test import csv (class header) Flashcards
(168 cards)
1
Q
Acute Bronchitis - Aetiology
A
Viral
2
Q
Acute Bronchitis - Key findings
A
loose rattly cough + sputumpost-tussive glut/vomitwellpost URTINO creps/wheeze
3
Q
Acute Bronchitis - Managment
A
Supportive
4
Q
Acute Bronchitis - Prognosis
A
Self-limiting
5
Q
Anaemia - Aetiology
A
Deficiencies (iron, B12, folate)ThalassaemiamalignancySecondary (of chronic disease)
6
Q
Anaemia - Epidemiology
A
Menstruating girls and womenPregnant/PPYoung children
7
Q
Anaphylaxis - Key findings
A
Sudden and rapid progressionABC problems +- skin and mucosal changesurticaria, pruritus, flushingVasodilation -> warm extremtities, low BPCapillary leak -> hypovolaemia, oedemaBronchospasmGI symptoms
8
Q
Anaemia - Key findings
A
Low HgPallor. fatigue, dyspnoea, anorexia, headache, bowel disturbance
9
Q
Anaemia - Investigations
A
FBCBlood filmFerritinReticulocyte count
10
Q
Anxiety disorder - Key findings
A
Excessive worry about everyday issues disproportionate to risk3 or more of: restless/nervous, easily fatigued, poor concentration. irritability, muscle tension, sleep disturbance>6msignificant distress or impairment
11
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insert new card - position 11 with blank Answer
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update answer
12
Q
insert new card - position 11 with blank Answer
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update blank to answer
13
Q
Anaemia - Managment
A
IMAGE HERE - DM
14
Q
Anaphylaxis - Aetiology
A
Type I hypersensitivityFood, drugs, venom
15
Q
Anaphylaxis - Investigations
A
Tryptase blood sample (ASAP = 1-2 h after)
16
Q
Anaphylaxis - Managment
A
AdrenalineChlorphenamineHydrocortisoneNebulised salbutamolADMIT
17
Q
Anaphylaxis - Prognosis
A
ResolutionDeath due to resp failure or cardio collapse
18
Q
Anxiety disorder - Aetiology
A
Biopsychosocial factors???
19
Q
Anxiety disorder - Epidemiology
A
Most common psych disorder1-7% prevalence in EuropeF>M35-55 yo
20
Q
Anxiety disorder - Investigations
A
GAD-7 questionnaire
21
Q
Anxiety disorder - Complications
A
Impaired functioningComorbidities (depression, substance misuse or dependance)SuicideIncreased use of healthcare
22
Q
Anxiety disorder - Prognosis
A
Chronic fluctuatingLow rates of remission
23
Q
Anxiety disorder - Managment
A
Step approach (if marked impairment - 3.)1. Communicate and educate, monitor2. Individual non-facilitated self-help, individual guided self-help, psychoeducational groups (all CBT based)3. Hight-intensity psych intervention (CBT, 12-15w 1 h), SSRI (sertraline, paroxetine, escitalopram), SNRI (duloxetine, venlafaxine) - monitor weekly for first month for suicide4. Referral
24
Q
Atrial Fibrillation - Aetiology
A
Unknown
25
Atrial Fibrillation - Epidemiology
2.5% in EnglandM>F
26
Atrial Fibrillation - Key findings
Supraventricular tachyarrhythmiaHR 160-180Irregularly irregular pulseParoxysmal/persistant/permanentBreathless, palpitations, chest discomfort, syncope, dizziness
27
Atrial Fibrillation - Investigations
12-lead ECG (normal/ambulatory)EchoCXRBloodsCHA2DS2-VASCc
28
Atrial Fibrillation - Complications
StrokeHeart failure
29
Atrial Fibrillation - Managment
If CHADSVASC 2 or more - DOAC (Apixaban, dabigatran, edoxaban and rivaroxaban)If CI - vit K antagonist (warfarin)Beta blockerRate-limiting calcium channel (verapamil)
30
Asthma - Aetiology
Unknown
31
Asthma - Epidemiology
12 % of UKChildren (M>F)M=F in adulthoodCould be occupational
32
Asthma - Key findings
SOBWheezeCoughChest tightness Episodic, diurnal, triggers
33
Asthma - Investigations
Hx FeNOSpirometry PEFRBronchodilator reversibility
34
Asthma - Management (Adults)
IMAGE HERE - DM
35
Asthma - Management (Children)
IMAGE HERE - DM
36
Asthma - Complications
Acute exacerbation
37
Asthma - Acute exacerbation management (adults)
