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2015-05-25 18:20:31
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  1. what scoring system is relevant in ACS?
    GRACE scoring – future mortality. Age, HR, Systolic BP, creatinine, ECG, trop, CCF, JVP, pulmonary oedema, cardiogenic shock.
  2. what scoring system is relevant to infective endocarditis?
    Duke's criteriae. Major criteriae (evidence of endocardial involvement, 2 x blood cultures) minor criteriea (predisposing criteriae, fever, vascular signs, microbiology consistent, ECHO consistent)
  3. what scoring system is relevant to atrial fibrillation?
    CHA2DS2VAS score. CCF, Hypertension, Age, Diabetes, Stroke/TIA, Vascular disease, Sex
  4. what study produces most evidence for hypertension?
    Framingham heart study
  5. what is the hacek group?
    haemophilus, actinobacilus, cardiobacterium, eikenella, kingella
  6. what are signs of malignant hypertension?
    Check for malignant hypertension: headaches, nose bleeds, eye changes, low urine output, chest pain, SOB. Rule out stroke
  7. what are secondary causes of hypertension?
    chronic renal failure, kidney disease, phaeochromocytoma, Conn’s syndrome, Cushing’s syndrome, Acromegaly, Hyperthyroid, Hyperparathyroid, Hypothyroid, alcohol, nicotine, oral contraceptive pill
  8. what score is important in pericarditis?
    Tygerberg score for TB pericarditis: weight loss, fever, night sweats, serum albumin, low leukocyte count
  9. what scoring system is used in small cell lung cancer?
    manchester score (LDH, hyponatraemia, ALP raised, acidosis, performance status)
  10. what is scoring for COPD?
    diagnostic: FEV1/FVC < 0.7. Scoring based on FEV1. GOLD score.
  11. what scoring system is relevant in pleural effusion?
    light's criteria - protein most important
  12. what scoring system is relevant to chronic liver disease?
    child-pugh score (ABCDE): albumin, bilirubin, coagulation (INR), distension (ascites), encephalopathy
  13. what scoring system is relevant to pancreatitis?
    ranson's criteria / glasgow score. Ransons: severity (WCC, LDH), complications (glucose, AST, age)
  14. what are causes of GORD?
    hiatus hernia, anxiety, obesity, smoking, zollinger-ellison syndrome, scleroderma, prednisolone, smoking
  15. what are causes of peptic ulcer?
    steroids, NSAIDs, smoking, cancer,
  16. what are signs of severity of IBD?
    number of stool per day, blood PR, systemic (anaemia), ESR/CRP
  17. how are internal haemorrhoids graded?
    1. no prolapse 2. prolapse on bearing down, spontaneous reduction 3. prolapse + manual reduction 4. irreducible
  18. what is the criteria for colon cancer?
    Duke's grading: A (inside serosa), B (through muscularis propria), C (nodes involved), D (distant metastasis)
  19. how is staging for CRF based?
    staging based on GFR
  20. what are specific signs of graves disease?
    Thyroid acropachy (clubbing of digits and toes, periosteal reaction of extremity bones, opthalmopathy, myxoedema)
  21. what is scoring for rheumatoid arthritis?
  22. what is definition of stroke?
    sudden onset focal neurological deficit
  23. what are the criteriae for MS?
    McDonald criteriae: 2 or more lesions seperated by space or time.
  24. what are the presenting symptoms of MND?
    nasal regurgitation, focal weakness, difficulty breathing, cramping, stiffness, clumsiness, foot drop
  25. what are the components of a mental state examination?
    AMS TPI: Appearance + Behaviour, mood + affect, Speech, Thought process + content, Perceptions, Cognition + insight
  26. what are the diagnostic criteriae for schizophrenia?
    at least 1 first rank symptom or first rank symptom, present for at least 1 month, without other explanatory factors (drugs, brain disease, affective symptoms)
  27. what are schneider's first rank symptoms for schizophrenia?
    3 Ts + 2 Ps: thought echo, thought insertion/withdrawal/broadcasting, Third person auditory hallucination, Passivity, delusional Perceptions
  28. what are schneider's second rank symptoms of schizophrenia?
    catatonia, second person auditory hallucinations
  29. what are the cardinal symptoms of depression?
    low mood, anhedonia, low energy, every day for 2 weeks.
  30. what are the secondary symptoms of depression?
    concentration, self esteem, guilt and worthlessness, self-harm, sleep and appetite, pschosis (always means severe)
  31. what is a diganosis for bipolar type I?
    one or more of each manic and depressive episodes
  32. what is the diagnosis for bipolar type II?
    recurrent major depressive and hypomanic episodes
  33. what is the diagnosis for cyclothymic disorder?
    chronic mood fluctuation over 2 years at least.
  34. what is the time duration of manic and depressive episodes in BP?
    manic (4 months), depressive (6 months)
  35. what are symptoms of a manic episode?
    somatic (psychomotor activity, sexual overactivity), speech (pressured), mood (mood-congruent delusions, self esteem, optimism, spending, dangerous driving, religious convictions, political or business initiatives)
  36. what is the accepted sequence of acute stress reaction?
    dazed, depression/anger/despair, purposeless overactivity, intense subjective anxiety, wandering aimlessly, reduced sleep and nightmares
  37. what is the timeline of an adjustment disorder?
    within weeks of the stressful event and less than 6 months. Not anxiety or depression.
  38. what is the diagnosis for PTSD?
    persistent intrusive thinking or reexperiencing, 2. avoidance of reminders 3. numbing, detachment and loss of interest in normal activities 4. increased arousal 5. lasting at least one month
  39. what are the classic stages of grief?
    1. shock and disbelief 2. anger 3. searching or pining 4. guilt 5. sadness and despair 6. acceptance and return of interests
  40. what are the signs of a panic disorder?
    recurrent panic attacks unpredictably without situational context, at least 3 times/3 weeks.
  41. define generalised anxiety disorder
    must last for 3 weeks, generalised, persistent, excessive anxiety about a number of events. Associated: apprehension, vigilance, restlessness, sleeping, motor tension, autonomic hyperactivity
  42. define obsessions
    unwelcome, persistent recurrent intrusive senseless uncomfortable for the individual.
  43. define compulsions
    repetitive, purposeful physical or mental behaviours
  44. what are the criteriae for OCD?
    time consuming (>1 hour / day) for most days, interfering with function.
  45. how are personality disorders defined?
    deeply ingrained and enduring patterns of behaviour that are abnormal and lead to distress of the person and others.
  46. how are personality disorders classified?
    bad/mad/sad: A (paranoid, schizoid, schizotypal) B (borderline, histrionic, antisocial), C (avoidant/anxious, dependent, obsessive compulsive)
  47. define ADHD
    core symptoms: 1. short attention span 2. distractability 3. overactivity 4. impulsivity in at least 2 settings, by age 7.
  48. define autism
    1. pervasive failure to make social relationships, 2. major difficulties verbally and non-verbally 3. resistance to change, ritualistic behaviour 4. cannot process emotional cues.