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CCT ALCOHOL and others
get crunk
79
Medical
Undergraduate 4
06/02/2017

Additional Medical Flashcards

 


 

Cards

Term
how to work out alcohol units?
Definition
1 unit of alcohol is = 10ml of alcohol

strength of alcohol = ABV

sum: multiply the millilitres x ABV and divide by 1000

eg 175ml of 12% wine =

175 x 12 /1000 = 2.1 = ~ 2 units
Term
limits for men and women?
Definition
no more than 14 units a week
spread this over 3 days or more
Term
what is audit questionnaire?

audit-c is the short version consisting of 3 questions.
Definition
10 items
min score = 0
max score is 40

score of 8 or > in men
7 or > in women
indicates strong likelihood of hazardous drinking


15 or > in men
13 or > in women
alcohol dependence
Term
what are the 3 questions in aUDIT C? to ID hazardous drinkers or have active alcohol use disorders

out of 12

in men 4 or > = positive
women 3 or > = positive
Definition
how often did you have a drink containing alcohol in the last year? 0-4

how many drinks did you have on a typical day when you were drinking in the past year? 0-4

how often did you have 6 or more drinks in the past year on one occasion? 0-4
Term
non HRT rx for menopause
Definition
lifestyle: weightless, mindfulness, CBT
avoidy spicy food, caffeine, sleep in cooler room, wear lighter clothing

alcohol may trigger hot flushes.

SSRIs and snris: VENLAFLAXINE
Term
herbal remedies for menopause

look for the Tradiational Herbal Remedy logo, this means its high quality and you can be sure of the dose
Definition
red clover
black cohosh: member of the buttercup family
st johsn wort
dong quai: female ginseng
ginseng : one of the 11 species of plants thought to help with those who are having a bad nights sleep due to menopause symptoms
Term
what does direct access mean in suspected cancer referral?
Definition
when a test is performed and primary care retain clinical responsibility throughout including acting on the result
Term
?lung cancer.
refer using 2 week wait for lung cancer if?
Definition
CXR findings suggest lung cancer OR
aged 40 or > with unexplained heamoptysis
Term
you should offer an urgent CXR within 2 weeks to asses for lung cancer in people who are 40 or > if they have 2 of the following symptoms OR
if they have ever smoked, 1 or more of the following unexplained symptoms
Definition
weight loss
appetite loss
cough
fatigue
SOB chest pain
Term
a 42 year old man, former smoker presents with weight loss

what do you do?
Definition
refer for urgent CXR to look for lung cancer within 2 weeks
Term
in people aged 40 or over with the following symptoms how could you proceed?
persistent recurrent chest infection
finger clubbing
thormbocytosis
chest signs consistent with lung cancer
persistent anterior cervical lymphadenopathy or supra clavicular lymphadenopathy
Definition
CONSIDER urgent CXR within 2 weeks
Term
oesophageal cancer.

offer urgent direct access for upper GI endoscopy to be done within 2 weeks assessing for oesophageal cancer in pts who?
Definition
have Dysphagia OR

aged 55 or > with weight loss AND the following:-
upper abdo pain
reflux
dyspepsia
Term
40 or > with jaundice?
Definition
refer 2 week pancreatic cancer pathway

in those aged 60 or over with weightloss and other symptoms suggestive of pancreatic cancer, consider urgent direct access CT or USS if CT not available within 2 weeks for pancreatic cancer.

eg 60 with weight loss and new onset diabetes
Term
upper abdominal mass consistent with stomach cancer, what pathway?
Definition
2 week stomach cancer pathway

urgent direct access for endoscopy within 2 weeks for those with
DYSPHAGIA or

55 or more with weight loss and:-

dysepsia
reflux
upper abdo pain
Term
referral for CRC 2 week wait for 60 or more
Definition
aged 60 or > and
iron deficiency anaemia or
changes to bowel habit or
FOB shows changes
Term
referral for CRC 2 week wait for those aged 50 or >
Definition
aged 50 or more with unexplained rectal bleeding
Term
referral for CRC 2 week wait
for those aged 40 or more
Definition
aged 40 or more with
unexplained weightloss and abdominal pain
Term
breast cancer 2 week referral for those aged 30 or over?
Definition
unexplained breast lump, with or without pain
Term
breast cancer 2 week wait referral for those aged 50 or more?
Definition
following symptoms in one nipple only:

