High Yeild Flashcards by Holly Macdonald

DMARDs and SE

Methotrexate
- hepatic toxicity, myelosupression, ulcers, ILD

Sulfasalazine
- Mouth ulcers, rash, myelosupression, reactivation of infections, orange urine

Hydrochloroquine
- retinal toxicity, GI upset, skin pigment changes, myopathy/cardiomyopathy

How well did you know this?

Not at all

Perfectly

TNF a inhibitors

Infliximab
- injection reaction
- increase risk of reactivation/infection
- increased risk HF
- every 8 weeks
- avoid live vaccines
- drug induced SLE

How well did you know this?

Not at all

Perfectly

CHADSVaSC - used for a fub

Congestive HF/LV dysfunction
Hypertension
Age >75 (2)
Diabetes
Stroke/TIA/Thrombosis (2)
Vascular Disease (MI, PAD)
Age 65-75
(Sex) Female

How well did you know this?

Not at all

Perfectly

HASBLEED

HTN
Abnormal renal/liver
Stroke
Bleeding Hx
Labile INR
Age >65
Drugs/ EtOH (NSAIDs etc.)

How well did you know this?

Not at all

Perfectly

A TNF a inhibitor

Adalimumab
- Increased risk infection
- avoid live vaccines
- autoimmune lupus

How well did you know this?

Not at all

Perfectly

METHBRO is the acronym for methotrexate SE what does it stand for?

Mucositis
Emesis
Thrombocytopenia
Hepatotoxicity
Bone marrow suppression
Repro- Teratogen
O - Lung fibrOsis

How well did you know this?

Not at all

Perfectly

Tacrolimus is the name of an immunsuppressant and its acronym for its side effects. What does it stand for?

T - Tremor
A - Alopecia
C - CV (HTN)
R - Renal insufficiency
O - Oncologic (SCC or BCC)
L - Lipids, hyperlipidaemia
I - Insulin dep diabetes
M - Mg wasting
U - Uric acid elevation
S - Seizures

How well did you know this?

Not at all

Perfectly

What is ENTRESTO?

ARNI

How well did you know this?

Not at all

Perfectly

What is the 6 minute walk test used for?

Assessing the severity of ILD (Theyre hooked up to oxygen saturation monitoring etc)

How well did you know this?

Not at all

Perfectly

What is cor pulmonale?

Enlargement of the right heart because of pulmonary HTN or lung disease

How well did you know this?

Not at all

Perfectly

What testing is done to diagnose cor pulmonale?

ECG
ECHO
CXR

How well did you know this?

Not at all

Perfectly

Whats the treatment of MS?

Methylprednisone for acute relapses

Interferons and MABs for reduction in relapse frequency

How well did you know this?

Not at all

Perfectly

What are the indications for warfarin?

Mechanically heart valve
ESRF

How well did you know this?

Not at all

Perfectly

What are the drugs considered dirty?

Amioderone
Nitrofurotoin
Digoxin
Phenytoin

How well did you know this?

Not at all

Perfectly

What are the SE of amioderone?

ILD
CLD
Thyroid dysfunction (either hyper or hypo)
Optic neuropathy
Can be arrhythmogenic (ironically)

How well did you know this?

Not at all

Perfectly

What are the SE of Nitrofurotoin?

ILD
CLD
Polyneuropathy
Vision changes
Heamolytic anaemia

How well did you know this?

Not at all

Perfectly

What are the SE of digoxin?

Vision changes
GI upset
Dilirium

How well did you know this?

Not at all

Perfectly

What are the SE of phenytoin?

Study These Flashcards

SJS
Osteomalacia
CLD
Polyneuropathy

Whats the treatment of angina?

Study These Flashcards

CCB or Beta blocker to act as a negative inotrope or rate limiting, plus opens vessels

Aspirin
Statin
Blood pressure control
Good diabetes control

What are some key parkinsons findings you might find on examination?

Study These Flashcards

Asymmetrical tremor
Rigidity, can be cog wheeling
Stooped gait, no arm swinging, shuffling
Check eyes for vertical gaze
Hypomimea (expressionless)
Monotonous
Lying-standing blood pressure
Can get them to do something with other hand to accentuate tremor

When taking a parkinsons history what are some other considerations youve recently learnt?

