Term
| ECG changes that occur in stemi (4) |
|
Definition
ST elevation
pathological Q waves
T wave inversion
hyperacute T waves |
|
|
Term
|
Definition
aspirin 300mg
sublingual glycerate trinitrate
morphine + antiemetic
O2 if sats < 94%
clopidogrel |
|
|
Term
| what is the time limit to offer PCI in? |
|
Definition
| within 12 hours of presentation if it can be delivered within 120 minutes. |
|
|
Term
| secondary prevention medications after MI |
|
Definition
Aspirin
beta blocker
statin
ace-inhibitor
clopidogrel |
|
|
Term
| in HF with reduced ejection fraction which two drugs should be initiated? |
|
Definition
|
|
Term
| 2nd line drug treatment in HF? |
|
Definition
spironolactone
ARB
Hydralazine in combination with nitrate |
|
|
Term
mx of pulmonary oedema in HF?
mneumonic is IPODMAN |
|
Definition
iv access
position upright
oxygen
diuretics furosemide
morphine
antiemetic
nitrates: GTN infusion if SBP >110 or 2 puffs if SBP> 90 |
|
|
Term
| ECG signs associated with AF? |
|
Definition
absent P waves
tachycardia
irregularly irregular rhythm |
|
|
Term
| options for rate control in AF |
|
Definition
rate limiting Ca channel blocker such as diltiazem or verapamil
or
beta blocker |
|
|
Term
| Score of 2 on CHA2DS2VASc so we offer anticoagulation. what are the options? |
|
Definition
Warfarin
NOACS: apixiban, digabatrin, rivaroxiban |
|
|
Term
| two major criteria for endocarditis? |
|
Definition
positive blood culture
evidence of endocardial involvement such as echocardiogram showing vegetations |
|
|
Term
| 5 points from the minor criteria to diagnose IE |
|
Definition
microbiological evidence that does not meet major criteria
fever >38
predisposing heart condition or IVDU
vascular phenomena: emboli, splinter haemorrhages, clubbing
immunological phenomena: rots spots, osiers nodes |
|
|
Term
|
Definition
rheumatic heart disease
prosthetic valves
IVDU
congenital heart defects |
|
|
Term
| what does modified dukes criteria rehire to diagnose IE? |
|
Definition
2 major or
5 minor or
1 major 3 minor criteria |
|
|
Term
| organisms that commonly cause IE? |
|
Definition
staph aureus
Strep viridians
Staph epidermis |
|
|
Term
|
Definition
lose weight
exercise more
stop smoking
reduce coffee and caffeine rick products
moderation of alcohol
reduce salt
relaxation therapies |
|
|
Term
| examinations to grade exacerbation of asthma? |
|
Definition
Resp rate
Pulse rate
O2 sats
PEFR
respiratory exam |
|
|
Term
| mx of asthma exacerbation that does not need admission? |
|
Definition
nebulised salbutamol
PO prednisolone short course
follow up 48 hours |
|
|
Term
|
Definition
fine tremor
headache
muscle cramp
tachycardia |
|
|
Term
| you suspect COPD in a pt, name 3 ix and why to confirm diagnosis? |
|
Definition
post bronchodilator spirometry: obstructive airway severity and confirm diagnosis
FBC: aneamia or secondary polycythaemia
CXR: hyperinflation or to exclude other pathology |
|
|
Term
| organisms that commonly infect people with COPD? |
|
Definition
haemophilus influenza
strep pneumonia
moraxella catarrhalis |
|
|
Term
exacerbation of COPD, how to mx
NB: not infective |
|
Definition
increase bronchodilator therapy, consider negs
PO pred 30mg 7-14 days
do not give Abx if it is not infective exacerbation of copd |
|
|
Term
CURB score of 2 how to mx non pharmacologically a 82 year old smoker?