discharge
retraction
other changes of concern
Term
you identify ascites and a pelvic mass in a women who is more than 18. the mass is not due to fibroids, what do you do?
Definition
refer urgently
Term
when ca125 is greater than what ?.. do we worry?
Definition
> 35
Term
when to refer for prostate cancer 2 week pathway
Definition
if prostate feels malignant on DRE

or if PSA are above range for their age
Term
2 week bladder cancer pathway
Definition
45 or more with
unexplained heamaturia w/o UTI or
visible blood that persists after successful rx of UTI or

aged 60 or > and have unexplained non visible heamaturia and either dysuria or raised WCC on a blood test
Term
renal cancer 2 week pathway referral criteria?
Definition
45 or >
unexplained visible blood or
visible blood that persists even after successful rx of UTI
Term
skin cancer 2 week referral. if they have a skin pigmented lesion with a weighted 7pt checklist score of 3 or more

whats the check list?
Definition
major features opts each
size
shape
colour

minor features 1 pt each
diameter 7mm or >
inflammation
oozing
change in sensation
Term
laryngeal cancer 2 week referral
Definition
aged 45 or > with
persistent unexplained hoarseness or
unexplained lump in neck
Term
oral cancer 2 week referral
Definition
unexplained oral ulceration for > 3 weeks or
persistent unexplained lump in neck
Term
you find hepatosplenomegaly and suspect leukaemia in primary care. what would you request?
Definition
very urgent blood test within 48 hours
Term
you find an upper abdominal mass consistent with an enlarged liver in GP. what would you request?
Definition
consider urgent direct USS to be done within 2 weeks
Term
in GP you find upper abdo mass consistent with an enlarged gall bladder. what do you do?
Definition
consider urgent direct access USS to be done within 2 weeks
Term
upper abdo ass consisted with stomach cancer what do you do?
Definition
refer 2 week for stomach cancer
Term
abdominal distension: persistent or frequent particularly > 12 times in women > 50 years. what would you do?
Definition
Ca125. if > 35 then ix further/refer
Term
abdominal pain with rectal bleeding aged 50? you should consider suspected cancer pathway within 2 weeks. what if they have abdominal pain WITHOUT rectal bleeding and are aged 50 or more?
Definition
offer occult faecal occult blood tests

FOB screening offered to those 60-74
Term
alcohol induced lymph node pain. what are you suspecting?
Definition
Hodkins lymphoma
Term
ca 15.3
Definition
breast cancer

ca125 ovarian
19.9 pancreatic


these are all monoclonal antibodies
Term
S-100
Definition
melanoma, schanoma
Term
AFP
Definition
HCC, teratoma
Term
small cell lung cancer, neuroblastoma, gastric cancer. which antigen might be raised?
Definition
bombesin
Term
most common cause of death in men under 50?
Definition
trauma

in over 50 it is heart disease
Term
psa age and upper limits
Definition
50-59 = 3
60-69 = 4
70 > =5
Term
what can you say about the PSA test specificity and sensitivity?
Definition
it has poor specificity and poor sensitivity
Term
explain PSA testing
Definition
an enzyme made by normal and abnormal cells of the prostate
can be raised in conditions that are not prostate cancer
as you get older you produce more.
the test is not sensitive or specific. this means that people with prostate cancer may have normal PSA levels whilst only a proportion of those with raised PSA will be found to have prostate cancer.
Term
rx for epididymoorchitis from ecoli?
Definition
Ciprofloxacin 500mg BD
Term
what is phrens sign? which condition is it found in?
Definition
it is found in epidydimoorchitis but not in torsion. it is when lifting the testicle relieves the pain.
Term
around what % of men have prostate cancer with a normal PSA?
Definition
15%
Term
how to test for late onset hypogonadism?
Definition
do 2 x morning tests of testosterone.
if levels are < 8 you can rx with testosterone.

if levels are >12 then it is not considered hypogonad.

inbetween 8-12 consider a trial of testosterone
Term
you have done 2 x morning testosterone samples checking for hypogonadism.

