Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
51 Cards in this Set
- Front
- Back
|
BTS/SIGN asthma guidelines, what are steps 1-5?
|
1. SABA
2. Inh Steroid 3. LABA 4. Increase steroid/add adjunct 5. Oral steroids |
|
|
Step 1 of BTS/SIGN asthma guidelines
|
Mild intermittent asthma
SABA PRN (Salbutamol = Ventolin) |
|
|
Step 2 of BTS/SIGN asthma guidelines
|
"Regular preventer therapy"
SABA PRN from step 1 + Inhaled Steroid 200-800mcg/day. 400mcg is an appropriate starting dose for most patients. Beclometasone (Qvar) Fluticasone (Flixatide) Budesonide (Pulmicort) |
|
|
Step 3 of BTS/SIGN asthma guidelines
|
Initial add-on therapy
Already have SABA and Inh Steroid + LABA --> assess response: Good response, continue Good response but control issues, increase steroids to 800mcg/day No response to LABA, discontinue, increase steroids to 800mcg/day. LABA: Salmaterol |
|
|
Step 4 of BTS/SIGN asthma guidelines
|
Persistent poor control.
Already on SABA, inh steroid, LABA Consider trials of : 1) increased inhaled steroid to max dose 2) adjunctive drug e.g leukotriene (montelukast)/ theophylline |
|
|
Step 5 of BTS/SIGN asthma guidelines
|
Continuous or frequent use of oral steroids.
Already on SABA, inh steroid 2000mcg/day, LABA, ?adjunct. + Oral steroids. Prednisolone, low dose as therapeutic. |
|
|
Side effects of steroids
|
Cataracts
Ulcers Skin: striae, thinning, bruising Hypertension/ Hirsutism/ Hyperglycemia Infections Necrosis, avascular necrosis of the femoral head Glycosuria Osteoporosis, obesity Immunosuppression Diabetes |
|
|
Fasting blood glucose levels:
|
Normal: 3.9 to 5.5 mmols/l
Prediabetes or Impaired Glucose Tolerance: 5.6 to 7.0 mmol/l Diagnosis of diabetes: more than 7.0 mmol/l |
|
|
Random blood glucose information
|
The normal blood glucose level in humans is about 4 mmol/l
The body, when operating normally, restores the blood sugar level to a range of about 4.4 to 6.1 mmol/L Shortly after eating the blood glucose level may rise temporarily up to 7.8 mmol/L |
|
|
HBA1C
|
Target: Below 53mmol/l
|
|
|
Pellagra is..
|
Niacin deficency
Diarrhoea, confusion, eczema |
|
|
Vitamin C deficiency...
|
Bleeding gums (scurvy)
|
|
|
Vitamin D deficiency...
|
Rickets / Osteomalacia
|
|
|
B12 deficiency...
|
Megaloblastic anaemia
(Pernicious) |
|
|
Vitamin K deficiency...
|
Clotting inability
Haemorrhagic disease of newborn |
|
|
Drugs used to control -rate- in acute AF
|
Beta Blockers
Calcium Channel Blockers Digoxin (not 1st line) |
|
|
Drugs used to maintain -rhythm- in chronic AF
|
Sotalol
Amiodarone Flecainide |
|
|
in AF, when do you choose a Rate Control drug as opposed to a Rhythm Control drug?
|
Over 65
History of IHD |
|
|
First line treatment for tonic clonic seizures
|
Sodium Valproate
(Lamotrigine if high risk of pregnancy) |
|
|
First line treatment for complex partial seizures
|
Carbamazepine
|
|
|
Ethosuximide is useful in...
|
Absence seizures (if Valproate contraindicated)
|
|
|
First step of COPD management
|
SABA or SAMA
|
|
|
Second step of COPD managament if FEV1 > 50%
|
(SABA/SAMA already)
Add LABA/LAMA |
|
|
Second step of COPD management if FEV1 < 50%
|
(SABA/SAMA already)
Add LABA + Corticosteroid combination inhaler |
|
|
Hypertension guidelines: Step 1
|
If under 55: A
Over 55 / Afro Carribean: C |
|
|
Hypertension guidelines: Step 2
|
A + C
|
|
|
Hypertension Guidelines Step 3
|
A + C + D (thiazide-like diruetic, such as chlorthalidone and metolazone)
|
|
|
Hypertension Guidelines Step 4:
|
(A + C + D)
Add another diuretic (consider potassium) or add Alpha Blocker or add Beta Blocker |
|
|
Calcium Channel Blockers
|
Amlodipine, Nifedipine
|
|
|
URTI + amoxicillin --> Rash.
What do you need to think of? |
Infectious Mononucleosis (Glandular fever)
|
|
|
Right Bundle Brach Block versus Left Bundle Branch Block
|
WiLLiaM
MaRRoW L = W in 1, M in 6 R = M in 1, W in 6 |
|
|
First line anti anginal
|
Beta Blocker (Atenolol)
|
|
|
Drugs to avoid in chronic kidneys disease
|
Tetracycline + Nitrofurantoin
NSAIDs Lithium Metformin |
|
|
FEV1 % expected, severity of COPD:
|
>80% mild
50-79% moderate 30-49% severe <30 very severe |
|
|
Antibiotic for infective COPD exacerbation
|
Amoxicillin, or Tetracylcine, or Clarithromycin
|
|
|
Antibiotic for Chronic Pyelonephritis
|
Broad spectrum Cephalosporin
|
|
|
Antibiotic for acute cellulitis
|
Flucloxacillin
|
|
|
Avoid ____ in IBS?
|
Lactulose
Caffeine Wheat |
|
|
Drugs that have proven efficacy in reducing mortality in heart failure
|
Bisoprolol + Carvedilol are Beta Blockers that are proven.
All stable HF patients should be on a B Blocker and Calcium Channel Blocker. ISMN does not reduce mortality, only morbidity |
|
|
Animal bite antibiotic:
|
Co-amoxiclav.
|
|
|
Monitoring for ACE Inhibitors
|
U+E prior to treatment/increase dose
U+E at least annually ACE Inhibitors can affect renal function and cause hyperkalaemia. Also cough, hypotension. |
|
|
Monitoring for Statins
|
LFTs at baseline, 3 months, 6 months
Statins can cause myalgia - STOP |
|
|
Patients taking aspirin, before receiving dental work, should alter their dose how?
|
Not at all.
|
|
|
Presentation of SLE
|
Joint pain
Malar rash History of mental health CRP is often normal, ESR is raised. |
|
|
In heart failure, which drugs are contraindicated?
|
Negative inotropes (Verapamil)
NSAIDs (can cause fluid retention) Class I antiarhythmics (Flecainide) |
|
|
Cluster headaches
|
Men 5:1 Women
"Alarm clock headache" Watery eyes, nasal stuffiness Intense retro orbital pain Restlessness |
|
|
What drugs can lower a diabetes sufferer's awareness of their hypos?
|
Beta Blockers (Atenolol)
|
|
|
Adult adrenaline dose
|
0.5ml 1 in 1,000
Can repeat every 5 minutes. |
|
|
First line heart failure treatment
|
B Blocker and ACE Inhibitor.
(ARB if intolerant to ACE) |
|
|
Second line heart failure treatment
|
Aldosterone Antagonist or
ARB or Hydralazine + Nitrates |
|
|
Third line heart failure treatment
|
Cardioversion or
Digoxin |
