AKT REVISION - ENDOCRINOLOGY Flashcards
(22 cards)
Alkaptonuria (AKU) is also known as:
Select one:
a. Black bone disease
b. Black tongue disease
c. Red foot disease
d. Blue skin disease
BLACKBONE DISEASE
A key early diagnostic feature seen in babies with AKU is:
Select one:
a. Pigmented palmar skin creases
b. Stiff hips and knees
c. Failure to thrive
d. Darkly pigmented urine seen in nappies
Darkly pigmented urine seen in nappies
The gold standard diagnostic test in patients with suspected AKU is:
Select one:
a. Plasma sample for HGA levels
b. Retinal screening for HGA deposits
c. Urine for organic acid analysis
d. Cultured fibroblast for HGA staining
Urine for organic acid analysis
The key difference clinically in the presentation of adults with AKU and Ankylosing spondylitis (AS) is:
Select one:
a. Sacroiliac joint sparing in AKU
b. Morning stiffness more pronounced in AKU
c. A negative HLA-B27 test in AKU
d. Small joint sparing in AKU
Sacroiliac joint sparing in AKU
Which are the characteristic clinical signs of AKU in adults:
Select one or more:
a. Urine darkly pigmented after being left to stand
b. Ears – blue cartilage
c. Pigmented nail beds
d. Eyes– dark brown-black spots
e. Periumbilical discolouration
f. Joint ochronosis- darkly pigmented joint at time of surgery
Urine darkly pigmented after being left to stand
Ears – blue cartilagE
Eyes– dark brown-black spots
Joint ochronosis- darkly pigmented joint at time of surgery
Regarding the prescribing of diabetes medication, which of the following statements are true?
Select one or more:
Diabetes medication prescribing now accounts for nearly 10% of all prescription costs
Prescriptions should only be issued for one month at a time due to the risk of hypoglycaemia
Prescriptions for diabetics are free across the UK
There are seven classes of oral blood-glucose-lowering drugs
Medications tend to be switched rather than combined in order to achieve control
The correct answers are: Diabetes medication prescribing now accounts for nearly 10% of all prescription costs,
There are seven classes of oral blood-glucose-lowering drugs
Which of the following have an evidence base for preventing or treating complications of diabetes?
Select one or more:
ACE inhibitors
Bendroflumethiazide
Statins
H2 receptor antagonists
Orlistat
ACE inhibitors
Statins
Which of the following are components of a high quality medication review?
Select one or more:
Checking that the medication is effective for the patient
Exploring side effects
Identifying use of over-the-counter and complementary medicines
Returning unused medication to the practice
Ensuring the medication is a cost-effective choice
Checking that the medication is effective for the patient
Exploring side effects
Identifying use of over-the-counter and complementary medicines
Ensuring the medication is a cost-effective choice
According to NICE, which of the following statements regarding diabetic medication and HbA1c targets are true?
Select one or more:
If HbA1c levels are not adequately controlled by a single drug which is being taken correctly, and rise to 58 mmol/mol or higher, drug treatment should be intensified
If a patient is on a single drug to control their diabetes, and the drug is not associated with hypoglycaemia, the target HbA1c level should be 48 mmol/mol
For a patient taking more than one drug for diabetes, the target HbA1c level should be 56 mmol/mol
Consideration should be given to de-intensifying treatment in patients with an HbA1c of less than 48 mmol/mol
All patients should have the same HbA1c targets
If HbA1c levels are not adequately controlled by a single drug which is being taken correctly, and rise to 58 mmol/mol or higher, drug treatment should be intensified,
If a patient is on a single drug to control their diabetes, and the drug is not associated with hypoglycaemia, the target HbA1c level should be 48 mmol/mol,
Consideration should be given to de-intensifying treatment in patients with an HbA1c of less than 48 mmol/mol
The Scottish Government Polypharmacy Model of Care Group have recommended that a treatment approach to minimise symptoms related to hyperglycaemia rather than targeting an HbA1c level should be taken in which of the following patient groups?
Select one or more:
Age over 80
Resident in a nursing home
Dementia
End-stage kidney disease
Learning disability
Age over 80
Resident in a nursing home
Dementia
End-stage kidney disease
AKI diagnosis, where is it more ?
Primary
Secondary
Tetiary
AKI is diagnose more in the primary care
AKI means worsening of kidney function over a short period of time ?
TRUE
AKI definition. Which three tools are used to define AKI?
A. Serum creatinine rise in 48 hours of 26 micromol/L or more
B. Serum creatinine rise of 50% or more in 7 days
C. Urine output fall 6 hours to less than 0.5ml/hour/kg
AKI is owrsening of kidney function in context of an acute illness
What proportion of cases of AKI start in the community?
Select one:
10%
20%
40%
60%
60%
What are common causes of AKI
Sepsis
Hypoperfusion
Obstruction
All of the following but one puts a person at risk of AKI
Which of the following factors put a person at increased risk of AKI?
Select one or more:
Increasing Age
Physical incapacity
Dementia
Chronic kidney disease
COPD
Diabetes mellitus
Chemotherapy
COPD
Aptient takes the following medication for RA. All of the follwoing but one puts the patient at risk of RA
In a patient with rheumatoid arthritis which of the following medications puts them at risk of AKI?
Select one or more:
Naproxen
Ibuprofen
Paracetamol
Gold
Methotrexate
PARACETAMOL
All of the following but one puts a heart failure patient at risk of AKI
Select one or more:
Ramipril
Candesartan
Furosemide
Spironolactone
Eplereone
Bisoprolol
None of the above
NONE OF THE ABOVE
You are the duty doctor and notified by the laboratory that a patient has AKI stage 2.
Which of the following are the appropriate actions in response to this?
Select one or more:
Leave this for the patients own GP to deal with tomorrow
Access the patients notes to review past history and medications
Identify why the blood test was taken
Telephone the patient/carer and find out how the patient is
Immediately arrange admission to hospital
Access the patients notes to review past history and medications,
Identify why the blood test was taken,
Telephone the patient/carer and find out how the patient is
The level of which ion needs to be considered when assessing the severity of AKI
Select one:
Sodium
Potassium
Calcium
Potassium
Which of the following are considered specific exposures which may cause an episode of AKI?
Select one or more:
Diarrhoea and vomiting
Sepsis
Major surgery
Recent coronary angiogram
Treatment with trimethoprim
Diarrhoea and vomiting,
Sepsis,
Major surgery,
Recent coronary angiogram
Which of the following are appropriate immediate actions in assessment of the patient with AKI?
Select one or more:
Urine dipstick testing
Renal ultrasound scan
Blood pressure check
Catheterisation to monitor urine output
Nephrology referral
Urine dipstick testing
Blood pressure check
Urine dipstick results showing haematuria and proteinuria, without urinary tract infection or trauma due to catheterisation.? Think Acute nephritis