what result would allow you to rx?
what result would make you give a trial of testosterone
what result suggests there is no hypogonadism?
Definition
< 8 we rx
8-12 we give trial of testosterone
> 12 implies there is no hypogonadism
Term
ranges of the international prostate symptom score

they can be answer 0-5
0 = not at all
5 = almost always

out of 35

there is one quality of life question too
Definition
0-7 mild
8-19 moderate
20-35 severe
Term
mx of BPH
Definition
conservative; diet, avoid caffeine, smoking
medical: tamsulosin to relax bladder neck, finesteride decreases size overtime
sx: TURP
Term
complications of BPH?
Definition
urinary retention
overflow
recurrent UTI
impaired renal fx
bladder calculi
haematuria
Term
20 y/o had cystoscopy now complaining of tender balls and swelling of scrotum. leucocytes positive. diagnosis?
Definition
epidydimoorchitis. Phrens sign will be positive

rx is with ciprofloxacin 500mg BD 10 days
Term
8 year old just recovered from viral illness affecting both parotids, presents with scrotal swelling. dx?
Definition
orchitis
Term
pea sized lump on testicle. located posterior to the testicle. diagnosis?

associated with?
Definition
epidydimal cyst.
diagnosed with US
associated with CF and polycystic kidney disease.
Term
prostate cancer metastasise to which nodes?
Definition
obturator nodes
Term
what is Beethans score?
Definition
hypermobility score.

5 or > = hyper flexibility
Term
bankhart lesions associated with which part of the rotator cuff?
Definition
the anterior part.
Term
mx of 1st time dislocation?
Definition
sling for 3 weeks

recurrent: get them moving ASAP
Term
causes of posterior dislocation of shoulder?
Definition
seizures
electricution

light bulb sign on X-ray
most useful X-ray is axial X-ray
Term
which movement is affected most in adhesive capsulitis?
Definition
external rotation
Term
lasting power of attorney

two types
health and welfare
property and financial affairs

features
Definition
needs to be registered. there is a fee

health and welfare only start working once the pt is lacking capacity.

the other one can start once it has been registered
Term
if a pt wants to refuse life sustaining treatment what needs to be done for advanced refusal?
Definition
it needs to be written, signed and witnessed
Term
best site to perform veneoucnture?
Definition
antecubital fossa

apply tourniquet 5-10 cm above site
Term
potential complications of venepuncture?
Definition
infection
haematoma
bleeding
brusing
syncope
extravasation of injected medicines
Term
order of blood bottles
Definition
blue
gold
lilac
pink
grey
Term
SE of chloramphenicol?
Definition
aplastic anaemia
Term
monitoring of ACE in hibitors
Definition
BL measurements
2 weeks after
after dose change
Term
what affect do beta blockers have on raynauds?
Definition
make it worse.

avoid propanalol in PVD it can worsen raynauds
Term
dose of amitriptiline for neuropathic pain v depression
Definition
10-20mg neuropathic
75-150mg depression
Term
difference between ISMN and ISDN?
Definition
ISMN is the active metabolite of ISDN

ISMN has a longer half life than ISDN and taken prophylactically in chronic stable angina
Term
risk factors for PID
Definition
young age
low socioecomonic status
many sexual partners
lack of barrier method
IUCD in past 20 days
TOP
Term
mx for PID?
Definition
ofloxacin and metronidazole 400mg PO BD for 14 days OR

single dose ceftriaxone 500mg and doxycycline 100mg PO BD and metronidazole 400mg PO BD for 14 days
Term
rx for cervical ectropian?
Definition
cautery
Term
what is the motor supply to the pyloric sphincter?
Definition
vagus nerve AKA nerve of latter jay
Term
what happens to back pain in uraemia pericarditis?
Definition
when the pt lays supine the back pain gets worse but when they sit forward it gets better
Term
if you just replace the ball of the hip joint what is this called?
Definition
hemi arthroplasty

total hip replacement is when you replace the ball and socket
Term
DHS is used in what type of hip fractures?
Definition
intra trochanteric ie extra capsular
Term
what pred dose in exacerbation of COPD?
Definition
30mg PO 7 to 14 days
Term
C diff

gram positive rod
mx?
Definition
metronidazole 400mg tds for 14 days

2nd line vancomycin 10-14 days
Term
if a pt with c dif is NBM can you give IV metronidazole or vancomycin?
Definition
you can give IV metronidazole but you cannot give IV vancomycin
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