Placement (additional things) Flashcards by Hiba Alhasso

what is the difference between HHS and DKA

HHS has no ketones and is more commonly associated with T2DM
DKA is more commonly associated with T1DM and has ketones
There can be an overlap between the 2

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what is pathognomonic of superficial femoral artery blockage on clinical examination

black specks on the legs/soles of feet that are exquisitely painful

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3 main things for neuroischaemic ulcer management

increase pressure - boots
improve blood supply - angioplasty
treat infection - deep infection with antibiotics

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what is a cause of raised urea in isolation

dehydration

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what is a cause of low creatinine

low muscle mass ie low body weight

especially in context of substance misuse

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what are important side effects of carbimazole and PTU

agranulocytosis

liver failure

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what is a side effect of nerve conduction studies

significant bruising

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why do patients on long term steroids carry a steroid card

in case of an emergency

adrenal crisis

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what is the function of erythropoeitin

hormone released by the kidneys that helps to make RBC in the bone marrow

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what class of drug is bumetanide

diuretic

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why might someone receive ‘split dose’ of LMWH

for example in someone with metallic heart valves but also a subdural haematoma
you want to find a good balance of anticoagulation that is predictable, reversible and short acting
warfarin and DOACs would not be ideal
IV heparin if administered and monitored correctly would be the most ideal option however it is a nuisance to carry out correctly

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how many blood cultures do you send of for suspected IE

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how many lumen does a central venous catheter have

4 - labelled as proximal, distal and 2 medial

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for management of alcohol withdrawal, which BZD is used in hospital and in the community

hospital - diazepam

community - chlordiazepoxide

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how much fluid should be prescribed in:
resuscitation
routine maintenance

resuscitation - 500ml bolus over 15 min

routine maintenance - 25-30ml/kg/day

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what is the most important clue when seeing a patient on the ward

end of bed inspection - sweets, inhalers, walking stick…

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oxycodone is twice as strong as morphine (PO)?

yes

oxycodone is also hepatically excreted

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what is Sando K

oral potassium replacement

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why might a patients with bruising / haematoma have a raised bilirubin

from breakdown of the haematoma

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after taking an ascitic tap sample, who should you send it to

biochemistry - SAAG to tell you about portal HTN
cytology - malignancy
microbiology - infection /SBP

Being on steroids can mask a silent GI perforation, true or false

true

what is a VRE UTI

Vancomycin resistant enterococci UTI

what are the causes of finger clubbing

Cyanotic heart disease 
Lung 
- Abscess 
- Bronchiectasis 
- CF 
- Don't say COPD
- Empyema 
- Fibrosis 
UC / Crohns disease 
Biliary cirrhosis 
Birth defect 
Infective endocarditis 
Neoplasm - lung cancer 
GI malabsorption - Coeliac disease

what is leukonychia a sign of

hypoalbuminaemia

what are causes of hypoalbuminaemia

liver disease | nephrotic syndrome

where do you palpate the brachial pulse

medial aspect of arm at antecubital fossa

ECG changes of digoxin toxicity

PR prolongation reverse tick (ST segment) PVC AVN block

function of digoxin

increases cardiac contractility and controls HR

what is takotsubos cardiomyopathy

essentially HF due to a significant event such as stress, emotion, procedure, bereavement... has a good prognosis

salbutamol can cause a raised lactate, true or false

true

if someone has a collapsed lung, what investigation is important to do and why

bronchoscopy to visualise the airways and see if there is an obstruction leading to collapse such as foreign body, sputum plug, tumour, mass

if someone has a leg amputation where do you place the ECG stickers

on the bony prominences of the hips

how much local anaesthetic can you give

3mg/kg

D.Dx for raised Hb levels

1. polycythaemia rubra vera 2. Secondary to: COPD, chronic hypoxia 3. pseudopolycythaemia: dehydration, diuretics, obesity, alcohol

high Hb levels can do what to your blood

make it thicker and more likely to clot

on a CXR, fluid pushes the trachea away/towards the affected side

away

how to interpret a CXR

``` name, DOB, date of CXR projection, rotation, penetration, inspiration Striking abnormality ABCDE overall impression ```

what is the D sign on a CXR

empyema

what is a wedge infarct on a CXR indicative of

PE - necrosis

term for liver failure/cirrhosis/disease causing a pleural effusion?

hepatic hydrothorax

when doing an ABG, use your pinky to stretch out the skin

useful tip

what kind of vein should you aim for in cannulation

a straight vein

you can use a SAMA and LAMA at the same time, true or false

false, use one or the other | could lead to anticholinergic toxicity

what is re expansion pulmonary oedema a complication of

chest drain insertion | output of >1L over a short period of time

which antibiotic class can cause torsades de pointes

macrolides cause QT prolongation

in a collapsed lobe on a CXR, the trachea is pulled away/towards the affected side

towards

treatment of choice for ABPA

PO prednisolone

Widespread ST elevation implies a partial/complete occlusion of the affected coronary artery

complete occlusion