protein intolerance |
Milk exclusion from moms diet Hydrolysed formula ( aa based formula) Minimum 2-4 week trial No soya < 6 months Early weaning ( 4 and a half months is the earliest you can wean ) |
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What is mnx for Crohns |
MDT APPROACH elemental or polymetric diet for 6-8 weeks 90% of them relapse in 12 months time Medical Steroids in severe disease Biological ; mesalazine immunosuppressants azathioprine ( u need monitor FBC and LFT ) Anti TNF antibodies infliximab |
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How is UC mnx |
Mild or left sided : topical mesalazine / steroids or oral mesalazine Moderate : topical mes plus oral steroids Severe : IV methylprednisolone |
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How is UC mnx |
Mild or left sided : topical mesalazine / steroids or oral mesalazine Moderate : topical mes plus oral steroids Severe : IV methylprednisolone |
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What are the complications of uc |
Toxic megacolon, |
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What is the classical presentation of coeliac disease |
Faltering growth Weight loss / buttock wasting abdominal distension |
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What are the most common pathogens in gastroenteritis |
Rotavirus Adenovirus Norovirus Campylobacter jejuni Shigella Salmonella |
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What are the most common pathogens in gastroenteritis |
Rotavirus Adenovirus Norovirus Campylobacter jejuni Shigella Salmonella |
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What is frailty |
It is the state or condition related to the ageing process in which multiple body systems gradually lose their in build reserves |
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What is frailty |
It is the state or condition related to the ageing process in which multiple body systems gradually lose their in build reserves |
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What is frailty syndrome |
Includes : fidis Falls Incontinence Delirium Immobility Side effects to medication |
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What is frailty |
It is the state or condition related to the ageing process in which multiple body systems gradually lose their in build reserves |
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What is frailty syndrome |
Includes : fidis Falls Incontinence Delirium Immobility Side effects to medication |
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What are some medications associated with adverse outcomes in frailty |
Anticholinergics Benzodiazepines Codeine (opioids) Diuretics ( anti hypertensive ) NSAIDS |
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Which drugs would score 3 points on the anticholinergic risk scale |
Chlorpromazine Amitriptyline Oxybutinin |
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Which drugs would score 3 points on the anticholinergic risk scale |
Chlorpromazine Amitriptyline Oxybutinin |
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What is delirium |
New acute confusion or sudden worsening of confusion in someone with previous dementia/ memory loss |
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How does delirium present |
Confusion Fall Hallucination Memory impairment Incontinence |
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Why is recognising delirium important |
Often a sign of underlying pathology High mortality rate Risk of falls and sepsis |
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Which drugs would score 3 points on the anticholinergic risk scale |
Chlorpromazine Amitriptyline Oxybutinin |
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What is delirium |
New acute confusion or sudden worsening of confusion in someone with previous dementia/ memory loss |
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How does delirium present |
Confusion Fall Hallucination Memory impairment Incontinence |
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Why is recognising delirium important |
Often a sign of underlying pathology High mortality rate Risk of falls and sepsis |
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What are causes of delirium |
Infection Dehydration Pain Constipation or urinary retention Drugs ( benzo) Change in surroundings |
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What are the components of the confusion screen |
FBC , CRP , ESR , none profile , UE , TFT , glucose , folate , b12 Consider troop in Urine dip , ECG consider ct brain and LP |
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Which drugs would score 3 points on the anticholinergic risk scale |
Chlorpromazine Amitriptyline Oxybutinin |
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How is osteoporosis managed |
Calcium and vit D supplements Weight bearing exercise Fall prevention Bisphosphonates Reassess in 5 years - may need bisphosphonate holiday |
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What is the pathophysiology of Alzheimer’s-disease |
Degeneration of the cerebral cortex Cortical atrophy Amyloid plaques Reduced Acetyl Choline production |
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What is the role of primary care in Alzheimer’s disease |
Screening and initial assessment - excluding reversible causes Refer to memory clinic for definitive diagnosis Treat co morbid illnesses Signpost parent and career to the appropriate support agencies |
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What are some side effects of MAO B inhibitors such as selegiline |
Postural hypotension Atrial fibrillation |
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What is delirium |
New acute confusion or sudden worsening of confusion in someone with previous dementia/ memory loss |
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How does delirium present |
Confusion Fall Hallucination Memory impairment Incontinence |
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Why is recognising delirium important |
Often a sign of underlying pathology High mortality rate Risk of falls and sepsis |
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What are causes of delirium |
Infection Dehydration Pain Constipation or urinary retention Drugs ( benzo) Change in surroundings |
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What are the components of the confusion screen |
FBC , CRP , ESR , none profile , UE , TFT , glucose , folate , b12 Consider troop in Urine dip , ECG consider ct brain and LP |
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What is the management of delirium |
Be put in a well lit room Try to have consistent staff Ensure fluid intake Medication review Pain relief |
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What are some causes of falls |
Delirium ( cognitive impairment ) Orthostatic hypotension Motor problems Sensory impairment Polypharmacy Environmental |
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What are the key component of fall prevention programmes |
Advocating exercise Home assessment Medication review Vision assessment |
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What are the risk factors for fragility fractures |
Long use of steroids (over three months) BMI < 19 Female Smoking Alcohol use more than 3 u daily |
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Which drugs would score 3 points on the anticholinergic risk scale |
Chlorpromazine Amitriptyline Oxybutinin |
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How is osteoporosis managed |
Calcium and vit D supplements Weight bearing exercise Fall prevention Bisphosphonates Reassess in 5 years - may need bisphosphonate holiday |
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What is the pathophysiology of Alzheimer’s-disease |
Degeneration of the cerebral cortex Cortical atrophy Amyloid plaques Reduced Acetyl Choline production |
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What is the role of primary care in Alzheimer’s disease |
Screening and initial assessment - excluding reversible causes Refer to memory clinic for definitive diagnosis Treat co morbid illnesses Signpost parent and career to the appropriate support agencies |
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What are some side effects of MAO B inhibitors such as selegiline |
Postural hypotension Atrial fibrillation |
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What are some cognition assessment tools |
MOCA - results are out of 30 General practitioner assessment of cognition 6 item cognitive impairment test . Scoring more than 8 is suggestive of cognitive impairment |
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What is the underlying pathology in Parkinson’s |
Degeneration of the dopaminergic neurones in the substantia nigra Decrease in the striatal concentration of dopamine Presence of Lewy bodies in neutrons of the substantia nigra |
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What is delirium |
New acute confusion or sudden worsening of confusion in someone with previous dementia/ memory loss |
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How does delirium present |
Confusion Fall Hallucination Memory impairment Incontinence |
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Why is recognising delirium important |
Often a sign of underlying pathology High mortality rate Risk of falls and sepsis |
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What are causes of delirium |
Infection Dehydration Pain Constipation or urinary retention Drugs ( benzo) Change in surroundings |
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What are the components of the confusion screen |
FBC , CRP , ESR , none profile , UE , TFT , glucose , folate , b12 Consider troop in Urine dip , ECG consider ct brain and LP |
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What is the management of delirium |
Be put in a well lit room Try to have consistent staff Ensure fluid intake Medication review Pain relief |
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What are some causes of falls |
Delirium ( cognitive impairment ) Orthostatic hypotension Motor problems Sensory impairment Polypharmacy Environmental |
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What are the key component of fall prevention programmes |
Advocating exercise Home assessment Medication review Vision assessment |
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What are the risk factors for fragility fractures |
Long use of steroids (over three months) BMI < 19 Female Smoking Alcohol use more than 3 u daily |
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Who needs emergency contraception |
Day 5 after a miscarriage or abortion From day 21 after childbirth Regular contraception used incorrectly/ missed |
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What are the contraindication for ulipristal |
Pregnancy Severe asthma Liver disease |
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How do you diagnose menopause |
It is a clinical diagnosis But if they are less than 45 the consider an FSH test 6 weeks apart (should be > 30) ( they must not be taking the COCP) |
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What are the symptoms of menopause |
Vasomotor symptoms MSK symptoms Psychological/Mood Urogenital symptoms Sexual symptoms |
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How is atorvastatin monitored |
LFT within 3 months then after that it is yearly |
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How is atorvastatin monitored |
LFT within 3 months then after that it is yearly |
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How is methotrexate monitored |
Before needs CXR , FBC , renal and liver function During : FBC and LFT monthly for fortnightly first 2 months Then it is 1-3 monthly |
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How is clozapine monitored |
Before : FBC looking for risk of neutropenia and ECG for QT prolongation Blood test every week for the first 18 weeks of treatment Every 2 weeks after After a year, monthly test |
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How is atorvastatin monitored |
LFT within 3 months then after that it is yearly |
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How is methotrexate monitored |
Before needs CXR , FBC , renal and liver function During : FBC and LFT monthly for fortnightly first 2 months Then it is 1-3 monthly |
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How is clozapine monitored |
Before : FBC looking for risk of neutropenia and ECG for QT prolongation Blood test every week for the first 18 weeks of treatment Every 2 weeks after After a year, monthly test |
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How is lithium monitored |
After a week lithium levels are checked and continue weekly until levels are stabilised Check 3 monthly for first year and the 6 monthly unless high risk Long term lithium can be associated with hypothyroidism therefore 6 monthly renal , TFT and calcium levels are needed |
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When is LTOT indicated in patient with COPD |
PO2 < 7.3 kPa PO2 7.3 to 8 with one of the following : secondary polycythaemia , pulmonary hypertension and peripheral Odema |
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What is the monitoring regime for ramipril |
Check u and e 7-10 days after each dose increase then a minimum of yearly |
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How do you monitor spironolactone |
Baseline : ue and egfr After commencing repeat these test 1,4,8,12 weeks after commencing dose change Then 3 monthly |
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WHat are the factor influnecing prescription |
1. clinical needs 2. pharmacaeutical comapny 3. cost 4. patient demand 5. evidence based 6. doctor experience |
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What are the common side-effects of glitazones |
Weight gain Fluid retention Risk of bladder cancer Risk of fractures Liver dysfunction |
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How does acute viral labyrinthitis present |
Sudden onset horizontal nystagmus Hearing disturbances Nausea Vomiting Vertigo |
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Name three possible symptoms that would prompt and urgent chest x-ray to rule out long cancer |
Unexplained weight loss Unexplained appetite loss Unexplained chest pain |
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Name three possible symptoms that would prompt and urgent chest x-ray to rule out long cancer |
Unexplained weight loss Unexplained appetite loss Unexplained chest pain |
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Name three clinical features which would prompt you to consider requesting an x-ray in a patient with a history of asbestos exposure |
Finger clubbing Cervical lymphadenopathy Recurrent chest infection |
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What are some complications of a bronchoscopies |
Haemoptysis Infection Cough after procedure Pneumothorax Haemothorax |
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What are some seronegative arthropathies |
P; psoriatic Ulcerative colitis Behcet disease Crones disease Ankylosing spondylitis Reiter syndrome |
