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Phase 3A > ILAs > Flashcards

ILAs Flashcards

1
Q

What are the common secondary causes of hypertension?

A

ROPED
renal disease, obesity, pregnancy, endocrine, drugs (alcohol, steroids, NSAIDs, oestrogen)

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2
Q

What is stage 1 hypertension?

A

clinic reading > 140/90 or at home > 135/85

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3
Q

What is stage 2 hypertension?

A

clinic reading > 160/100 or at home > 150/95

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4
Q

What is stage 3 hypertension?

A

clinic reading > 180/120

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5
Q

What tests should be done in patients with a new diagnosis of hypertension?

A

Urinalysis, bloods - HbA1c, renal function, lipids, fundus examination, ECG

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6
Q

What are the management guidelines for hypertension?

A

Step 1: Aged under 55 or type 2 diabetic of any age or family origin, use A. Aged over 55 or Black African use C.
Step 2: A + C. Alternatively, A + D or C + D.
Step 3: A + C + D
Step 4: A + C + D + fourth agent (see below)

(ARBs in patients of african-caribbean origin)

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7
Q

Give an example of a potassium sparing diuretic?

A

Spironolactone

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8
Q

What is malignant hypertension?

A

Hypertension above 180/120 with retinal haemorrhages or papilloedema

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9
Q

What are the features of Rheumatoid arthritis?

A

Autoimmune joint inflammation, symmetrical polyarthritis. Joint pain, swelling and stiffness worse in the morning. associated with HLA DR4

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10
Q

What antibodies are usually present in RA?

A

Rheumatoid factor (in 70%)
Anti-CCP antibodies (in 80%)

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11
Q

Which joints are usually affected in RA?

A

MCP, PIP, wrist, MTP

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12
Q

What signs are present in advanced RA?

A

Z-thumb, swan-neck deformity, boutonniere deformity, ulnar deviation

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13
Q

What X-ray changes are seen in RA?

A

periarticular osteopenia, bony erosions, soft tissue swelling

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14
Q

How do you treat RA?

A

short term steroids
DMARDs - methotrexate, leflunomide, sulfasalazine
cDMARDs - azathripine, ciclosporin, cyclophosphamide

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15
Q

What joints are commonly affected in OA?

A

hips, knees, DIP, lumbar and cervical spine

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16
Q

What X-ray changes are seen in OA?

A

LOSS
loss of joint space
osteophytes
subarticular sclerosis
Subchondral cysts

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17
Q

What are the features of osteoarthritis?

A

Joint pain and stiffness, worse at the end of the day. reduced ROM, crepitus, effusions around the joint

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18
Q

What signs are associated with osteoarthritis?

A

Heberden’s nodes (DIP), Bouchard’s nodes (PIP)

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19
Q

What is the treatment of OA?

A

Weight loss, exercises, topical NSAIDS then oral NSAIDS (with PPI) then intra-articular steroids

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20
Q

What is the blood pressure target for hypertension?

A

> 80y/o 150/85
<80y/o 140/85
Diabetic with end organ damage - <135/85

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21
Q

What levels do you use to diagnose diabetes?

A

Fasting BG - > 11mmol/L
Random BG > 7mmol/L
Glucose tolerance > 11.1mmol/L at 2 hrs
HbA1c - 48 mmol/mol

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22
Q

What is the first line treatment for diabetes?

A

Trial diet and lifestyle for 3 months
Meformin (biguanide)

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23
Q

What is the second line management of diabetes?

A

Sulphonylureas - glicazide

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24
Q

What are the risk factors for COPD?

A

smoking, occupational exposure, air pollution, al[ha-1 antitrypsin

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25
Q

What investigations do you do in suspected COPD?

A

CXR, FBC, PHQ-9 and GAD 7, oxygen sats, ECG, sputum culture if purulent

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26
Q

What is the management of COPD?

A
  1. SABA / SAMA
  2. LABA or LAMA
    • ICS
  4. LAMA, LABA, ICS, SABA
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27
Q

Give an example of a SABA?