pharmacologically? |
|
Definition
rest, fluids, stop smoking advice
pharmacological: amoxicillin and clarithromycin dual therapy or Doxycycline mono therapy. |
|
|
Term
| pt information to give when rx for pneumonia |
|
Definition
1 week: fever should have resolved
4 weeks: chest pain and sputum production should have substantially reduced
6 weeks: cough and breathlessness should have substantially reduced
3 months: most symptoms should have resolved but fatigue may still be present
6 months: most people will feel back to normal. |
|
|
Term
| what are the 2 major types of lung cancer and which one is more common/. |
|
Definition
small cell
non small cell
more common: non small cell |
|
|
Term
| clinical signs on examination for lung cancer? |
|
Definition
cachexia
tracheal deviation
Hoarseness of voice
stridor
clubbing
ptosis
lymphadenopathy
tachypnoea |
|
|
Term
| reason for unilateral ptosis in someone with suspected lung cancer? |
|
Definition
| pancoast tumour, in apical lung. affects T1 nerve root |
|
|
Term
| which sites do lung cancer most commonly metastasise to? |
|
Definition
|
|
Term
| name 3 risk factors for developing type 2 diabetes? |
|
Definition
obesity
previous gestational diabetes
ethnicity Black or asia
FHX
lack of physical activity
drugs such as thiazide diuretics and corticosteroids |
|
|
Term
| GP organises HBA1c for pt to diagnose diabetes. what level would confirm diagnosis? |
|
Definition
|
|
Term
| a pt has just been diagnosed with type 2 diabetes, what lifestyle advice would you give her? |
|
Definition
education about the condition
dietary advise
exercise alcohol intake
smoking cessation if appropriate
education programs such as DESMOND |
|
|
Term
| pt has started on metformin, what SE should they be warned about? |
|
Definition
| diarrhoea, nausea, anorexia |
|
|
Term
| once stable how often should HBA1c be measured? |
|
Definition
|
|
Term
| what options are available for second line drugs if metformin isn't controlling diabetes? |
|
Definition
gliptin - DPP-4 inhibitor eg vildagliptin
sulfonyurea - gliclazide, glibenclamide
pioglitazone: reduces insulin resitance and improves insulin sensitivity |
|
|
Term
Gliptins eg Vildagliptin
MOA?
the enzyme they inhibit usually breaks down incretin. what does incretin do? |
|
Definition
DPP-4 inhibitor. DPP4 is an enzyme that usually breaks down incretin.
incretin helps body produce more insulin only when it is needed and reduce the amount of glucose being produced by the liver when it is not needed. |
|
|
Term
| what are people with diabetes screens for every year? |
|
Definition
retinopathy
diabetic foot
cvd risk factors
nephropathy |
|
|
Term
| 3 causes of hypothyroidism |
|
Definition
Hashimotos
De quervains
drugs: lithium, amiodarone, carbimazole
post thyroidectomy
iodine deficiency |
|
|
Term
| examination sigs suggestive of hypothyroid |
|
Definition
dry coarse hair and skin
hoarse voice
delayed relaxation of deep tendon reflexes
periorbital oedema
goitre
bradycardia
paraesthesia due to carpal tunnel syndrome |
|
|
Term
| after an initial review when starting thyroxine how often should TFTs be measures? |
|
Definition
|
|
Term
| how to differentiate crohns from UC on clinical exam? |
|
Definition
mouth ulcers
anal tags fistulas
arthritis
abdominal mass in right iliac fossa |
|
|
Term
| features on colonoscopy that fit with a diagnosis of Crohns |
|
Definition
|
|
Term
| what life style advice would you give to someone diagnosed with crohns? |
|
Definition
stop smoking if applicable
to return to clinic to discuss rx before trying for a family, contraception |
|
|
Term
| what is used to induce remission in Crohns? |
|
Definition
|
|
Term
| what is used to maintain remission in Crohns? |
|
Definition
aminosalicylates eg mesalazine
immunosuppressant eg MTX, azathioprine |
|
|
Term
| red flag signs in someone who presented with IBS |
|
Definition
unexplained weight loss
rectal mass
aneamia
change of bowel motion becoming looser or more frequent for > 6 weeks in someone aged 60 years or more
rectal bleeding
abdominal mass
FHX of cancer ovaries/CRC |
|
|
Term
| what can be tested for in the stool to differentiate IBS from IBD? |
|
Definition
|
|
Term
| lifestyle advice given to those with IBS |