Study These Flashcards

Get up and go time
How long do they experience sx prior to next dose // how long does it wear off for
How often do they get freezing episodes?
Are they dyskinetic at time of dose?
Do they see a dietician for increased colorie intake given dyskinesia can burn lots of colories or because they cant swollow
Do they know of parkinsons NZ for education and support
AVDOID DOXAZOSIN for urinary retention
MOCA for cognition

What are the SE of sinemet

Study These Flashcards

Sexual diavaince
Gambling
Risky behaviours

What is EGPA?

Study These Flashcards

Eosiniophilic granulomatosis (previously Charg straus syndrome)

Adult onset Asthma eosinophilia and vasculitis…. septic shock picture. Renal failure common.

Tx with RUTUXIMAB

Impairs small to medium vessels such as those that supply the heart, lungs, kidneys…

What is GPA vasculitis?

Study These Flashcards

Granulmatosis with polyangiitis

Autoimmune, necrotizing
Small to medium vessles
Upper airway disease and glomerulanephritis predom
Test ANCA etc
Treat with cyclophosphamide and rutuximab.. Maintainence with azithioprine and methotrexate

What is a marked raised in 60% of sarcoidosis?

ACE But also test: ESR, LFTs, Ca, IG and check for TB

What can sarcoidosis do to the heart?

Complete heart block

What is takutsubo cardiomyopathy?

Stress induced weakness of the heart - ECG changes that mimic STEMI - Coronary angio done usually and found to be fine.

How long do heart valve replacements last? what abouts stents?

Mechanical 20-30 years Biological - 10-20 years Stents can last a lifetime and more likely to re-oclude in the first 18 months

Whats a unique treatment to middlemore regarding COPD?

Endobronchial valves to reduce the residual volume

What is prabinex for?

Rapid replacement of B and C vitamins typically in alcoholics... + Thamine 500mcg and Lorazepam 10mg QID

What are atypical infections in term of resp that you might cover for?

Use of macrolides i.e azithromycin to cover for mycoplasm, legionella

What are the broad causes of ILD?

Connective tissue i.e RA Hypersensitivity pneuonitis i.e drugs Organised pneumonia Exposure etc

Whats required to qualify for at home oxygen therapy?

ABG proving hypoxia in the absence of supplemental O2. Cant be hypercapnic - Cant smoke or vape

How can you get palliative oxygen home therapy?

<3 month life expectency Underlying disease <90% saturation after 15mins off oxygen Demonstrate sx relief.

1mg bumetanide is equivilent to?

40mg Furosemide

Whats a standard dose of furosemide in decomp HF?

80mg BD

How frequently can you give metalazone?

Every second day, watch K

What diabetic medicaitons should be withheld if sick?

Empag or metformin also SU

Whats the NYHA classification of heart failure?

Class 1: Ordinary activity = no sx Class 2: Ordinary activity = sx Class 3: Fine at rest, but any activity = symptoms Class 4: Symptoms at rest Symptoms: Fatigue, dyspnoea, palpitations, angina

What can you give in place of statins?

Ezetimibe

What are the causes of restrictive lung disease?

ILD Neuromuscular disorders Lobectomy Obesity Decrease FEV1 and FVC thus ratio is normal or increased.

What are the classes of pulmonary hypertension?

Group 1 (Pulmonary Arterial Hypertension), Group 2 (Pulmonary Hypertension due to left-heart disease), Group 3 (Pulmonary Hypertension due to lung diseases and/or hypoxia), Group 4 (Pulmonary Hypertension due to chronic thromboembolic disease), and Group 5 (Pulmonary Hypertension with unclear or multifactorial mechanisms) Treat underlying cause

Apart from the four pillars of heart failure then what are the other considerations?

- ACEi has a three day wash out period, ARB does not so better to start and then escalate to ARNI if SA - No b block till euvolaemic - Stat dose of iron if evidence of anaemia - Mitral regurg is most common valve issue because of LV and LA hypertrophy Ask if they know their dry weight, BP check , SPO2 check, SX of becoming fluid overloaded.

When listening for heart sounds, what must you do?

Use the bell to check for mitral stenosis

High Yeild Flashcards

(44 cards)