A

salbutamol

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28
Q

Give an example of a SAMA?

A

ipratropium

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29
Q

Give an example of a LABA?

A

salmeterol

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30
Q

Give an example of a LAMA?

A

tiotropium

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31
Q

What meds can you give in a COPD exacerbation?

A

Prednisolone OD for 1-2 weeks
increase dose of SABA/SAMA

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32
Q

What are the common causes of heart failure?

A

Myocardial, valvular, pericardial, arrhythmias, high output states (anaemia, hyperthyroid), CKD - volume overload, obesity, alcohol

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33
Q

What are the key signs of heart failure?

A

orthopnoea and nocturnal dysnoea, raised JVP, basal crepitations, gallop rhythm, displaced apex.
breathless, oedema, syncope, fatigue

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34
Q

What investigations do you do for heart failure?

A

ECG in everyone, bloods, if history of MI refer to cardio and do echo within 2 weeks, if not history of MI measure BNP

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35
Q

What is the management of heart failure?

A

Loop diuretic - for symptomatic relief
ACE-I / BB

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36
Q

What needs to be checked after 2 weeks of an ACE-I?

A

U&Es

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37
Q

Why does an ACE-I cause a dry cough?

A

Bradykinin accumulation

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38
Q

What is the first line treatment of a DKA?

A

IV saline

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39
Q

Give an example of a loop diuretic?

A

Furosemide

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40
Q

What are the causes of microcytic anaemia?

A

TAILS
- Thalassaemia, anaemia of chronic disease, iron deficiency, lead poisoning, sideroblastic anaemia

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41
Q

What are the causes of megaloblastic macrocytic anaemia?

A

B12 and folate deficiency

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42
Q

What are the causes of normoblastic macrocytic anaemia?

A

alcohol, hypothyroid, liver disease, drugs (azathioprine)

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43
Q

What are the signs and symptoms of iron deficiency anaemia?

A

Pica (craving non-food substances), hair loss, koilonychia, angular cheilitis, atrophic glossitis

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44
Q

What is the ratio for chest compressions to rescue breaths in paediatric resus?

A

15:2 (30:2 if only one rescuer available)

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45
Q

What is the treatment for pyloric stenosis?

A

Ramstedt pyloromyotomy

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46
Q

When does IgA nephropathy usually occur?

A

days after an infection - presents with nephritic syndrome

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47
Q

Under which age should children with a limp be admitted for a paeds review?

A

3 years

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48
Q

If a patient is antibiotic resistant to one bacteria what do you do?

A

Culture and sensitivity, and give a different class of antibiotics

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49
Q

In a baby born to a cocaine addicted mother, what medication should you give?

A

Phenobarbital

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50
Q

Which side does a diaphragmatic hernia usually affect?

A

the left

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51
Q

What are the points in a feverpain score?

A

Fever in past 24hrs, purulent tonsils, attendance within 3 days, inflammation of tonsils, no cough/coryza

52
Q

What are the red flags that put an unwell kid in the high risk catagory?

A

pale/blue, won’t stay awake, appears ill to healthcare professional, weak cry, grunting, RR>60, chest indrawing, reduced turgor, no response to social cues, neurological signs

53
Q

What are the amber flags that put an unwell kid into the moderate risk catagory?

A

pallor, wakes with prolonged stimulation, nasal flaring, RR>40, sats <95% on air, tachycardia >140ish, dry mucous membranes, reduced feeding and urine output, joint issues

54
Q

What features of a head injury require an urgent CT head?

A

focal neurological signs, convulsions, 3+ discrete episodes of vomiting, signs of basal skull fracture (panda eyes, battles signs, CSF leakage), suspicion of non-accidental injury

55
Q

What are the potential side effects of chemotherapy for ALL?

A

pancytopaenia, tumour lysis syndrome, infection, nausea

56
Q

What biochemical features are associated with tumour lysis syndrome?

A

hyperkalaemia, hyperuricaemia, hyperphosphataemia, hypocalcaemia

57
Q

What are the red flag developmental milestones?

