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Year 4 > CCC > Flashcards

CCC Flashcards

1
Q

neutropenic sepsis Mx

A

Fluids

immediate broad spectrum antibiotics

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2
Q

metastatic spinal cord compression Mx

A

Lie flat
Dexamethasone 16mg + PPI cover
urgent MRI scan

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3
Q

superior vena cava obstruction Mx

A 
A to E
sit up 
dexamethasone 16mg & PPI cover 
CXR
morphine is SOB
vascular stenting / radiotherapy to reduce tumour size
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4
Q

Hypercalcaemia Mx

A

Fluids - saline

Bisphosphonates - IV zolendronic acid

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5
Q

management of cancer can be…

A

surgery
radiotherapy
chemotherapy (kills rapidly growing cells)
pallative

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6
Q

radical means

A

curative intent

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7
Q

neo-adjuvant meaning

A

Before an operation/radiotherapy

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8
Q

adjuvant meaning

A

After an operation

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9
Q

chemoradiation meaning

A

With radiotherapy

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10
Q

pallative approach meaning

A

Incurable disease, to alleviate Sx, prolong life

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11
Q

bone pain management

A

NSAIDs e,g diclophenac
radiotherapy
bisphosphonates

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12
Q

visceral pain

A

NSAIDs + corticosteroids
for colic pain - Anticholinergics
Bowel colic → SC hyoscine butylbromide
Bladder spasm → oral oxybutynin

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13
Q

headache due to raised ICP Mx

A

Corticosteroids → to reduce the oedema - 16mg PO dexamethasone OD

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14
Q

N&V - cause; gastric stasis / irraitation. Mx =

A

metoclopramide

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15
Q

neuropathic pain Mx

A

Amitriptyline
Gabapentin
Pregabalin
(Corticosteroids may help)

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16
Q

Toxic causes N&V Mx=

A

hapoperidol
cyclizine
(however if N&V caused by chemo - give dexamethasone & ondansetron)

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17
Q

cerebral causes N&V Mx =

A

Dexamethasone

Cyclizine

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18
Q

Anxiety and Anticipatory Causes of N&V Mx

A

Benzodiazepines

or CBT

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19
Q

if got renal failure what N&V med should be used

A

haloperidol

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20
Q

if opiod causing N&V which med can be used?

A

haloperidol

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21
Q

if get oral thrush due to chemo use

A

Fluconazole

& topical agent; Nystatin

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22
Q

For opioid induced constipation use a softener & stimulant

A

Movicol

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23
Q

bulking laxative

A

Movicol

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24
Q

stimulant laxative

A

senna

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25
Q

softener laxative

A

Lactulose Docusate

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26
Q

softener & stimulant laxative

A

Movicol Co-danthrusate

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27
Q

dysponea Mx

A

fan
Midazolam
Morphine

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28
Q

for morphine also prescibe

A

laxative (senna)

& anti-emetic (haloperidol)

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29
Q

terminal restlessness Mx

A

Look for evidence of reversible causes - Pain, retention, impaction, secretions
Midazolam - SC

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30
Q

Mx death rattle

A

Antisecretories → buscopan

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31
Q

4 things for end of life care

A

Analgesic → Morphine (double effect, will cause resp depression), Diamorphine
Antiemetic → haloperidol (acts as an antiemetic)
Anxiolytic → Midazolam
Anti-secretory → Buscopan (hyoscine butylbromide),
glycopyrronium

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32
Q

Asthma step 1 Mx

A

short acting beta agonist e.g salbutamol

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33
Q

step 2 astma Mx

A

SABA + ICS

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34
Q

step 3 asthma

A

SABA + ICS + LABA

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35
Q

step 4 asthma

A

SABA + ICS + LABA + Consider increasing ICS and start trial

of LTRA or theophylline

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36
Q

step 5 asthma

A

increase dose ICS + LRTA, theophylline

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37
Q

step 6 asthma

A

refer to specialist

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38
Q

T1DM Mx

A

insulin

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39
Q

T2DM Mx (after failed lifestyle modifications)

A

Metformin 500mg BD

after food

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40
Q

If metformin in T2DM not tolerated

A

Gliptin or gliclazide or pioglitazone

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41
Q

step 2 T2DM

A

DUAL THERAPY
Metformin + sulphonylurea (gliclazide 40mg
OD) or pioglitazone, or SGLT2 inhibitor

42
Q

step 3 T2DM - If at HbA1c still >58 at 6 months add

A

insulin

43
Q

Metformin good as

A

Increases insulin sensitivity & helps weight

44
Q

Sulphonylureas - E.g. gliclazide side effects

A

hypoglycaemia

45
Q

what score do you do for coronary heart disease

A

QRisk2

46
Q

Tx angina with GTN spray

A

GTN – if you have chest pain, stop what you’re
doing, use GTN
Take second dose after 5 mins, if not eased after
another 5 mins/or earlier if got worse, call 999

47
Q

1st line Tx angina (after GTN)

A

B blocker/CCB

48
Q

2nd line angina

A

Dual therapy B Blocker/CCB and
Isosorbide mononitrate
Nicorondil (K+ channel blocker)

49
Q

2ndry prevention angina

A

Antiplatelet – low dose aspirin or clopidogrel (If PVD/stroke use clopidogrel)
ACEi if stable angina and diabetes
Statin

50
Q

Mx recurrent / prolonged seizures

A

Buccal Midazolam

51
Q

Mx focal seizure

A

Carbemazepine or lamotrigine

52
Q

Mx tonic clonic seizure

A

Sodium Valproate

53
Q

Mx absence seizure

A

Sodium Valproate

54
Q

Mx Myoclonic / Tonic / Atonic seizure

A

Sodium valproate

55
Q

Tx heart failure

A 
ACEi
Beta blockers
CCB
Diuretics
anticoag (if Hx VTE)
aspirin (if co-exisiting with atherosclerosis)
56
Q

