Conditions, Explanations and Treatments Flashcards Preview

year 2 osce > Conditions, Explanations and Treatments > Flashcards

Flashcards in Conditions, Explanations and Treatments Deck (57):
1

What is the management plan for MCL injury?

Brace

Physio

Early movement

2

What are the two names for a raised lesion?

<0.5cm

>0.5cm

 

<0.5cm = Papule

>0.5cm = Nodule

3

How would you explain fribromyalgia?

Medicine as a whole doesnt know the wholes story with fibromyalgia. There is a theroy though that it is to do with abnormal pain messages. So changes in your brain and nerves could be responsible for the pain you are feeling rather than your muscles and joints actually been damaged.

4

How do you treat thrush?

Nystatin or Clotrimazole

5

What vitamin supplements should babies and mothers be taking?

all children not on formula could take ACD supplements

 

BF mothers vitamin D and Iron

6

How do you manage an LCL injury?

If pulled:- Physio , NSAIDs and rest

If ruptured :- Surgery

7

How would you explain a cholesteatoma?

you have some abnormal collection of skin cells inside your ear. Its not a cancer but it is quiet serious.

 

ENT referall for surgery

8

How do you treat ringworm/athletes foot?

Clotrimazole

9

What is the management plan for Psoriasis?

Emollients

Vitamin D analogues

Steroids

Dithranol

Coal tar

 

UVB/PUVA

Methotrexate

Biologics

10

How do you diagnose congenital hip dysplasia?

Barlow and Ortolani

 

Ultrasound if less than 3 months

xray if older than 3 months

11

What are the red flags for back pain?

Urinary retention/incontinence

saddle anasthesia

loss of sensation

weight loss

old or young

night sweats

12

What is the managment plan for rosacea?

Reduce aggravating factors

  • Spicy food,
  • Alcohol
  • Caffeine
  • sun

 

Creams

  • Topical metronidazole
  • Oral tetracycline

13

What are the special parts of a Paeds History?

Birth

Feeding

Growth

Development

14

How would you explain eczema to a patient?

Usualy the skin acts as a barrier strong barrier to infection or irretation. However if your skin gets too dry this barrier doesnt work as well resulting in your skin becoming inflamed giving you a rash

15

How do you treat transient synovitis?

NSAIDs

Rest

Self limiting

16

How would you explain addison's disease to a patient?

Your Adrenal glands which sit on your kidneys normally produce hormones that your body needs to work properlly. Addisons disease is an autoimmune condition where your immune system accidently attacks your adrenal glands meaning that they no longer work properlly. As a result the adrenal glands dont produce the hormones that you need

17

What is the management plan for OA?

Physio

Weightloss

Paracetamol or cocodamol

 

Surgery

 

18

What important saftey things should you remember about hyperthyroidism?

Carbimazole cant be used in early pregnancy

Use propythiouracil 1st trimester

 

Risk of agranulocytois- fever, swollen glands and a sore throat then come back just to be safe

 

Cancer:- Lumps? changing voice? Weight loss?

 

 

19

What is the managment plan for Gout?

NSAIDs

Colchicine

Corticosteroids

 

if >2 attacks start allopurinol

 

Reduce Purines - Alcohol, red meat, pulses

20

What RA drugs are safe in breatfeeding and pregnancy?

Unsafe:

  • Methotrexate
  • Leflunnomide

 

Safe:

  • Sulfasalazine
  • Hyroxychloroquine
    • anti-TNF

 

21

What is the management plan for Eistaxis?

Nasal Spray

Ligation

22

How can you pick up saftey marks when talking about eczema?

  • If you think it might be infected e.g pus or blood then come right back
    • Use the correct amount of steroid cream.( one finger tip covers a whole palm)

23

What are the two names for a flat lestion?

<1cm

>1cm

 

<1cm = macule

>1cm = Patch

24

What are the differences between the three skin cancers?

BCC- 80% common, slow growing and locally invasive. Rarley met

SCC- arise of sun damaged skin, grow fast, can bleed and metastases

 

Melanoma - Superficial and dangerous, metastases

25

What is the managment plan for a metatarsal stress fracture?

Prolonged rest for 6-12 weeks in a "moon boot"

26

How would you explain hyperthyroidisim to a patient?

Your thyroid gland sits in your neck and its jump is to produce hormones. These hormones do lots of things in your body to keep everything working correctly. In your case your thyroid gland is overactive so you are making too many thyroid hormones resulting in the symptoms you are experiancing

27

How would you describe psoriasis?

Well demarcated scaly erythematous plaques on extensore surfaces. Silvery appearance

 

( give dimensions)

28

What must you remember to tell patients if you are prescribing a diuretic?

It will make you pee more

Come back in a week and we will check that your electrolyte balance is ok ( vitamins and minerals)

 

Theres a risk small risk that the medication might make you low in potassium. If this happens then you will start to feel tired with sore muscles, you might also notic some funny heart beats. If this does happen then come back to hospial

29

What is the management plan for impingement syndrome?