Admit if life threatening or near fatal or severe persistent after initial treatment (according to PAAP)OxygenBeta agonists (Salbutamol) + steroids (Prednisolone, 40-50 mg for at least 5 days)Nebulised Ipratropium bromide (severe or life-threatening asthma or those with a poor initial response)IV Magnesium SulfateIV Aminophylline
38
Asthma - Acute exacerbation (children)
IMAGE HERE - DM
39
Asthma - Acute exacerbation managment (children)
OxygenSABAIpratropium bromide (every 20-30 mins)Oral prednisoloneNebulised magnesium sulfate if severe2nd lineIV SalbutamolIV Aminophylline if severeIV Magnesium sulfate
40
Eczema - Aetiology
Skin barrier dysfunction??? FilaggrinEnvironmental factors or allergens
41
Eczema - Epidemiology
Children 20%Adults 10%
42
Eczema - Key findings
Dry, pruritic skin, and is typically an episodic disease of flaresChronic inflammatoryPersonal and familial atopic hx
43
Eczema - Investigations
HxExam rash
44
Eczema - Management
EmollientsTopical CorticosteroidsAntihistaminesOral corticosteroids
45
Eczema - Complictaions
Eczema herpaticum (admit)Infected eczema (weeping, pustules, crusts, fever and malaise)
46
Bronchiolitis - Aetiology
Viral
47
Bronchiolitis - Epidemiology
Peak at 3 - 6 m<1 yo (up to 2yo)
48
Bronchiolitis - Key findings
Symptom peak at 5dResolution within 3wCoryzal prodromePersistent cough + tachypnoea/chest recession + wheeze/cracklesYoung infants (<6 we) may only have apnoea
49
Bronchiolitis - Differentials
Pneumonia if high fever and/or persistently focal cracklesViral induced wheeze (older, no crackles, recurrent episodes, atopic hx)
50
Bronchiolitis - Investigations
Oxygen satsTempResp exam
51
Bronchiolitis - Managment
Reassure + conservativeAdmit to hospital if apnoea, sats <90% (<92% if under 6w), inadequate fluids, persistent sever reps distress, risk factorsOxygenCPAPNG tube
52
Bronchiolitis - Complications
Acute resp distress syndromeBronchiolitis obliterans Congestive HF
53
Heart failure - Aetiology
Coronary artery diseaseMIIschaemiaHypertension Cardiomyopathy Arrhythmias Valvar and congenital heart diseaseAlcohol and drugsPericardial diseaseHigh output
54
Heart failure - Epidemiology
Age
55
Heart failure - Key findings
SOBFatigue Swollen ankles and legsLightheaded mess and faintingCoughWheezeBloatingAppetite lossWeight gain/lossConfusionFast HRPalpitations
56
Heart Failure - Investigations
N-terminal pro-B-type natriuretic peptide >400ng/L diagnostic (if >2000ng/L refer urgently)EchoECGCXRBloodsUrinalysis Peak flow/spirometry
57
Heart failure - Managment
Lifestyle adviceTreat underlying causeIf reduced ejection fraction - ACEi + beta blocker, Ivabradine, Savibitril valsartan, DigoxinAll HF types - diuretics, calcium channel blockers, amiodarone, anticoagulant, vaccinations
58
Heart failure - Complications
Arrhythmias DepressionCachexia AnaemiaCKDAKISexual dysfunction Sudden cardiac death
59
Chronic kidney disease - Aetiology
DiabetesHypertension Glomerulonephritis
60
Chronic kidney disease - Epidemiology
Over 65sF>M
61
Chronic kidney disease - Key findings
FatigueTrouble concentratingPoor appetite Trouble sleeping
62
Chronic kidney disease - Investigations
U&EscreatinineeGFRUrine albumin-to-creatinine ratiourine dipstick for haematuriaCheck nutritional status, BMI, BP, and serum HbA1c and lipid profile (cardiovascular risk factors)renal US if indicated, (suspected urinary tract stones or obstruction, FHx of polycystic kidney disease and > 20 yo)
63
Chronic Kidney Disease - Managment
Underlying causesMonitor serum creatinine and eGFRManage hypertension urinary ACR of 70 mg/mmol or more - lisinopril or losartan irrespective of blood pressureatorvastatin 20 mgantiplateletsavoid nephrotoxic drugs
64
Chronic Kidney Disease - Complications
AKIHypertension and dyslipidaemiaCVDRenal anaemiaRenal mineral and bone disorderPeripheral neuropathy and myopathyMalnutritionMalignancyEnd stage renal disease
65
COPD - Aetiology
SmokingOccupationalAir pollutionAlpha1-antitrypsin deficiency
66
COPD - Epidemiology
1.2 million in UK>40 yoM=F
67
COPD - Key Findings
