Case 5 medical conditions Flashcards
(30 cards)
What are the two medications given as emergency hormonal contraception
Levonelle (levongesterel) and Ella One (Ulipristal acetate)
What is the time from unprotected sex that the two EHCs can be used
Levonelle: 72 hours
Ella One: 5 days
What are some counselling points to include in supplying EHC
- may delay the next period
- if you vomit in the next 2-3 hours, you will need to take another pill
- other forms of contraception if relevant -signpost if the pharmacy cannot supply this
What type of insulin is used in gestational diabetes and why
Fast acting, such as aspart and lispro. They have advantages over soluble human insulin in pregnancy.
what is some of the lifestyle advice that can be given to someone suffering with morning sickness
- Small and frequent meals
- Acupressure
- Bland food
- Cold food can be easier tolerated
- Medicine review!
- Avoiding triggers ie smells
- Less medication the better!!!
- Dont start any NEW exercises unless they are pregnancy-approved
when should morning sickness usually resolve
weeks 16-20 of pregnancy
what is the effect of taking vitamin A during pregnancy
Vitamin A during pregnancy can cause birth defects such as bone, urinary tract and nerve damage. When taken in excess, it can also cause liver damage. It is fat soluble and is stored in the liver.
if someone is suffering with migraines whilst taking the COC, what type of contraceptive can we switch them to
Progesterone only.
Migraines are associated with the estrogen in the med.
why might we try and avoid metformin in pregnancy unless it is needed
crosses placenta and therefore side effects in pregnancy - if it’s not needed don’t take it
at what stage in pregnancy should trimethoprim be avoided
first trimester
what is a D-dimer test
a test to assess if a person has a clotting disorder. It measures the amount of d-dimer in the blood (degradation product of fibrin). High levels may indicate that she has a clotting disorder
what are some symptoms of a DVT
- One leg swollen - measure calf circumferences and compare
- Pitting oedema
- Tenderness and redness
what tool is used to calculate the probability of having a DVT
well score
what is HbA1c
A blood test that can measure your average blood glucose levels over the past 2-3 months. It is used to monitor how well diabeties manaement is working or be used in diagostics.
what is diabetic ketoacidosis
DKA
this is when the body has a lack of insulin so cant move sugar into cells resulting in the breakdown of fat into ketones.
theres 2!!
what diabetic drugs are associated wih a higher risk of hypoglycemia
insulin and sulfonylureas
what are 2 examples of rapid acting insulin
lispro and aspart
what 2 insulins are safe in pregnancy
lispro and aspart
what test should be donein the initial management of hypogylcemia
CBG test to measure glucose levels
are insulin devices interchangeable
NO - they are biologics.
Macrovascular problems in diabeties
atherosclerotic disease (CVD)
- result of chronic inflammation of the arterial wall in the peripheral or coronary vascular system
increased risk of a stroke
- result of increased platelet adhesion in T2DM
microvascular complications of diabeties
nephropathy
- diabetic kidney disease. indicated by proteinuria. - also a CV risk.
neuropathy
- - numbness, shooting pain, neuropathic pain
- postural hypotension
-sexual dysfunction
retinopathy
- blurred vision
how are macrovascular and microvascular complications managed in T2DM
- Diabetic eye screening
- footware advice
- nail cutting advice
- screening for diabetic kidney disease
- smoking cessation
- CV risk assessment
- antihypertensives
-lipid modification - statins
overall glycemic control is KEY
diabetic foot symptoms
painful swelling
if infection may be warm to touch, purulent discharge