|
Definition
reduce fibre intake
take time to eat food
drink 8 cups of water a day
restrict tea/coffee to 3 cups a day
exercise: moderate intensity 30mins at least 5 days of the week |
|
|
Term
| medication to treat abdominal pain in IBS described as spasms |
|
Definition
antispasmodic: mebeverine 135mg tds
alverine
peppermint oil |
|
|
Term
| diarrhoea in IBS what medication? |
|
Definition
| loperamide antimotility drug |
|
|
Term
|
Definition
|
|
Term
| how to asses malnutrition on examination in someone |
|
Definition
|
|
Term
| tests for coeliac disease |
|
Definition
Tissue transglutaminaseantibody TGA
Total IgA
endomysial antibody |
|
|
Term
| what should you ensure before testing someone for coeliacs disease? |
|
Definition
ensure the person has eaten gluten containing food at least twice everyday for the past 6 weeks
gluten in in wheat, barley and rye |
|
|
Term
| there are a number of conditions associated with coeliacs. name them and tests you can do to exclude them |
|
Definition
FBC and ferritin to screen for anemia
TFT for auto immune thyroiditis
LFTs to screen for autoimmune hepatitis
electrolytes for Addisons disease |
|
|
Term
| someone with coeliacs get pregnant. what dose folic acid would they need to be on? |
|
Definition
|
|
Term
| name one method of assessing a pt with coeliacs for risk of osteoporosis? |
|
Definition
|
|
Term
| name 2 renal/intrinsic causes of AKI? |
|
Definition
Acute tubular necrosis
glomerulonephritis
contrast induced nephropathy-iodine
rhabdomyolysis
tumour lysis syndrome |
|
|
Term
| name 2 post renal causes of AKI |
|
Definition
renal stones
BPH
bladder stones
cancer of bladder, urethra, prostate |
|
|
Term
| name some drugs that can cause AKI |
|
Definition
aminoglycosides
cyclophosphamide
NSAIDs
furosemide
penicillamine
thiazide diuretics |
|
|
Term
| Signs of acute renal failure |
|
Definition
reduced urine output
pulmonary oedema
ECG chnages due to hyperkalemia or acid base disturbances
ureamia eg pericarditis |
|
|
Term
| ECH changes associated with Hyperkalemia |
|
Definition
tall tented T waves
small P waves
widened QRS complexes leading to sinusoidal pattern
prolonged PR interval |
|
|
Term
|
Definition
diuretic resistant pulmonary oedema
hyperkalemia refractory to medical therapy
metabolic acidosis refractory to therapy
ureamic complications eg pericarditis, encephalopathy, bleeding |
|
|
Term
| stages of chronic kidney disesase |
|
Definition
90 =1
60 =2
45= 3
30=4
<15 = esrf |
|
|
Term
|
Definition
hypertension
diabetes
glomerulonephritis
polycystic kidney disease
chronic pyelonephritis
renal artery stenosis
vasculitis |
|
|
Term
symptoms of CKD remember 5Ps
SOB- pulmonary oedema
lethargy and bone pain - PTH over activity and renal osteodystrophy
peripheral neuropathy - amylodosis
itching - ureamia |
|
Definition
parathyroid overactivity
pruritus
pigmentation
peripheral neuropathy
pulmonary oedema |
|
|
Term
|
Definition
hypertension
anemia
renal osteodytrophy
cardiovascular disease: MI, angina
calcium low phosphate high
acidosis
malnutrition
hyperlipideamia |
|
|
Term
| by what mechanism does anemia occur in CKD? |
|
Definition
|
|
Term
| in CKD which kind of hyperparathyroidism occurs? |
|
Definition
| secondary (to renal disease) |
|
|
Term
| complications of continuous ambulatory peritoneal dialysis? |
|
Definition
infection
peritonitis with staphy epidermis
mechanical problems with fluid drainage |
|
|
Term
| causes of microcytic anemia? |
|
Definition
fe deficiencey
thalassemia
congenital sideroblastic anemia
lead poisoning |
|
|
Term
| causes of macrocytic anemia? |
|
Definition
B12 deficiency
folate deficiency
alcohol
hypothyroid
pregnancy
reticulocytosis
liver disease |
|
|
Term
| causes of polycytheamia. it can be relative or secondary true polycythemia |
|
Definition
secondary causes:
due to hypoxia: COPD, altitude, smoking
inappropriate EPO making: due tor enal artery stenosis, renal cancer
relative polycythemia
due to burns, D+V, diuretics, Gaisbock syndrome |
|
|
Term
|
Definition
| secondary polycythemia that occurs in males who have a sedentary lifestyle and are on a high calorie diet |
|
|
Term
what mutation do 90% of people with polycythemia rubra vera have?
(jack has it too) |
|
Definition
|
|
Term
| causes of haemolytic anaemia |
|
Definition
autoimmune
sphrerocytosis
elliptocytosis
sickle cell disease
glucose-6-phosphate deficieny
thallasaemia |
|
|
Term
| multiple myeloma is cancer in which type of cells? |
|
Definition
|
|
Term
| what are the clinical features of multiple myeloma? |
|
Definition
backpain, osteoporosis, pathalogical fractures
lethargy
renal failure
amyloidosis
hypercalcamia
carpal tunnel, neuropathy
hyperviscosity |
|
|
Term
| name of urinary protein we look for in multiple myelopma? |
|
Definition
|
|
Term
|
Definition
IV fluids to rehydrate
IV bisphosphonate eg palmindronate |
|
|
Term
|
Definition
p24 antigen
combined HIV antibody |
|
|
Term
|
Definition
progression to aids
pulmonary infection: pnuemocytis jirovecio
CNS infections: toxoplasmosis, cryptococcal meningitis
occular disease: CMV retinitis
tumours: Kaposis, non hodgkins
GI;oesophageal candidiasis, oral hairy leukoplakia |
|
|
Term
HIV protease inhibitor (PI) drugs have the ending -naviir.
give some examples of PI |
|
Definition
indinavir
ritonavir
nelfinavir |
|
|
Term
| Zidovudine is an example of which type of HIV drug? |
|
Definition
nucleoside analogue reverse transcriptase inhibitor
other examples lamividune, didanosine |
|
|
Term
| lamivudine, didanosine and zidovudine are examples of which HIV drugs? |
|
Definition
| nucleoside analogue reverse transcritptase inhibitors |
|
|
Term
| give an example of a non nucleoside analogue reverse transcriptase inhibitor? |
|
Definition
|
|
Term
|
Definition
| non nucleoside analogue reverse transcriptase inhibitors used in HIV |
|
|
Term
| what is the first marker to appear in Hep B infection |
|
Definition
| HBsAg Hep B surface antigen |
|
|
Term
| which marker implies immunity from Hep b infection e.g. immunisation? |
|
Definition
|
|
Term
| Anti-HBs in serology implies? |
|
Definition
| vaccination/immunity against hep B |
|
|
Term
| in Hep B which serology result implies active infection with Hep B? |
|
Definition
|
|
Term
|
Definition
chronic Hep b
fulminant liver failure
polyarteritis nodosa
hepatocellular carcinoma
glomerulonepritis
cryoglobulinaemia |
|
|
Term
|
Definition
| antiviral (pegylated interferon alpha) |
|
|
Term
| skin manifestation from Hep C especially if concomitant alcoholic or IVDU? |
|
Definition
|
|
Term
|
Definition
chronic disease 80-90%
HCC
cirrhosis
CRYOGLOBULINEAMIA
porphyria cutanea tarda |
|
|
Term
| chronic disease in Hep B versus Hep C |
|
Definition
| more people have chronic hep c than Hep b |
|
|
Term
|
Definition
PEGYLATED INTERFERON ALPHA
RIBAVIRIN
protease inhibitor -boceprevir |
|
|
Term
ribavirin
boceprevir and pegylated interferon alpha would be used to treat which viral infection? |
|
Definition
|
|
Term
| risk factors for ischemic stroke? |
|
Definition
age
smoking
htn
diabetes
carotid artery disease
hyperlipideamia
AF |
|
|
Term
| Left homonymous hemianopia with macular sparing, where is the lesion? |
|
Definition
| Right posterior cerebral artery |
|
|
Term
| absolute CI to thrombolysis following ischemic stroke? |
|
Definition
previous hemorrhagic stroke
stroke tia in last 6 motnhs
active bleeding
unconscious
cerebral neoplasm |
|
|
Term
| relative CI to thrombolysis following ischemic stroke? |
|
Definition
known bleeding disorders
pregnancy
anticoagulant therapy |
|
|
Term
| secondary prevention following stroke? |
|
Definition
Clopidogrel
anti hypertensive if HTN
statin |
|
|
Term
| sodium valproate is used in epilepsy, name another condition it is used in? |
|
Definition
|
|
Term
|
Definition
alopecia: regrowth may be curly
increased appetite and weight gain
GI: nausea
tremor
hepatitis
pancreatitis |
|
|
Term
| in established epilepsy how long do you need to be seizure free before you can drive? |
|
Definition
|
|
Term
|
Definition
unilateral
pulsatile quality
4-72 hours duration
aggravated by normal physical activity
photoboia or phonophobia
aura
nausea or vomiting |
|
|
Term
| common triggers for migraine? |
|
Definition
stress
foods
dehydration
menstrual cycle in women
strong smell
bright light |
|
|
Term
| how to manage acute migraine attack providing there are no contraindications? |
|
Definition
NSAIDs
oral triptan eg sumatriptan |
|
|
Term
| clinical features of parkinsons disease |
|
Definition
bradykinesia
tremor
drooling saliva
rigidity
micrographia
depression |
|
|
Term
| complications of parkinsons disease? |
|
Definition
falls, immobility
slowness
dementia
depression/psychosis |
|
|
Term
|
Definition
| dopamine receptor agonist |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| name 3 drugs that can cause drug induced parkinsonism |
|
Definition
metoclopromide
Haloperidol
procholpromazine |
|
|
Term
|
Definition
swan neck deformity
Boutonniere deformity
swelling
z shaped thumb
ulnar deviation
positive MCP squeeze test |
|
|
Term
| extra articular manifestations of RA |
|
Definition
pericarditis
pulmonary effusions
keratoconjunctivitis sicca
anaemia of chronic disease
IHD
carpal tunnel
palmar erythema |
|
|
Term
| Anti-CCP higher specificity for RA what does it stand for? |
|
Definition
| Anti cyclic citrillunited peptide antibody |
|
|
Term
|
Definition
|
|
Term
|
Definition
neutropenia
liver enzyme derangement
pulmonary fibrosis
steven johnsons syndrome
pericarditis
vasculitis |
|
|
Term
| criteria before RA can be treated with biologics? |
|
Definition
severe disease. DAS28 score >5.1
disease has not responded to a convention combination of DMARDS |
|
|
Term
|
Definition
pregnancy/puberty
thyroditis
iodine deficiency
toxic multinodular goitre
AI thyroid disease
tomours: malignant/benign
TB/sarcoid |
|
|
Term
|
Definition
fine tremor
lid lag
sinus tachycardia, AF
thyroid acropachy
pre tibial myoedema |
|
|
Term
| medical rx options for hyperthyroid? |
|
Definition
for symptomatic rx: beta blocker
for high T4: carbimazole |
|
|
Term
| indications for surgical rx of hyperthyroid? |
|
Definition
reocccuring graves disease despite rx
intolerant of medical rx
patient preference
large goitres |
|
|
Term
| complications of thyroidectomy? |
|
Definition
bleeding
damage to recurrent laryngeal nerve
hypocalcemia if there is damage to PTH glands
late hypothyroidism |
|
|
Term
| causes of upper GI bleed? |
|
Definition
duodenal ulcer
oesophageal varices
mallor weis tear
oesophagitis
oesophageal cancer |
|
|
Term
|
Definition
hypotension
increased CRT
tachycardia
oliguria
cold |
|
|
Term
| scoring systems used in upper GI bleed? |
|
Definition
Glasgow-Blatchford score
Rockall score |
|
|
Term
| scoring system for liver cirrhosis? |
|
Definition
|
|
Term
| apart from alcohol, other causes of cirrhosis |
|
Definition
drug: MTX
hepatitis B/C
NAFLD
haemachromatosis
wilsons disease |
|
|
Term
| examination features that would suggest OA of hip |
|
Definition
antalgic gait
positive trendelenberg test
positive thomas test
reduced movement or pain on hip movement
wasting of gluteal muscle
crepitus |
|
|
Term
|
Definition
inflammatory arthropathies e.g. reactive arthritis
neoplasm: metastatic cancer of femur
degenerative: lumbar spinal stenosis