Breathlessness — persistent, progressive, and worse on exertionChronic/recurrent coughRegular sputum productionFrequent lower respiratory tract infectionsWheezeCyanosisRaised jugular venous pressure and/or peripheral oedema CachexiaHyperinflation of the chestUse of accessory muscles and/or pursed lip breathingWheeze and/or crackles on auscultation of the chest
68
COPD - Investigations
Spirometry - post bronchodilator FEV1/FVC less than 0.7 confirms persistent airflow obstructionCXRFBC
69
COPD - Managment
Stop smokingOffer pneumococcal and influenza vaccinationsOffer pulmonary rehabilitation if indicatedSABA/SAMA if limited by breathlessnessLABA + LAMA (if no asthmatic features/no steroid responsiveness)LABA + ICS
70
COPD - Complications
Reduced QoL, increased mortalityExacerbation (frequent chest infection)Depression and anxietyCor pulmonaleSecondary polycythaemia (due to hypoxia)Respiratory failurePneumothoraxLung cancerMuscle wasting and cachexia
71
COPD - Exacerbation treatment
Oral steroids - 30 mg oral prednisolone once daily for 5 daysAbx may be neededAmoxicillin 500 mg three times a day for 5 daysDoxycycline 200 mg on first day, then 100mg once a day for 5-day course in totalClarithromycin 500 mg twice a day for 5 days
72
COPD - End of life treatment
Advanced care planOpioids, Benzodiazepines, tricyclic antidepressants, major tranquillisers or oxygen
73
Conjunctivitis - Aetiology
80% viralAdenovirus, Streptococcus pneumoniae, Staphylococcus aureus and Haemophilus influenzae
74
Hyperacute conjunctivitis
Hyperacute conjunctivitis is a rapidly developing severe conjunctivitis typically caused by infection with Neisseria gonorrhoeae
75
Ophthalmia neonatorum (ON)
Conjunctivitis occurring within the first 4 weeks of lifeInfectious or non-infectious.Neisseria gonorrhoeae or Chlamydia trachomatisSerious complications if not treated promptly and appropriately
76
Conjunctivitis - Epidemiology
1% of all GP consultations in the UK
77
Conjunctivitis - Key Findings
Acute onset conjunctival erythema.Discomfort which may be described as ‘grittiness’, ‘foreign body’ or ‘burning’ sensationWatering and discharge which may cause transient blurring of vision
78
Conjunctivitis - Investigations
NO routine swabsSwabs for purulent discharge
79
Conjunctivitis - Red flags
Reduced visual acuityMarked eye pain, headache or photophobiaRed sticky eye in a neonate (within 30 days of birth)History of traumaCopious rapidly progressive discharge — may indicate gonococcal infectionInfection with a herpes virusSoft contact lens use with corneal symptoms (such as photophobia and watering)
80
Conjunctivitis - Management
Bathing/cleaning the eyelids with cotton wool soaked in sterile saline or boiled and cooled water to remove any dischargeCool compresses applied gently around the eye areaUse of lubricating agents or artificial tears
81
Conjunctivitis - Prognosis
Self-limiting, 7-14 days
82
Constipation - Aetiology
Idiopathic or secondary cause (eg malignancy, IBS, stricture, proctitis, neuro conditions, opioids etc)
83
Constipation - Epidemiology
60+ (children chronic idiopathic)PregnancyBlackDeprivation
84
Constipatio - Key findings
<3 bowel movements/weekExcessive straining, abdo pain bloatingElderly - confusion/delirium, nausea/loss of appetite, overflow diarrhoea, urinary retention
85
Constipation - Investigations
RED FLAGS?Diet?Normal bowel habits?Mental health?DRE
86
Constipation - Management
Diet advice (fibre intake, whole grains, fluids)ExerciseToileting routinesBulk-forming laxative (isphagula) - not if opioidsOsmotic laxative (macrogol - movicol, laxido; lactulose)Soft but difficult to pass - stimulant laxative (senna, bisacodyl)
87
Constipation - Management in children
Same lifestyle advice as adults + rewards, bowel habit diaryMovicol on escalating dose regimen for disimpaction2w nothing - sennaMaintenance - half the disimpaction dose for weeks - months
88
Constipation - Prognosis
Self resolution in children, variable in adults
89
Croup - Aetiology
Para'flu 1
90
Croup - Epidemiology
