final push Flashcards
(36 cards)
when not to give calcium and vid D
breast cancer with high calcium, high PTH
first choice bone protection
zoledronic acid
digoxin recommended conc
1-2 micrograms/l
What is the recommended INR range in a patient with AF, receiving warfarin for the prevention of stroke?
2-3
erythromycin
increases INR, inhibits digoxin
low Na+ can be caused by
thiazides of hypothyroidism
UTI in elderly cause
e coli, staph, proteus sp
do you manage bp in stroke acutely
no
Guideline from NICE found here: https://www.nice.org.uk/guidance/ng128/chapter/Recommendations#maintenance-or-restoration-of-homeostasis
advise that in the acute management of ischaemic stroke to avoid treatment of hypertension unless there are certain hypertensive complications such as:
hypertensive encephalopathy
hypertensive nephropathy
hypertensive cardiac failure/myocardial infarction
aortic dissection
pre-eclampsia/eclampsia
5 bloods for confusion
FBC, glucose, Us and Es, calcium, TFTs
how to obtain more info in elderly
collateral from family, from GP, hospital records, summary care records
C diff complications
psuedomembranous colitis, toxic megacolon, peritonitis
Clostridium difficile is a very serious infection and mortality is approximately 25% for in hospital infection of frail elderly patients. This is due to a combination of the infection itself and the vulnerability of the patients which tend to be infected – the elderly, neonates, the immunocompromised etc. Severe infection is associated with the presence of pseudomembranes on sigmoidoscopy. More severe infection may lead to fulminant colitis and toxic dilatation (toxic megacolon), the diarrhoea may reduce and the abdomen swells and becomes tender. This may result in perforation, peritonitis and death. A dilated colon can often be seen on plain abdominal x-ray, with ‘thumb printing’ indentation in the wall of the colon
Abx causing C diff
random complication of lung tumours
rib erosion
lung mets consequences
Primary lung tumours can metastasise to the bone as in this case presenting with pain, anaemia, hypercalcaemia. Brain – presenting with seizures or focal neurology. Liver –presenting with jaundice, painful hepatomegly. Adrenals – presenting with Addison’s disease.
PCV risk for
stroke then ALL
what else can raise BNP
chronic kidney disease
falls examinations
BP, neuro, gait and balance
labs after fall
FBC, Us and Es, LFTs, CRP,
Bone profile, TFT
G and S and clotting profile
Glucose
reversible dementia found on neuroimaging
normal pressure hydrocephalus, subdural haematoma (banana)
lewy body special Ix
Datscan for parkinsonism
delirium contributions
Post-surgery state
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Morphine use
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Urinary retention
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Previous cognitive impairment
supportive features for delirium diagnosis
Acute onset
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Fluctuating course
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Inattention
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Disorganised thinking
. Further components of delirium assessment
Collateral history
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4AT test / MMSE etc / cognitive screening
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Review of medications
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Infection screening
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Pain assessment
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Environmental assessment
legal procedure when pt tries to leave
Legal procedure (1 mark)
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Deprivation of Liberty Safeguards (DoLS).
6. Role of procedure (1 mark)
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To protect and manage care while ensuring least restrictive measures.