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Martha Phase 2a > PTS SBA 1 corrections/notes > Flashcards

PTS SBA 1 corrections/notes Flashcards

1
Q

Treatment of MI

A

Dual antiPLATELET therapy
aspirin and PY12 inhibitor (clopidogrel, ticagrelor, prasugrel).
DUAL AP
(AntiPlatelet, Aspirin + py12i)

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2
Q

how and where does aspirin affect the kidney?

A

inhibits COX in the PCT

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3
Q

how and where do CCB act?

A

inhib L type voltage gated calcium channels in the nephrons
eg. amlodipine

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4
Q

how and where do thiazide like diuretics act?

A

inhib sodium chloride transporter in DCT
eg. bendroflumethiazide

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5
Q

how and where do loop diuretics work?

A

inhib the na/k/cl sympoter in the loop of henle
eg. furosemide

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6
Q

how and where does a k sparing diuretic work?

A

inhib aldosterone in the distal tubules.

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7
Q

differentiate between mitral stenosis and mitral regurgitation?

A

stenosis would have a diastolic murmur as well as a systolic (heard at the apex)

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8
Q

describe the changes on an ECG of an MI

A

ST elevation, ST depression, T wave inversion, abnormal Q wave.

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9
Q

which conditions are absent P waves commonly seen in?

A

SVT, A fib, atrial flutter.

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10
Q

what ECG finding indicates hyperkalaemia?

A

tall tented T wave

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11
Q

when are wide QRS complexes commonly seen

A

in bundle branch blocks

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12
Q

what are the recommendations for managing hypertension?

A

-blood pressure >135/85 requires pharmacological management
-differences in Caucasian vs Afro-Caribbean: first line for C= ACEi (ramipril)- if intolerant start an ARB (losartan). if no response start thiazide like diuretic.
first line for AC= CCB (amlodipine)

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13
Q

what is CHA2DS2-VASc score used for?

A

calculates stroke risk for patients with ATRIAL FIBRILLATION

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14
Q

What is QRISK3 score used for

A

Calculates stroke risk in patients over the next ten years

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15
Q

what are three key aspects of conns syndrome?

A

hypertension with hypokalaemia
hypertension despite being on 3 or more antihypertensives
hypertension before 40 years old

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16
Q

which diuretic should be used in conns syndrome

A

spironolactone as it is potassium sparing- this reduces the risk of hypokalaemia.

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17
Q

renin and aldosterone values in primary and secondary hyperaldosteronism

A

primary- renin is decreased while aldosterone increases
secondary- both renin and aldosterone are increased

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18
Q

describe addisons

A

Addison’s is a form of adrenal insufficiency (primary)
it causes reduced aldosterone levels due to an autoimmune response destroying the tissue of the adrenal glands.

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19
Q

signs of hypercalcaemia

A

bones, stones, groans and psychic moans.

20
Q

describe carcinoid syndrome

A

D+, heart palpitations, feeling flushed.
paraneoplastic syndrome, symptoms are due to tumour cells producing 5-HT.

21
Q

which tests are specific to coeliac disease?

A

IgA tissue transglutaminase or IgA endomysial

22
Q

why is hyperkalaemia a medical emergency?

A

it can cause cardiac arrest

23
Q

which lymphoma causes pain when drinking alcohol

A

Hodgkins

24
Q

is non hodgkins lymphoma a symmetrical or asymmetrical presentation?

A

non hodgkins is symmetrical, while hodgkins is asymmetrical

25
Q

which leaukaemia is the phildelphia chromosome linked to?

A

CML

26
Q

when are auer rods found

A

in aml

27
Q

which condition is reed sternberg cells found in?

A

hodgkins lymphoma (owl cells)

28
Q

what clinical findings are in myeloma?

A

bence jones proteins and monoclonal antibodies.

29
Q

which type of anaemia causes reduced reflexes?

A

macrocytic from hypothyroidism or b12 deficiency.

30
Q

what is the action of warfarin?

A

vitamin K antagonist
vitK is used in synthesis of factors 2,7,9,10 (1972)

31
Q

how can spinach affect warfarin

A

high in vitamin K so there will be reduced effect.

32
Q

how can grapefruit, cranberries and alcohol affect warfarin?

A

increases the effect

33
Q

what does a high/low INR indicate a risk of?

A

high INR= haemorrhage (H-H)
low INR= clotting (lo-lot)

34
Q

what is the pathology of coffee ground vomitus?

A

indicates a bleed in the upper GI
blood mixes with acid and looks like black spots

35
Q

which valve is most affected in infective endocarditis?

A

tricuspid- it is the first valve touched by the blood from the circulation.

36
Q

which antibiotics inhibit cell wall synthesis?

A

penicillins, cephalosporins, glycopeptides

37
Q

what is the mechanism of macrolide abx?

A

erythromycin and clarithromycin inhibit PROTEIN synthesis

38
Q

what is the first and second line treatments for osteoporosis

A

first; alendronic acid (bisphosphonate) and AdCal (vit D and calcium).
second; introduce Denosumab (MAB to RANK ligand, inhibits osteoclast activity and bone resorption

39
Q

what is colchicine used for?

A

reduce inflammatory responses such as acute gout

40
Q

what is the most specific investigation for RA?

A

Anti citrullinated peptide antibody (anti CCP)

41
Q

what is the first line treatment for a migraine?

A

NSAIDS- Ibuprofen

42
Q

what is the history for a medication headache?

A

regular (>3 months) history of drug use such as triptans, opioids and NSAIDS

43
Q

which nerve is involved in carpal tunnel?

A

median nerve

44
Q

how to tell which acidosis/ alkalosis it is

A

pH: >7.45= alkalosis. If it is <7.35= acidotic.
CO2: If the CO2 goes in the same direction as the pH it is metabolic, if it goes in the
opposite direction it is respiratory. (Tip to remember= 2 people who travel in the same direction
are likely to ‘meet’= ‘met).

45
Q

what is a key finding of sarcoidosis

A

hypercalaemia

Martha Phase 2a (10 decks)

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