drug induced:avascular necrosis of hip
neuropathic: lateral femoral cutaneous nerve entrapment
trochanteric bursitis |
|
|
Term
| non pharmacological treatments for OA |
|
Definition
physiotherapy
lose weight if appropriate
strengthening exercises
walking aids and support such as insoles
heat and ice packs |
|
|
Term
| pharmacological treatments for OA hip |
|
Definition
paracetamol
nsaids (+ppi)
opiates eg codeine
intra articular steroid injections |
|
|
Term
| general and specific complications of total hip replacement |
|
Definition
general: infection, anaesthesia risk, post op delirium, AKI, death
specific
intraoperative: fracture of acetabulum
early: DVT/PE, fat embolism, sciatic nerve palsy
late: leg length discrepancy, dislocation |
|
|
Term
component of the glasgow score for pancreatitis and interpretation
remember: PANCREAS |
|
Definition
PaO2
Age >55
Neutrophilia >15
Calcium low
Renal urea raised
Enzymes LDH raised
Albumin low
Sugars glucose raise
> 3 criteria present within 48 hours suggests severe pancreatitis |
|
|
Term
causes of acute pancreatitis?
IGETSMASHED |
|
Definition
idiopathic
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion sting
Hyperlipid, hypercalcium
ERCP
Drugs Mesalizine |
|
|
Term
| complications of acute pancreatitis? |
|
Definition
chronic pancreatitis
pancreatic abscess
pancreatic pseudocysts
ARDS
Hypovoemia/shock
metabolic disturbances: hypocalcemia/hyperglyceamia |
|
|
Term
complications of knee replacement
general and specific |
|
Definition
general: infection, GA risk, post op pyrexia,pain, N&V, death
specific
intraoperative: fracture tibia
early:vascular damage, PE/DVT, fat embolism, perineal nerve palsy
late: infection, loosening, patellar instability |
|
|
Term
| complications of receiving a blood transfusion. these can be divided into immune mediated and non immune mediated. |
|
Definition
non immune mediated:
infection
hyperkalemia
congestive cardiac failure
immune mediated
ABO incompatibility
heamolysis
urticaria
pyrexia |
|
|
Term
causes of post operative pyrexia
remember 7 Cs |
|
Definition
chest-pnuemonia
catheter- UTI
CVP - infection
cannula - thrombophlebitis
Cut - wound infection
Collection - abscess
Calves - DVT |
|
|
Term
| Wells score of 3 for ?DVT rx? |
|
Definition
|
|
Term
| risk factors for developing breast cancer |
|
Definition
BRCA genes
1st degree premenopausal family member with breast cancer
COCP
nulliparity
ionising radiation |
|
|
Term
| NHS breast screening programme runs for which ages? |
|
Definition
|
|
Term
| what 3 examinations occur in one stop clinic? |
|
Definition
breast examination
mammorgraphy/USS
FNA/biopsy |
|
|
Term
| which is the most common type of breast cancer? |
|
Definition
| invasive ductal carcinoma |
|
|
Term
| side effects of tamoxifen |
|
Definition
hot flushes
nausea
increased risk for endometrial cancer
mood swings
cerebrovascular events
thromboembolic event
eye disorders: cataracts, blurring |
|
|
Term
| premenopausal women with oestrogen receptor positive breast cancer are offered tamoxifen. what are post menopausal women offered? |
|
Definition
|
|
Term
|
Definition
| mixed agonist antagonist of oestrogen |
|
|
Term
| HER2 positive breast cancer. what can be offered? |
|
Definition
|
|
Term
| what is the difference between a direct and an indirect inguinal hernia? |
|
Definition
direct hernia:
due to a weakness in the posterior wall of the transversals fascia. the hernia protrudes through hesselback triange medial to the inferior epigastric artery, it doesnt go down to the sctrotum.