A

cant hold an object at 5 months
cant sit unsupported at 12 months
cant stand or talk at 18 months
cant walk at 2 years
cant run at 2.5yrs

58
Q

How do you work out maintenance fluids for kids?

A

100ml/hr/kg for first 10kg
50ml/hr/kg for next 10kg
20ml/hr/kg for the rest
(for over 20kg its 1500ml + the rest) - divide by 24 for the rate

59
Q

What are the common chromosome 15 deletions?

A

paternal deletion = prader-willi
maternal deletion = angelman

60
Q

What is the acute management of a cyanotic episode caused by agitation in a child?

A

Calm child and put in the knees to chest position

61
Q

What abnormalities are detected during the 20 week scan?

A

edwards, patau, anencephaly, gastroschisis, cleft lip, bilateral renal agenesis

62
Q

What anomalies are detected during the 14 week scan?

A

Down’s syndrome, neural tube defects

63
Q

What are the indications for early referral to fertility specialists?

A

age > 35, menstrual disorder, previous STI/PID, previous surgery

64
Q

Name 4 causes of polyhydramnios

A

foetal anaemia (increased cardiac output), macrosomia (big baby - more urine), twin-twin transfusion (one baby will have poly, one has oligo), maternal diabetes

65
Q

What is the karyotype for a complete molar pregnancy?

A

XX (or rarely XY) - due to an empty egg being fertilised - the sperm dna duplicates

65
Q

What are the karyotypes for incomplete molar pregnancy?

A

XXX, XYY

66
Q

If someone with an existing diagnosis of diabetes gets pregnant, what meds do they get changed to?

A

Metformin + insulin (all other oral antidiabetics should be stopped)

67
Q

What vaccine is given to pregnant women from 16 weeks + ?

A

Flu and pertussis

68
Q

What is the definition of a severe PPH?

A

> 2000ml of blood loss

69
Q

What is the definition of a moderate PPH?

A

1000-2000ml blood loss

70
Q

How do you classify PPH into primary and secondary?

A

primary = <24hrs
secondary = >24hrs

71
Q

What is the FIGO staging of endometrial cancer?

A

1: confined to endometrium
2: extends to cervix but not beyond uterus
3: Pelvis
4: involves bladder/bowel or has mets

72
Q

What is Meig’s syndrome?

A

A complication of ovarian cysts - ovarian fibroma, ascites and pleural effusion

73
Q

What are the physiological changes seen in pregnancy on blood tests?

A

raised WCC, ESR, D-dimer, ALP
Low albumin and platelets

74
Q

What is the first line management of primary dysmenorrhoea?

A

NSAIDS then COCP

75
Q

What is the management of a breast cyst?

A

abscess drainage and culture

76
Q

What blood tests do you need to do to detect menopause/premature ovarian insufficiency?

A

FSH 4 weeks apart

77
Q

What is an endometrioma?

A

A chocolate cyst - a cyst on the ovary caused by endometriosis

78
Q

What is the treatment of endometriomas?

A

Laparoscopic ovarian cystectomy

79
Q

What are the features of lichen sclerosis?

A

itching, discomfort, pain in the genitalia. white patches, scarring, and shrinking

80
Q

What is the treatment for lichen sclerosis?

A

steroids and emollients

81
Q

What do you give for a paracetamol overdose?

A

N-acetyl cysteine - parvolex

82
Q

What do you need to monitor in patients on methylphenidate?

A

BP, appetite, weight and height

83
Q

What is the definition of a staggered overdose?

A

more than 1 hour apart

84
Q

What is clomipramine?

A

A tricyclic antidepressant

85
Q

What drugs can you give for OCD?

A

SSRI
Then tricyclic - clomipramine

86
Q

What is preservation?

A

the repetition of words and ideas

87
Q

What are the anti-cholinergic side effects (TCAs)?

A

Cant see, cant wee, cant shit, cant spit

88
Q

What type of drug is phenelzine?

A

MAO-i

89
Q

What is the treatment for acute dystonia?

