Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3 Medicine > Random 12 > Flashcards

Random 12 Flashcards

1
Q

What is the amber care bundle?

A

The AMBER care bundle encourages regular review of a patients care and ensures that patients, or with their permission, their families are involved in decisions about their care. This may be decisions about treatment, or discussions about what they would like to happen in the future.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is in the amber care bundle?

A

Google

Action within 4 hours
- Medical plan documented in patient record including: current key issues, anticipated outcomes, resuscitation plan

Escalation plan documented

Medical plan discussed and agreed with MDT

Action within 12 hours
- Patient /carer discussions or meeting held and clearly documented. May include….

Uncertain recovery and treatment options
Preferred place of care
Any concerns or wishes
Who was present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the role of a doctor when it comes to palliative care?

A
  • Identify palliative need
  • Evaluate symptoms
  • Anticipate problems
  • Managing distress
  • Educating family
  • Treatment goals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What three questions do you ask yourself that are triggers someone is nearing the end?

A
  1. Would you be surprised if the patient were to die in the next few months?
  2. Treatment is no longer working, patient not eating, chemo not working.
  3. Specific clinical indications related to their condition e.g COPD on NIV or recurrent infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are symptoms patients have in palliative care?

A
  • Pain
  • Fatigue
  • N+V
  • SOB
  • Insomnia
  • Constipation
  • Seizures
  • Cough
  • Hiccups
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are non-pharmacological treatments for pain?

A
  • Acupuncture
  • CBT
  • Physical therapy
  • Relaxation techniques
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the pain ladder and give examples of each

A
  1. Paracetamol and NSAIDS
    - Ibuprofen, Naproxen and Celecoxib
  2. Add a weak opioid
    - Coedine and tramadol
  3. Add a strong opioid
    - Morphine, Oxycodone and Fentanyl
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Common steroids given for pain

A

Dexamethasone and Prednisolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Common anti-spasmotic

A

Baclofen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What condition do you use radiotherapy for pain relief?

A

Spinal mets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How can you reduce nausea and vomiting?

A
  • Add lime/lemon
  • Frequent small meals
  • Cyclizine and Ondansetron
  • Domperidone and Metoclopramide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can you reduce anorexia?

A
  • Add spices
  • Change food
  • Give steroids (increase appetite)
  • Domperidone and metoclopramide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can you reduce constipation?

A
  • Increase fruit and fibre
  • Increase water
  • Encourage activities
  • Oral laxatives, laxedo, glycerol
  • Rectal suppositories, senna
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How can you reduce breathlessness?

A
  • Bronchodilators
  • Steroids
  • Opioids
  • Anxiolytics (diazepam, lorazepam)
  • Oxygen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How can you limit insomnia?

A
  • Melatonin
  • Anti-histamines (piritin)
  • Non-diazepine sedatives like Zolpidem
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are palliative care emergencies?

A
  • Spinal cord compression
  • SVCA obstr
  • Hypercalcemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What questions do you have to ask in EOL care?

A
  • Is the patient in the right place?
  • Is the patient comfortable, eating?
  • Any wishes?
  • Any family members that need to be there?
  • Any unfinished business
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a ring enhancing lesion on a head CT scan?

A

A bright ring with a hypodense centre. An area of oedema and inflammation that takes up the contrast (white) with an abscess, tumor, vascular lesion in the middle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Explain what you would find with an extradural hemorrhage?

A
  • Convex shape
  • Lemon shape
  • Lucid interval
  • Middle meningeal artery
  • Head injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Explain what you would find with a subdural hemorrhage?

A
  • Concave
  • Banana
  • Bridging veins
  • Elderly and alcoholics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is PCOS?

A

Polycystic ovary syndrome is a condition in which the ovaries produce large amounts of testosterone. The disorder is characterised by hyperandrogenism (manifesting as oligomenorrhoea, hirsutism, and acne), ovulation disorders, and polycystic ovarian morphology.

22
Q

What are the common hormonal results seen?

A

Flipped FSH:LH ratio. LH is higher
Higher testosterone (2ng/dL)
High prolactin
Increased sex hormone-binding globulin

23
Q

What is the Rotterdam diagnostic criteria?

A

Upon exclusion of other causes, PCOS can be diagnosed if at least two of the following criteria are met:

Polycystic ovaries (>12 cysts seen on imaging or ovarian volume >10 cubic cm)
Oligo-/anovulation
Clinical or biochemical features of hyperandrogenism

24
Q

What imaging do you do in PCOS?

A
  • MRI of the brain to rule out a prolactinoma
  • Transabdominal or transvaginal ultrasound of the ovaries to check for cysts
25
Q

Do you still do an ultrasound if 2/3 of the rotterdam criteria are met?

