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57 Cards in this Set
- Front
- Back
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Parkinson's treatment first line |
Ropinirole or pramipexole |
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Alzheimer's treatment (AChE inhibitors) |
Donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon). |
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Available doses of cocodamol |
8/500, 15/500, 30/500 |
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Why might a normal Cr still be worrying in an old person? |
Low muscle mass means low baseline Cr so if raised from baseline it still may be in the normal level |
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What do you use to differentiate delerium from dementia |
The confusion assessment method (CAM) |
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What is the MMSE really for |
Alzheimer's. So other types of dementia may score in the normal range |
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Within what time should a fractured neck of femur be x-rayed, seen and begun to be treated? |
2 hours |
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How might u&e differentiate between AKI and dehydration |
Relative increase in urea compared to creatinine in dehydration |
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What's the R of SBAR for anaphylaxis |
monitor for continued improvement on ward, measure serum tryptase after a few hours, continue chlorphenamine 4mg/6h if itching Serum tryptase is used as a marker for mast cell activation |
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In cardiac event, why should you take BP in both arms |
To check for aortic dissection |
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Drugs to give in a STEMI |
morphine (+GTN if LVF/HTN) & metoclopramide aspirin 300mg + ticragelor 180mg |
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What's the R of an SBAR for STEMI |
contact nearest PCI centre for referral and thrombolysis advice, check LV function with echo if time |
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What extra blood should you take for STEMI |
Troponin |
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What is the lowest MMSE score that's still no cognitive impairment (/30) |
24 |
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Most common side effect of nitrofurantoin |
Haemolytic anaemia |
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If an old person is worried about their memory loss, is probably |
Depression rather than dementia |
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What drug is given for IBS-like symptoms |
Mebeverine |
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Which drugs might accumulate in renal failure and need dose adjustment (dog fam) |
Digoxin Opioids Gliclazide and glibenclamide (and other sulphonylureas) Furosemide ABx (except erythromycin and rifampicin) Methotrexate |
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Which drugs must be stopped in renal failure |
Lithium Metformin NSAIDs Nitrofurantoin Tetracycline |
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Which drugs don't accumulate in renal failure |
Warfarin Diazepam Rifampicin Erythromycin |
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To whom would you prescribe lower doses of opioid due to greater risk of toxicity? |
Hepatic impairment Renal impairment Hypotensive Hypothyroidism Asthmatics Prostatic hypertrophy! |
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What do you do for a intertrochanteric fracture? |
DHS |
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How do you tell a #NOF that needs a hip replacement rather than internal fixation |
If it's displaced at all, it's a Garden 3 or 4 and needs a replacement Do a THR if the patient has good baseline mobility (a stick is allowed) cognition and health. Otherwise hemiarthroplasty If undisplaced (Garden 1/2) do internal fixation unless unfit, in which case you do a hemiarthroplasty |
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Prophylactic dose of Tinzaparin before orthopaedic surgery |
4500 units 12h before Teen 4500 units daily (For non-ortho surgery it's 3500, 2h before, then 3500 daily) |
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What age is early onset dementia |
< 65 |
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What is the inheritance of early onset dementia. What genes are involved |
Autosomal dominant! Presenilin 1 Presenilin 2 Amyloid precursor protein (c'some 21) |
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What gene predisposes to late onset Alzheimer's |
ApoE e4 allele (a cholesterol transport protein) |
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What are the 4 As in the presentation of Alzheimer's |
Agnosia Apraxia Aphasia Amnesia |
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What is BPSD |
Behavioural and psychosocial Sx of dementia |
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Why is HMPAO SPECT helpful in Alzheimer's |
Shows difference from vascular dementia |
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Alzheimer's Tx (NMDA antagonist) When is it indicated |
Memantine If AChE inhibitors not tolerated or severe Alzheimer's |
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Side effects of AChE inhibitors (rivastigmine, donepezil...) |
Bradycardia Exacerbation of ulcers |
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What's the psych TX for dementia that I need to remember |
Cognitive stimulation therapy |
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Side effects of NMDA antagonist memantine |
Hallucinations Hypertonia Hypersexuality Confusion |
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When is a PEG indicated in Alzheimer's |
If TRANSIENT dysphagia (not severe, ongoing) |
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What is binswanger disease |
Small vessel, subcortical vascular dementia |
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Mutation of what gene gives you CADASIL vascular dementia |
NOTCH3 |
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What's the most unequivocal sign in vascular dementia |
Reflex assymetry |
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Name the individual cognitive domains (LOVE AMP) |
Language Orientation Visuospatial Executive Attention Motor control Praxis |
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What are the three abnormalities in biochemistry/anatomy related to lewy body dementia
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alpha synuclein Ubiquitin Abnormally phosphorylated neurofilament proteins |
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What type of dementia has fluctuating Sx |
Lewy body |
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What drug can you give for hallucinations in lewy body dementia |
Rivastigmine |
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People with lewy body dementia get REM sleep disturbance. How can we help pharmacologically |
Clonazepam |
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Which type of frontotemporal dementia is PSP associated with |
Tau+ |
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Which type of frontotemporal dementia is MND associated with |
Ubiquitin+ |
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Which type of frontotemporal dementia is MND associated with |
Ubiquitin+ |
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If FTD is familial, what genes indicated |
Tau or PGRN (progranilin) |
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What are the three variants of FTD |
Behavioural variant Semantic dementia Progressive non-fluent aphasia |
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If Parkinson's symptoms present with FTD, what blood test should you do |
Caeruloplasmin and copper to rule out Wilson's disease Both low in blood, copper high in urine |
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What is the assessment of FTD called |
Frontal assessment battery |
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Difference between Parkinsonian SX in LBD and Parkinson's |
Bilateral in LBD Precede dementia for under 1y (if >1y it's probably Parkinson's with dementia, rather than LBD) |
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Side effect of metronidazole |
Peripheral neuropathy |
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SOAP BRAIN MD |
Serositis – Pleurisy, pericarditis Oral ulcers Arthritis Photosensitivity Blood disorders Renal involvement Antinuclear antibodies Immunologic phenomena Neurologic disorder Malar rash Discoid rash |
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What specific medications should you ask about in falls history |
Blood thinners |
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What do you do for a subtrochanteric hip fracture |
Intramedullary device |
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What do you do for an undisplaced #NOF |
Internal fixation usually If unfit, do hemiarthroplasty |
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When should you mobilise after hip orthopaedic surgery |
The day after surgery! |