Common in children
91
Croup - Key findings
Coryza, stridor, hoarse voice, barking cough, well, 1 day
92
Croup - Managment
Oral dexamethason
93
Croup - Prognosis
Resolution within 48 hours
94
Crystal Arthropathy - Aetiology
monosodium urate crystals OR calcium pyrophosphate
95
Crystal Arthropathy - Risk factors
HyperuricaemiaCKD, hypertension, DM, hyperlipidaemia, OA, lympho/myeloproliferaive disorders, exfoliative psoriasisAlcohol, sugary drinks, red meat and seafoodExcess weightFHxDiuretics, aspirin
96
Crystal Arthropathy - Epidemiology
M>FOlder (>40)
97
Crystal Arthropathy - Key findings
Rapid onsetTophiSevere pain, redness and swelling in big toe OR knee
98
Crystal Arthropathy - Investigations
Serum urateRefer to secondary care if uncertain - aspiration
99
Crystal Arthropathy - Management of acute episode
NSAIDsColchicineOral prednisolone for 3-5 daysIA/IM corticosteroid if previous easures ineffectiveIce packs
100
Crystal Arthropathy - Prevention
AllopurinolULT if multiple/bad flareups, CKD, diuretics, tophi, chronic
101
Crystal Arthropathy - Prognosis
Usually self-limiting in 5-15 daysRecurrence of 85%
102
Dementia (Alzheimer's) - Key Findings
Most common causeProgressive over yearsForgetfulnessRepetitionMisplacing thingsConfusionMood and behaviour problemsLanguage and speech problems
103
Dementia - Lewy body
a
104
Dementia - Frontotemporal
a
105
Dementia - Vascular
a
106
Depression
a
107
Type 1 Diabetes
a
108
Type 2 Diabetes
a
109
Hypertension
a
110
Gastro-oesophageal reflux
a
111
Herpes Simplex Virus
a
112
Hiatus Hernia
a
113
Hyperthyroidism
a
114
Hypothyroidism
a
115
Impetigo
a
116
Influenza
a
117
Irritable Bowel Syndrome
a
118
Ischaemic Heart Disease
a
119
Migraine
a
120
Osteoarthritis
a
121
Osteoporosis
a
122
Otitis Media
a
123
Parkinson's Disease
a
124
Pelvic Inflammatory Disease
a
125
Polymyalgia Rheumatica
a
126
Prostate Cancer
a
127
Psoriasis
a
128
Rhinosinusitis
a
129
Sexually Transmitted Infections
a
130
Stress Inocntinence
a
131
Substance Use Disorder
a
132
Tonsillitis
a
133
Urinary Tract Infection
a
134
Urticaria
a
135
Varicella Zoster
a
136
Vasovagal Syncope
a
137
Viral Gastroenteritis
a
138
Dementia (Alzheimer's) - Investigations
Memory testsPsych evaluationBrain imagingLumbar puncture - amyloid and tau proteins
139
Dementia (Alzheimer's) - Managment
Cholinesterase inhibitors (donepezil, rivastigmine, galantamine) for mild/moderateMemantine - NMDA receptor antagonist (ebixa, axura) for moderate/severe
140
Anaemia - SE of treatment
Iron* Feeling or being sick (nausea or vomiting)* Stomach discomfort or heartburn* Losing your appetite* Constipation* Diarrhoea* Darker than usual poo* Black stained teeth (from the liquid only)B12 Injection
141
Anaemia - CI to treatment
Iron* hereditary hemochromatosis* hemosiderosis* a history of hemolytic anemiaB12 injection
142
Anaemia - Drug interactions
Iron may reduce effect of:* tetracycline* penicillin* ciprofloxacin* Parkinson's disease drugs* seizure medicationsB12 injections - reduced absorption* aminosalicylic acid* colchicine* metformin* proton pump inhibitors* vit C
143
Dementia (Alzheimer's) - Aetiology
Amyloid plaques and tau tangles
144
Dementia (Alzheimer's) - Epidemiology
>65 yo
145
Anaemia - SE of treatment
Iron* Feeling or being sick (nausea or vomiting)* Stomach discomfort or heartburn* Losing your appetite* Constipation* Diarrhoea* Darker than usual poo* Black stained teeth (from the liquid only)B12 Injection* Pain, swelling or itchy skin where you had the injection* Feeling or being sick (nausea or vomiting)* Diarrhoea* Headaches* Feeling dizzy* Hot flushes
146
Anaphylaxis - SE of treatment
Cardiomyopathy (rare)pain, swelling, warmth, redness at site of injection
147
Anaphylaxis - Drug interactions (Epipen)
* digoxin* diuretics* levothyroxine* chlorpheniramine or diphenhydramine (antihistamines that a commonly contained in cold, allergy, or over-the-counter sleep medications)* antidepressants* beta-blockers* ergot medicines* heart rhythm medications* MAO inhibitors
148
Anxiety disorder - Treatment SE
SSRIs* feeling agitated, shaky or anxious* feeling or being sick* indigestion* diarrhoea or constipation* loss of appetite and weight loss* dizziness* blurred vision* dry mouth* excessive sweating* sleeping problems (insomnia) or drowsiness* headaches* low sex drive* difficulty achieving orgasm during sex or masturbation* in men, difficulty obtaining or maintaining an erection (erectile dysfunction)*
149
Anxiety Disorder - Treatment CI
SSRIs* bipolar disorder* bleeding disorder* DM* epilepsy (uncontrolled)* narrow angle glaucoma* kidney/liver/heart problem* pregnancy (esp 1st trimester)
150
Anxiety Disorder - Drug Interactions
BLANK HERE - DM
151
Anxiety Disorder - Serious treatment SE/complications
Serotonin syndrome* Nervousness* Nausea and vomiting* Diarrhea* Dilated pupils* Muscle issues, like twitching, involuntary contractions, spasms and rigidity* Sweating and shivering* Side-to-side eye movementsSevere symptoms include:* Confusion or delirium (altered mental status)* Rapid heart rate (tachycardia)* High blood pressure* Fever* Seizures* Loss of consciousness**Get immediate medical help, can be fatal if it’s not treated in time**Antidepressant discontinuation syndrome (when stopped suddenly after 6+ weeks)* Flu-like symptoms, such as fatigue, headache, achiness and sweating* Insomnia* Nausea* Dizziness and lightheadedness* Sensory issues, such as burning, tingling, “buzzing” or mild electric shock-like sensations* Anxiety, irritability and agitation
152
Atrial Fibrillation
BLANK HERE - DM
153
What are the side effects of Beta blockers?
BLANK HERE - DM
154
What are the side effects of
BLANK HERE - DM
155
What are the side effects of SSRIs/SNRIs?
SSRIs/SNRIs* feeling agitated, shaky or anxious* feeling or being sick* indigestion* diarrhoea or constipation* loss of appetite and weight loss* dizziness* blurred vision* dry mouth* excessive sweating* sleeping problems (insomnia) or drowsiness* headaches* low sex drive* difficulty achieving orgasm during sex or masturbation* in men, difficulty obtaining or maintaining an erection (erectile dysfunction)
156
What are the CI to SSRI use?
SSRIs* bipolar disorder* bleeding disorder* DM* epilepsy (uncontrolled)* narrow angle glaucoma* kidney/liver/heart problem* pregnancy (esp 1st trimester)/BF* <18
157
What drugs do SSRIs interact with?
SSRIs* NSAIDs* antiplatelets* theophylline* clozapine and pimozide* lithium* triptans* other antidepressants
158
What are some serious SE/complications of SSRIs/SNRIs?
**Serotonin syndrome*** Nervousness* Nausea and vomiting* Diarrhea* Dilated pupils* Muscle issues, like twitching, involuntary contractions, spasms and rigidity* Sweating and shivering* Side-to-side eye movementsSevere symptoms include:* Confusion or delirium (altered mental status)* Rapid heart rate (tachycardia)* High blood pressure* Fever* Seizures* Loss of consciousness**Get immediate medical help, can be fatal if it’s not treated in time****Antidepressant discontinuation syndrome **(when stopped suddenly after 6+ weeks)* Flu-like symptoms, such as fatigue, headache, achiness and sweating* Insomnia* Nausea* Dizziness and lightheadedness* Sensory issues, such as burning, tingling, “buzzing” or mild electric shock-like sensations* Anxiety, irritability and agitation
159
What are the side effects of DOACs?| Apixaban, rivaroxaban, edoxaban
Bleeding
160
What are the side effects of rate-limiting calcium-channel blockers?
change here - DM
161
What are the side effects of vit K antagonists?| warfarin
BleedingA mild rashHair loss
162
What are the side effects of Beta blockers?
a
163
What are the side effects of rate-limiting calcium-channel blockers?
a
164
new card 167 with Answer
test
165
NEW CARD 170
switch to advanced
166
Anaemia - Investigations
FBCBlood filmFerritinReticulocyte count
167
Anaemia - Investigations
FBCBlood filmFerritinReticulocyte count
168
Acute Bronchitis - Aetiology
Viral