A

No because you can diagnose PCOS

26
Q

Describe the clinical presentation of PCOS

A

Oligomenorrhoea
Subfertility
Acne
Hirsuitism
Obesity
Mood changes including depression and anxiety
Male pattern baldness
Acanthosis nigricans (secondary to insulin resistance)

27
Q

What is key underlying PCOS?

A

Insulin resistance, increased glucose levels in the blood stimulates the production of more androgens.

28
Q

What is CAH?

A

Congenital Adrenal Hyperplasia (CAH) is a group of inherited genetic disorders caused by enzyme defects in the adrenal cortex, disrupting steroid hormone synthesis. The most common variant, 21-hydroxylase deficiency, can manifest in varying degrees of severity, from salt-wasting crises and ambiguous genitalia to virilisation or precocious puberty in males

29
Q

Why is there an increase in testosterone in CAH?

A

In the absence of the 21-hydroxylase enzyme, these accumulated precursors are shunted towards the androgen (male sex hormone) synthesis pathway, leading to an overproduction of androgens, including testosterone.

30
Q

What is the main difference between classical and non-classical?

A

In the non-classical form of CAH, the enzyme deficiency is milder, leading to less severe symptoms and later onset of clinical manifestations.

31
Q

What is the presentation of CAH?

A

Ambiguous genitalia, particularly in females due to in utero exposure to excessive androgens.
Hypotension.
Salt-wasting crises characterised by dehydration, low sodium, and high potassium levels leading to circulatory shock and metabolic acidosis.
Vomiting.
Virilisation, or the development of masculine secondary sexual characteristics.
Precocious puberty (males).

32
Q

If you want to rule out a bleed in the brain which scan will you do?

A

Non-contrast

33
Q

What are the features of an MCA main stem occlusion?

A
  • Contralateral hemiparesis of face, arm and leg
  • Contralateral sensory loss
  • Contralateral homonymous hemianopia
  • Global aphasia if left sided
  • Left sided neglect if the infarct is on the right side
34
Q

What are the features of a lenticulostriate artery stroke?

A
  • Pure motor stroke
  • Pure sensory stroke
  • Sensorimotor stroke (mix)
35
Q

What are the features of MCA inferior division occlusion?

A

Inferior division supplies lateral parietal and superior temporal lobe

Occlusion causes
- Contralateral sensory change in face and arm
- Receptive/Wernicke’s aphasia if left sided
- Contralateral field defect

36
Q

What are the features of MCA superior division occlusion?

A

Superior division supplies lateral frontal lobe

Occlusion causes
- Contralateral face and arm weakness
- Expressive/Broca’s aphasia if left sided

37
Q

What are the features of PCA occlusion?

A
  • Contralateral homonymous hemianopia with macular sparing
  • Contralateral sensory loss/change due to involvement of thalamoperforator/thalamogeniculate branches
38
Q

Explain the Oxfordshire community stroke project classification

A

Google

39
Q

What are the results of a cerebellar stroke?

A

DANISH (ipsilateral)

Dysdiadochokinesis
Ataxia
Nystagmus
Intention tremor
Slurred speech
Hypotonia

40
Q

What bleeds in the brain are very common in hypertension?

A

Thalamic bleeds

41
Q

What is the most common CT head you see in an infarct?

A

Normal! Many infarcts do not become visibly hypodense until hours or even a day after the stroke, if ever.

42
Q

What happens after brain tissue death?

A

Replaced with CSF to maintain pressure

43
Q

What is a DWI scan?

A

A Diffusion-Weighted Imaging (DWI) scan is a type of magnetic resonance imaging (MRI) technique that measures the random motion of water molecules in tissues

44
Q

What is a DWI scan useful for?

A
  • Stroke evaluation
  • Brain tumor assessment
  • Infection and inflammation
  • Traumatic brain injury
45
Q

What is Raynaud’s phenomenon?

A

Raynaud’s phenomenon is a condition caused by the vasospasm of small arteries and arterioles that decreases blood flow to the skin.

46
Q

What are the colour changes seen in Raynaud’s phenomenon?

A

White (ischaemia)
Blue (blood stasis)
Red (reactive hyperemia)

47
Q

What is non-pharmacological treatment of Raynaud’s?

A

Stop smoking and hand warmers

48
Q

How do you treat Raynaud’s pharmacologically?

A

Nifedipine (calcium channel blocker, dihydropyridine)

49
Q

Which antibody is associated with diffuse and limited sclerosis?

A

Diffuse= scl-70

Limited= anti-centromere

50
Q

If egfr is >60 what else has to be present to be classified as CKD?

A

One of
- Proteinuria
- Structurally abnormal kidneys
- Blood in the urine

Y3 Medicine (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions