Phase 3B 2015 Flashcards

1
Q

Mechanism of action that causes an ankle fracture

A

Inversion of the foot

Eversion of the foot

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2
Q

Classify the types of ankle fractures and outline the subsequent management

A

Weber Classification
A: below the syndesmosis
Stable
Cast

B: At the syndesmosis
No talar movement: stable, cast
Talar movement: unstable ORIF

C: Above the levels
Unstable
ORIF

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3
Q

Principles of fracture management

A

Anatomic reduction (realignment of feature fragment)
Stabilisation of fracture
Neurovascular supply must be maintained
Encourage early rehab

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4
Q

Complications of fracture

A
Non union
Delayed union 
Infection 
NV injury 
Malunion 
VTE events
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5
Q

Features of AF seen on ECG

A

Lost of P waves

Irregularly irregular rhythm

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6
Q

Medical management of AF

A

B-blockers: Bisoprolol
CCB: Verapamil (diltiazem)
Digoxin (cardiac glycoside)

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7
Q

Outline the drugs used in drug cardioversion and their mechanism of action

A

Amiodarone

  • Anti-arrhythmic
  • Potassium channel blocker
  • Also in this class (soltalol)

Flecanide

  • Don’t use this if structural heart problems
  • Sodium channel blocker
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8
Q

Outline the role for anticoagulation in AF

A

CHA2DS2-VASc
Acute
- Heparin until full assessment complete for possible emboli
- AF >48 3/52 of anticoagulation prior to cardioversion. Use warfarin INR 2.5

Chronic

  • Warfarin
  • INR 2-3
  • Dabigatran (thrombin inhibitor)
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9
Q

Causes of unilateral facial drop

A

Bell’s palsy
Stroke
Ramsay Hunt
Trauma to the facial nerve during parotid surgery
Tumour (acoustic neuroma, facial nerve tumour)

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10
Q

Causes of Ramsay Hunt

A

Reactivation of the varicella Zooster virus

Dormant in the geniculate ganglion of CNVII

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11
Q

Symptoms of Ramsay Hunt

A
Ear pain 
Vesicular rash 
Hyperacusis 
Tinnitus 
Vertigo 
Hearing loss 
Facial palsy
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12
Q

Treatment of Ramsay Hunt

A

Aciclovir (1st 72hrs)

Prednisolone

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13
Q

Actions of PTH

A

Increases osteoclast activity = release of calcium and phosphate
Increase calcium reabsorption from the kidney
Increase phosphate reabsorption from the kidney
Activate 1,25 dihydroxy Vitamin D3 production, increase absorption of calcium from the gut

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14
Q

Name the types of renal stone

A
Calcium oxalate 
Calcium phosphate 
Struvite 
Urate 
Cystine
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15
Q

Gold standard investigation for renal stones

A

Spiral non contrast KUB

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16
Q

Management of renal stones

A
  1. Diclofenac (IM/PR)
    <5mm: pass freely
    >5mm: Medical explosion therapy (tamulosin)
    > 10mm: extracorpeal shockwave lithoplexy
17
Q

Diagnosis of thalassaemia

A

Blood film

HB electrophoresis

18
Q

Complications of recurrent blood transfusions

A

Myocardial: cardiomyopathy
Endocrine: DM, low PTH
Athralgia
Liver cirrohosis

19
Q

Treatment of iron overload

A

Deferiprone (PO) + Desferrioxamine (SC)

20
Q

Risk factors for head and neck cancers

A
Alcohol 
Smoking 
HPV 
Vitamin A &amp; C deficiency 
GORD
21
Q

investigations for a possible head and neck cancer

A
MRI 
Fibreoptic endoscopy of upper digestive tract 
Biopsy masses 
Lymph node biopsy 
CT thorax for staging 
Blood 
HPV status
22
Q

Causes of a PR bleed

A
IBD 
Diverticultits 
Colon Ca 
Infective gastroenteritis 
Fissure 
Haemorrhoids
23
Q

Mainteance regime in UC and in Crohns

A

UC

  • Melsazine
  • Azathioprine
  • Infliximab

Crohn’s

  • Azathioprine
  • Methotrexate
  • Infliximab
24
Q

Mainteance regime in UC and in Crohns

A

UC

  • Melsazine
  • Azathioprine
  • Infliximab

Crohn’s

  • Azathioprine
  • Methotrexate
  • Infliximab
25
Q

Triggers for eczema

A

New washing/cleaning products
Stress
Warm weather
Poor compliance with treatment

26
Q

Questions to assess the severity of severe depression

A
Length of symptoms 
Suicide plans/ self harm 
Unexplained guilt/worthlessness
Inability to function 
Concentration impaired 
Impaired appetitis 
Decreased sleep/ early waking 
Energy low
27
Q

Assessing suicide risk

A
Plans made 
Methods 
Planned or spontaneous (under the influence)
Reasons for or against 
Protective factors 
Support network
28
Q

Classes of antidepressants with examples and side effects for each

A

SSRIs

  • Sertraline
  • headache, GI disturbance, sexual dysfunction

SNRIs

  • Venlafaxine
  • Headache, constipation, weight changes, sexual dysfunction

TCA

  • Amitrptylline
  • dry mouth, urinary retention, dry eyes, constipation

MAOi

  • selegline
  • Arrhythmia, headache, GI upset, muscle aches