A

Benzatropine (anti-cholinergics) or procyclidine

90
Q

What is the CSF appearance of viral meningitis?

A

clear, lymphocytosis, normal protein, normal glucose

91
Q

What is the second line treatment for migraine prophylaxis?

A

topiramate

92
Q

Is the facial paralysis in AICA ipsi or contra?

A

Ipsi

93
Q

What is the treatment for OA?

A

topic NSAIDs
Ibuprofen and omeprazole
intra articular steroids

94
Q

What investigation should be done to diagnose BPPV?

A

Dix Hallpike

95
Q

What is the first line treatment for bacterial vaginosis?

A

Metronidazole

96
Q

What are the 6 main AIDs defining illnesses?

A

kaposi’s sarcoma, pneuomcystitis jirovecii pneumonia, CMV infection, candidiasis, lymphomas, TB

97
Q

What medication is used to treat pneumocystitis jirovecii pneumonia?

A

co-trimoxazole

98
Q

Can you give live vaccines in HIV+ patients?

A

No, but do give years flu and pneumococcal vaccines

99
Q

What medications are used for post-exposure prophylaxis in HIV?

A

tenofovir + raltegravir for 28 days

100
Q

What medications are used for pre-exposure prophylaxis?

A

emtricitabine/tenofovir

101
Q

What bacteria causes syphilis?

A

treponema pallidum

102
Q

What is important to know about antiretroviral drugs?

A

They should be taken at the same time every day to reduce the risk of viral resistance

103
Q

What is seen on microscopy of a trichomonas infection?

A

clue cells

104
Q

What is fitz-hugh curtis syndrome?

A

A complication of PID that causes liver adhesions therefore RUQ pain

105
Q

What is the definition of an opioid use disorder?

A

A harmful pattern of use over a 12 month period or at least 1 month if use if continuous

106
Q

What is the relative risk reduction?

A

1-relative risk

107
Q

What are the 5 parts of the centor criteria?

A

fever > 38, tonsillar exudate, absence of cough, tender anterior cervical lymph nodes, (age <15)

108
Q

What is the treatment for strep throat?

A

Phenoxymethylpenicillin for 10 days

109
Q

What medications cause an itchy maculopapular rash in EBV?

A

amoxicillin and cephalosporins

110
Q

Name some ARBs

A

losartan, candesartan

111
Q

What is the management of scabies?

A

Permethrin 5% - given to whole family and close contacts

112
Q

What are the typical features of scabies?

A

intense itching at night, skin rash, grey-white lines, typically affects finger webspaces, wrists, armpits, waist, buttocks, genitals

113
Q

What do you give for an anaphylaxic reaction?

A

IM adrenaline 500mcg up to 2 doses, IV fluid bolus and get to resus - anaesthetists can give IV adrenaline

114
Q

What is the treatment of community acquired pneumonia?

A

Co-Amox and clarithromycin

115
Q

What is the curb-65 score for?

A

community acquired pneumonia

116
Q

What are the 5 parts of the curb-65 criteria?

A

age 65, urea >7, RR >30, systolic <90 diastolic <60, presence of confusion

117
Q

What is the treatment of hospital acquire pneumonia?

A

Tazocin

118
Q

What is the first line and gold standard investigation for stable angina?

A

First - exercise stress test
gold - angiography

119
Q

How long must fatigue be present for to have CFS?

A

3 months

120
Q

What is the main side effect of colchicine?

A

diarrhoea - which usually precedes pain relief

121
Q

what drugs are used to treat benign prostate hyperplasia?

A

5-alpha reductase inhibitors - finesteride

122
Q

What drugs are used to treat erectile dysfunction?

A

phosphodiesterase-5 inhibitors - sildenafil/tadalafil

123
Q

What is the first line treatment for a-fib?

A

DOAC - apixaban

124
Q

Methotrexate interferes with the absorption of which nutrient?

A

folic acid

125
Q

What is the management of children with suspected type 1 diabetes?

A

same day referral to paeds

126
Q
A

Phase 3A (14 decks)

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