Pass Med Q's Flashcards

(37 cards)

1
Q

where do Thiazide Diuretics act

A

block NaCl symporter on proximal part of distal convoluted tubule

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2
Q

where do Loop Diuretics act

A

ascending loop of Henley

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3
Q

side effects of thiazide diuretics

A
postural hypotension 
hyponatraemia , hypokalaemia 
hypercalcaemia 
hyperglycaemia
gout
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4
Q

side effects of loop diuretics

A

postural hypotension
hyponatramia, hypokalaemia, hypocalcaemia
ototoxicity

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5
Q

if a patient develops an AKI after being started on an ACEi, what condition do they most likely have?

A

bilateral renal artery stenosis

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6
Q

what is Buergers disease

A

also known as thromboangitis obliterates – small + median vessel vasculitis strongly associated with smoking

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7
Q

symptoms of Buergers disease

A

intermittent claudication
ischaemic ulcers
superficial thrombophlebitis
reynauds

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8
Q

What is Boerhaaves syndrome

A

rupture of the oesophagus following repeated episodes of vomiting (typically in alcoholics)
triad: vomiting, thoracic pain, subcutaneous emphysema

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9
Q

presentation of mitral valve prolapse

A

chest pain / palpitations
mid systolic click / late systolic murmur
- associated with Polycystic kidney disease, marinas, turners, WPW

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10
Q

What is De Mussets sign

A

head bobs in time with pulse

- seen in aortic regurgitation

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11
Q

mechanism of dipyridimole

A

phosphodiesterase inhibitor

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12
Q

how long should warfarin be stopped prior to planned surgery

A

5 days

- when INR < 1.5 surgery can go ahead

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13
Q

how should a patient on warfarin requiring emergency surgery be managed

A

if surgery can wait 6-8 hours give 5mg Vit K IV

if surgery cannot wait give 25-50 units/Kg prothrombin complex

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14
Q

what drugs are inducers of p450 system ?

how does this affect INR ?

A

inducers will decrease INR (increased risk of clot)

  • phenytoin / carbamazepine
  • rifampicin
  • st johns wart
  • phenobarbitone
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15
Q

what drugs are inhibitors of p450 system ?

how does this affect INR ?

A

inhibitors will increase INR (increased risk of bleeding)

  • ciprofloxacin
  • clarithromycin
  • amiodarone
  • fluoxetine / sertraline
  • fluconazole
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16
Q

management of a major bleed on warfarin

A

stop warfarin
give IV Vit K 5mg + prothrombin complex
- if prothrombin complex not available give FFP

17
Q

management of high INR (>8) + minor bleed on warfarin

A

stop warfarin
give IV vit K 1-3 mg
repeat dose of Vit K if INR still high after 24 hours
restart warfarin when INR < 5

18
Q

what heart murmur is associated with pulmonary HTN

A

tricuspid regurgitation
- pan systolic murmur
+ loud S2

19
Q

BP target for Type 1 diabetic

  • no albuminuria
  • albuminuria present
A

no albuminuria = 135 / 85

albuminuria = 130 / 80

20
Q

BP target for Type 2 diabetic

21
Q

what drugs can be given in orthostatic hypotension

A

fludrocortisone or midodrine

22
Q

electrical alternans on ECG

A

cardiac tamponade

23
Q

symptoms of subclavian steal syndrome

A

dizziness

vertigo during use of an arm

24
Q

when is atorvastatin given to Type 1 diabetics

A

20mg atorvastatin given if

  • > 40
  • diabetes > 10 years
  • nephropathy
25
side effects of ivabradine
visual effects - luminous phenomena headache bradycardia
26
why should statins be withheld while patient completes course of macrolide antibiotics (e.g. clarithromycin)
increased risk rhabdomyolysis - increased CK
27
mechanism of action aspirin
inhibits thromboxane A2 production
28
mechanism of action clopidogrel
inhibits ADP
29
mechanism of action enoxaparin
activates antithrombin III
30
what cardiac drugs are contraindicated in pregnancy
ACEi | statins
31
what is Holter monitoring used for
to capture episodic arrhythmias
32
how do thrombolytic agents work e.g. alteplase
activating plasminogen to form plasmin
33
what is an absolute contraindication to thrombolysis
intracranial neoplasm
34
presentation of skin necrosis due to warfarin
occurs when drug is first started INR will still be in therapeutic range large red patch that progresses to petechiae -- purpura -- ecchymoses
35
what can cause widespread T wave inversion on an ECG
head injury / brain herniation | - hypertensive, bradycardic, tachypnoeic patient
36
inferior MI + new aortic regurgitation murmur suggests what
proximal aortic dissection
37
side effects of beta blockers
``` cold peripheries impaired hypoglycaemic awareness erectile dysfunction bradycardia / heart block hypotension ```