NSAIDs

Physio

Steroid

Surgical decompression

30

What  "saftey marks" are available in Acne?

Ask about depression.

 

Oral Isotretinoin

  • Teratogenic
  • Can cause mood change

 

 

31

How would you explain transient synovitis?

Inflammation around the hip joint. Medicine doesnt really know why we happen but we do know it is common after an infection.

32

How do you treat DKA?

Insulin

Fluid challenge

Potassium

33

How do you treat congenital hip dysplasia?

Pavlik harness

 

Must be worn constantly. Only to be taken off by a health proffesional

 

Lots of support because it can take some time for you and baby to get used to it

34

Where can you pick up Safey marks in a psoriasis station?

 

Correct steroid usage

Only use Vitamin D on the plaques

Try and avoid the sun

 

"If you are feeling really down about your psoriasis or depressed then please do come back. Im here to to help you"

 

If you think your plaques might be infected e.g blood or puss then come back

35

How do you treat Addison's disease?

Steroid replacement:- hydrocortisone and fludrocortisone

36

How would you explain Rosacea to someone?

Medicine as a whole does not know the whole process behind rosacea. What we do know is that it is an inflammatory process which results in a spotty rash across the face and nose.

37

How would you explain osteoporosis?

It means that your bones are weaker than normal, so they are much more fragile and likely to break.


Everyones bones deteriorate at different rates, just some peoples bones weaker faster than others

38

How would you explain psoriasis to a patient?

Medicine as a wole doesnt yet know the whole story  with psoriasis. What we do know however is that it is and inflammatory condition which is causing your skin cells to be made really quickly. The main thing is that we can treat it

39

What is the management plan for eczema?

Emollients

avoid irretants

topical steroids

40

How do you treat hyperthyroidisim?

Carbimazole

41

What is the management plan for Acne?

Topical therapies:-

  • Benzoyl peroxide
  • Topical vitamin A derivatives
  • Topical antibiotic - Clindamycin

 

Oral Isotretinoin

  • Teratogenic
    • Dry skin, dry eyes, dry mouth, mood changes ( saftey net depression)

42

What saftey mark can you gain in an Epistaxis statin?

Are you taking Asprin or anything that thins your blood?

If its a child under the age of 2yrs then come to hospital

 

If you feel light headed and notice you are looking very pale then come back

 

come back if the bleeding is very heavy and/or lasts longer than 20 minutes

43

What is the treatment for osteoporosis and what saftey marks should you remember?

Bisphosphonates

 

They help to strengthen your bones.

Small chance of tummy upset, if this is the case then come back.

 

Also very rarley people get pain in their jaw from it. Come straight back if this happens. Have you had dental work done on your jaw?

44

What is the treatment pathway for RA?

  1. Methotrexate
  2. Sufasalazine
  3. Hydroxycholoroquine
  4. Leflunomide
  5. Biologics (infliximab, rituximab)

45

what is the management for an ACL rupture?

Phsyio and brace

or

Surgery

46

How do you treat Cushing syndrome?

Diagnose with dexamethasone suppression test

Treatment- surgery

47

What is the management plan for rotator cuff tears?

Conervative

Physio
NSAIDs

Steroid injections

 

Surgery has a 30% failure rate so if we can manage without then that would be alot better.

48

How would you explain RA to a patient?

It is an autoimmune disease which means your immune system which normally fights off infections is attacking the lining of your joints instead. This is resulting in you having sore, inflammed and stiff joints. Over time this leads to damage to the joint and the bone around the joint. However we are able to slow this process using medication and sometimes pretty much stop it all together

49

What is the management plan for Dupuytren's Contracture?

Do nothing

 

Surgery but it is likely to reoccur

50

How do you treat SUFE?

Surgery to pin the femoral head to prevent further slippage

51

How would you explain dupuytren's contracutre to a patient?

The connective tissue in your hand is thickening, evenually it gets so tight and thick it will pull back your ring finger

52

53

What important saftey marks should you remember to mention when starting a patient on methotrexate?

  1. Take Folic acid with it
  2. No pregnancy - Oral contraception + condoms
  3. Rarley Liver damage - LFT check in 2 weeks / carefull with alcohol

54

What are the red flags for child development?

Motor

6 month- unable to reach for objects

12 months- unable to sit supported

18 months- unable to walk

18 months - no speach

55

What is the checklist for ruling out viral tonsilitis?

History of fever

Tonsillar exudate

Tender lymphnodes

No cough

 

>3 = bacterial (give antibiotics)

56

what is the management plan for carpal tunnel syndrome?

Wrist splints + steroid injections

 

Surgical decompression

57

How would you explain Duchenne's muscular distrophy?

It is a genetic condition which results in the childs muscles not working properlly. It is progressive and very serious condition that gets worse with age. It can affect the muscles responsible for your heart beating and for breathing.

 

There is no cure but with can try our best to manage the symptoms

(death < 20 yrs)