LVF give

A

ACEi

57
Q

ischemic stroke Mx if less than 4.5 hrs

A

thrombolysis - IV Alteplase

58
Q

Tx iscahemic stoke

A

Aspirin 300mg
4 days treatment dose, then move to long
term antiplatelet – usually Clopidogrel 75mg

59
Q

haemorrhagic stroke Mx

A

Reverse anticoagulation if indicated
Surgical referral if; Previously fit and haemorrhage with
hydrocephalus
or Deteriorating neurologically
(Medical treatment if surgery not appropriate)

60
Q

TIA Mx

A

300mg aspirin daily with PPI

Clopidogrel 75mg daily for secondary prevention

61
Q

CKD Mx

A

Early diagnosis
Idenyify cause
Monitor progression of CKD and associated conditions (e.g. anaemia)
Acidosis – consider sodium bicarb supplements
Oedema – loop diuretics, restriction on fluid/sodium intake

Blood pressure control indicates speed of
progression
Manage BP and/or proteinuria
Atorvastatin 20mg OD for 1ry or 2ry prevention of CVD
ACEi/ARB, even if normotensive
• Prescribe antiplatelet for 2ry prevention of CVD • Advice on self-management
lifestyle
Avoid OTC NSAIDs, other nephrotoxins
stage 4 – haemodialysis (fistula to help get access), peritoneal dialysis (permanently inserted tube)
Kidney transplant – best rehabilitation and survival

62
Q

hypertension - what scoring system

A

Qrisk2

63
Q

HTN step 1 age less than 55

A

ACEi (alternate ARB)

64
Q

HTN step 1 if over 55 years or african / carribean family origin

A

CCB

65
Q

step 2 HTN

A

ACEi + CCB

66
Q

step 2 HTN if african / carribean origin

A

ARB + CCB

67
Q

step 3 HTN

A

ACEi + CCB + TLD

68
Q

step 4 HTN

A

ACEi + CCB + TLD + D (consider refferal)

69
Q

example TLD

A

indapamide

70
Q

side effect spironololactone

A

gynbaecomastia

71
Q

AF Mx - what do you wnat to prevent

A

Stroke

72
Q

AF rate control

A

First line;
▪ Beta blocker +/- CCB
• Bisoprolol
• Diltiazem, verapamil

73
Q

when would you use digoxin in Tx AF

A

(Digoxin - for paroxysmal AF for sedentary patients or in HF)

74
Q

rthym control AF

A
  • Beta-blockers

* Flecainide (if Hx of IHD/LVH don’t use as scarring in heart)

75
Q

If AF >48 hours what can you do

A

cardioversion

76
Q

how to assess stroke risk

A

CHA2DS2VASc

77
Q

Assess risks and benefits of anticoagulation → … (if controlled hypertension don’t give points) – score 3+ indicates high risk for bleeding

A

HAS-BLED

78
Q

COPD Mx

A

smoking cessation
yearly flu jab
pneumococcal vaccine
lifestayle

79
Q

1st line COPD

A

SABA/SAMA (short acting muscarinic antagonist)

80
Q

2nd line COPD

A

No asthmatic features→LABA (eg salmetrol), or LAMA (eg tiotropium)
Asthmatic features→LABA + ICS in a combination inhaler
If still breathless, LAMA & LABA & ICS

81
Q

other medicines to consider COPD

A

Oral theophylline
Mucolytics (eg carbocysteine)Loop diuretic and long term O2 therapy in
cor pulmonale

82
Q

MS Tx

A

optimal vit D levels

steriods for relapses

83
Q

MND Tx

A

riluzole

84
Q

parkinsons Tx

A

levodopa

85
Q

OA Tx

A 
footwear
excercise to strengthen muscle
wt loss
NSAID (consider PPI)
steroid injection
86
Q

RA Tx

A

analgesia
methotrexate
infliximab
steroids

87
Q

depression

A

1st line - SSRIs
CBT
social factors

88
Q

anxiety Tx

A

SSRIs

CBT

89
Q

bipolar disorder Tx

A 
antipsyhotics 
sleeping tablets
lithium
valproate
lamotrigine
carbamezapine
90
Q

chronic alcohol use - acute Mx

A

pabrinex infusion

chloridazepoxide

91
Q

chronic alcohol abuse Mx

A 
detox using BNZs to replace alcohol
disulfiram (for replapse)
AA
CBT
eductaion
92
Q

bronchiectasis Tx (Tx is not curative)

A

postural drainage (psychiotherapists)
steroids
bronchodilators
antibiotics (initially broad spectrum e.g cefaclor or ciprofloxacin)

93
Q

pulmonary fibrosis Tx

A

pulmonary rehabilitataion
O2 therapy
lung transplant

94
Q

diverticular disease

A

metronidazole
fluids
analgesia
(long term: increase fibre & fluid intake)

95
Q

chrons Mx - inducing remission

A

glucocorticoids
smoking cessation
mesalazine

96
Q

maintaining remission chrons

A

azathioprine 1st line
2nd line methotrexate
(surgery)

97
Q

inducing remission UC

A

rectal steroids or aminosalicylates (mesalazine)

oral pred

98
Q

maintaining remission UC

A

5-ASA
azathioprine
operate if severe

99
Q

coeliac Tx

A

gluten free diet

100
Q

CLD Mx

A

remove causes - alcohol, nsaids, opiates

vit K

101
Q

eczema Tx

A

emollients
steroid creams
avoid soaps

102
Q

psoriasis Mx

A

emollients
corticosteroid
vita D analogue e,g calcitriol

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