Phase 3B 2014 Flashcards

1
Q

Risk factors for a VTE

A
Previous VTE
Family history 
Thrombophilia 
Active cancer
Immobility 
Pregnancy/ Postnatal period 
HRT/COCP
Obesity 
Antiphospholipid syndrome
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2
Q

VTE prevention in hospitals

A
Ted stocking
Low molecular weight heparin 
Early mobilisation following surgery 
Leg elevation 
Flow throm boot
IVC filter
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3
Q

Test to do before prescribing LMWH

A
Renal function, U&Es especially potassium 
Weight 
Liver function tests 
FBC (look at platelets)
HASBLED score
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4
Q

Name and list the mechanism of action of one DOAC

A

Apixiban

Factor Xa inhibitor

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5
Q

Risk factors for gout

A

Obesity
Diet high in purines
Reduce excretion due to renal impairment
Tumour lysis syndrome
Increased cell turnover (leukaemia, lymphoma)
EtOH excess

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6
Q

What precipitates a server gout attack

A
Infection 
Starting allopurinol 
Chemo 
Joint injury 
Binger drinking 
Dehydration
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7
Q

Management of acute gout

A

NSAIDs: ibuprofen,
Colchicine: alkaloid drug
Steriods: prednislone

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8
Q

How does allopurinol act

A

Xanthine oxidase inhibitor, prevents the production of uric acid, reducing the levels of urate in the blood
Reduce urate in the blood, preventing the formation of urate crystals

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9
Q

Why does gout favour distal joints

A

Cooler temperature at distal joints, crystals more likely to precited

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10
Q

List the risk factors for melanoma

A
Sun exposure 
Pale/Fair skin 
Immunocompromised 
Increased number of moles (> 50 melanocytic navei)
History of sunburn 
Increase age
\+ve family history
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11
Q

How do you stage melanoma

A

Breslows depth (>5mm deep bad prognostic indicator)
- Clarks
- Tumour marker is S-100
TNM based on Breslows thickness

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12
Q

Risk factors for being vitamin D deficiency

A
Institusationiled 
Pigmented skin 
Concealing clothes
Sunscreen 
Poor diet/ Malabsorption 
Anti-convulsant
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13
Q

Action of Vitamin D on the bone

A

Improves the bone density

Stimulates the osteoblast to activate RANK ligand to absorb the bone

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14
Q

Prophylaxis for malaria

A

Malarone
Doxycycline
Prochloroquine

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15
Q

Why would malaria prophylaxis fail

A

Compliance
Malabsorption
Resistance
Prophylaxis

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16
Q

Diagnostic test for malaria

A

Serial thick and thin blood films (GIEMSA)

17
Q

Where is transitional cell carcinomas found

A

Ureter
Renal pelvis
Urethra
Bladder cancer

18
Q

Signs of cauda equine in three specific locations

A

Sphincter: Decreased anal tone, incontinence or retention of
Lower limb: Bilateral sciatic, foot drop,
Perianal tissue: Saddle paraesthesia, decreased pinprick and decreased light touch

19
Q

What test should be performed prior to starting lithium

A

U&Es
TFTs
LFTs
ECG

20
Q

Symptoms of hypothyroidism

A
Tired 
Sleepy 
Cold 
Depression 
Increased weight 
Dry thin hair 
Coarse skin 
Puffy round face 
Non-pitting oedema 
Slow reflexes 
Goitre 
Bradycardia
21
Q

Signs of lithium toxicity

A
Tremor 
Nausea 
Vomiting 
Drowsy 
Ataxia 
Confusion 
Coma 
Sedation 
Dysarthria
22
Q

Features of down syndrome on a neonatal exam

A
Flat nasal bridge 
Epicanthic folds 
Sandal gap 
Flat occiput 
Small mouth/ protruding tongue 
Single palmer crease 
Hypotonia
Up slanting eye
Round face 
Brush filed spots on iris
Abundant neck 
Pelvis dyplasia
23
Q

GI abnormalites in Down’s

A

Moscism
Non dysjunction
Robertsonian translocation
Balanced translocation

24
Q

Define health economics

A

Assessment of efficiency, in other words it’s the comparative study of the cost and effectiveness/benefits of a health care intervention

25
Q

Define a QUALY

A

Estimate of the years of life remaining for a patient following a treatment or intervention. Weighing each year of life lived with a QUALY life scale
Two things to make an economic evaluation: cost and effectiveness

26
Q

Types of Economic evaluation

A

Cost benefit analysis
Cost utility analysis
Cost effectiness
Cost minimisation analysis

27
Q

Define opportunity cost

A

Opportunity cost: to spend resources on one activity means a sacrifice in terms of 
lost opportunity elsewhere

28
Q

Define efficiency

A

When resources are allocated between activates in such a way as to maximize benefits for a given budget

29
Q

Features of bulbar palsy

A
Dysathria 
Dysphagia 
Nasal regurgitation 
Weak tongue 
Wasted tongue 
Fasciculations 
Hypersalivation