indirect hernia
these usually stop at the superficial ring. they do not emerge in heselbachs triangle. they are lateral to the inferior epigastric artery. |
|
|
Term
| which anatomical structure can be used to differentiate between direct /indirect hernias? |
|
Definition
|
|
Term
| which layers do you need to cut through to get to the inguinal canal? |
|
Definition
skin
campers fascia
scarpas faschia
external oblique aponeurosis |
|
|
Term
| which structure forms the floor of the inguinal canal? |
|
Definition
|
|
Term
| name an early and late complication to do with inguinal hernia repair |
|
Definition
early
infection
numbness
bruising
death
Late
reoccurrence
chronic pain
infertility |
|
|
Term
what makes up the borders of Hesselbachs triangle?
remember RIP |
|
Definition
medial: rectal sheath linea semilunaris
superolateral: Inferior epigastric artery
inferior: Popuparts ligament aka inguinal ligament |
|
|
Term
| in lap cholecystectomy why do we need to locate Calots triangle? |
|
Definition
| to find and ligate the cystic artery |
|
|
Term
| apart from acute cholecystitis name some other conditions caused by gallstones |
|
Definition
pancreatitis
ascending cholangitis
gallstone illeus
billiary coli
Mirrizi syndrome |
|
|
Term
| risk factors for developing Gallstones? |
|
Definition
obese
increasing age
female sex
crohns
diabetes melitus
smoking |
|
|
Term
| in lap chile you need to find and ligate the cystic artery. this lie in Calots triangle. what are the borders that make this triangle up? |
|
Definition
Inferior: cystic duct
medial: common hepatic artery
superior: visceral surface of liver
Cici! cystic duct, common hepatic artery |
|
|
Term
| specific complications of lap cholecystectomy? |
|
Definition
Infection
biliary leak causing peritonitis
bleeding from cystic or hepatic artery
bile duct injury |
|
|
Term
| the most common composition for a renal stone is? |
|
Definition
|
|
Term
mx options for 1cm stone in ureter?
stone < 5mm can pass expectantly |
|
Definition
shock wave lithotripsy
percutaneous nephrolithotomy
open surgery |
|
|
Term
| GP wants to exclude common risk factors for irate stones. what should he check levels in the blood? |
|
Definition
|
|
Term
| causes of raised PSA other than prostate cancer? |
|
Definition
BPH
prostatitis
UTI
ejaculation
vigourous exercise
instrumentation of urinary tract |
|
|
Term
| unexplained symptoms where prostate cancer should be suspected |
|
Definition
lower back pain
bone pain
erectile dysfunction
heamaturia
weight loss |
|
|
Term
| most common type of prostate cancer? |
|
Definition
| adenocarcinoma 95% of the time |
|
|
Term
| mx options for prostate cancer? |
|
Definition
radiotherapy
surgery: radical prostatectomy
hormonal therapy |
|
|
Term
| which ix are used to diagnose peripheral artery disease? |
|
Definition
|
|
Term
| conservative mx of peripheral artery disease |
|
Definition
smoking cessation
diet
exercise
weight loss |
|
|
Term
| what 2 drugs should someone diagnosed with peripheral artery disease be taking? |
|
Definition
|
|
Term
| rx options for pts with severe peripheral artery disease or critical limb ischemia |
|
Definition
bypass
angioplasty
amputation |
|
|
Term
| signs of acutely ischemic limb |
|
Definition
pale
pain
paraesthesia
pulseless
paralysis
cold |
|
|
Term
| which part of the colon are colorectal cancers most often found? |
|
Definition
|
|
Term
| which areas does CRC commonly metastasise to? |
|
Definition
liver
lung
peritoneal
brain
bone |
|
|
Term
SE of stoma formation
FOUL SHITS |
|
Definition
fluid loss
odour
ulceration
leakage
stenosis
herniation
ischeamia
terminal ileum loss
sexual and psychological problems |
|
|
Term
|
Definition
|
|
Term
| ix that occur in the 28 week antenatal visit |
|
Definition
BP
urine dipstick
fundal height
FBC |
|
|
Term
| risk factors for developing pre eclampsia |
|
Definition
age > 40
nulliparity or new partner
previous history of pre eclampsia
obesity
twins
fhx of pre eclampsia
pre existing vascular disease such as HTN or renal disease
diabetes melitis |
|
|
Term
| potential maternal complications of pre eclampsia |
|
Definition
eclamsia
dic
death
HELLP syndrome
acute renal failure |
|
|
Term
| complications to fetus due to pre eclamsia |
|
Definition
IUGR
feral bradycardia
respiratory distress syndrome
intracranial hemorrhage |
|
|
Term
| what ix occurs in a normal booking visit? |
|
Definition
BP
urine
BMI
FBC, blood group, rhesus status
Hep B, syphillis, HIV
urine culture |
|
|
Term
| risk factors for developing gestational diabetes? |
|
Definition
BMI >30
previous gestational diabetes
large baby >4.5kg
1st degree relative with diabetes
Family origin with high prevalence of diabetes |
|
|
Term
| diagnostic threshold for gestational diabetes? |
|
Definition
fasting > 5.6
2 hour > 7.8 |
|
|
Term
| mx for gestational diabetes |
|
Definition
joint diabetes antenatal clinic
dietary advise
exercise advice
metformin
insulin |
|
|
Term
| examination findings that support a diagnosis of bronchiolitis |
|
Definition
nasal flaring
tracheal tug
intercostal recession
pyrexia
inspiratory crackles
expiratory wheeze
increase HR increased RR |
|
|
Term
| what signs would make you send a 6 month old baby with bronchiolitis to hospital? |
|
Definition
RR >70
Feeding < 50% normal
dehydration
central cyanosis
apnoea
o2 sats persistently <92% on air |
|
|
Term
| what is the name of the prophylactic monoclonal antibody you can receive for bronchiolitis? |
|
Definition
|
|
Term
| which receptor does cystic fibrosis affect? |
|
Definition
| cystic fibrosis transmembrane conductance regulator gene |
|
|
Term
| organisms that can colonise people with CF |
|
Definition
staphloccocus aureus
psuedomonas aeringosa
burkholdeira cepacia
Aspergillus |
|
|
Term
| which tests can be used to ix a child with potential CF? |
|
Definition
sweat test
genetic test
stool analysis |
|
|
Term
|
Definition
multidisciplinary team care
chest physio
postural drainage
high calorie diet
fat soluble vitamin supplementation
pancreatic enzyme supplementation
bronchodilators
heart lung transplant |
|
|
Term
| which dopamine receptor do antipsychotics primarily antagonise? |
|
Definition
|
|
Term
| oral morphine to sc morphine |
|
Definition
|
|
Term
| oral morphone to sc diamorphine |
|
Definition
|
|
Term
|
Definition
analgesia (morphine)
sedation (midazolam)
secretions (hyoscine butylbromide or glycopyronium)
antiemetic (cyclizine) |
|
|
Term
| which areas of the body does eczema primarily affect? |
|
Definition
face
scalp
extensor surfaces of limbs |
|
|
Term
|
Definition
infection: with staphy aureus
psychosocial: bullying, reduce self confidence, days off school |
|
|
Term
|
Definition
| emolient and topical steroid |
|
|
Term
| class of drug to rx itchiness associated with eczema? |
|
Definition
|
|
Term
| symptoms of eczema herpeticum |
|
Definition
rapidly worsening eczema
painful eczema with blisters
punched out erosions
possible fever |
|
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