diseaseman3TF

Card Set Information

Author:
laurajane.price
ID:
87494
Filename:
diseaseman3TF
Updated:
2011-05-26 00:30:55
Tags:
Disease management
Folders:

Description:
Disease management 3
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user laurajane.price on FreezingBlue Flashcards. What would you like to do?


  1. Semi-permeable dressings;

    A. Are permeable to liquid water
    B. Are permeable to gases and water vapour
    C. Are ideal for use on wounds with large amounts of exudate
    D. Can only be used as a primary dressing
    E. Are self adhesive
    F. Shouldn't be used on fragile skin
    G. Are suitable for shallow wounds
    • A. F
    • B. T
    • C. F
    • D. F
    • E. T
    • F. T
    • G. T
  2. Hydrocolloid dressings;

    A. Are waterproof
    B. Produce a gel with the wound exudate
    C. Stimulate angiogenesis by creating an oxygen rich environment
    D. Can be left in place for up to 14 days
    E. May contain gelatine
    F. May be used on infected wounds
    • A. T
    • B. T
    • C. F (create hypoxic environment)
    • D. F (7 days)
    • E. T
    • F. F
  3. Alginate dressings;

    A. Derived from seaweed
    B. Indicated for wounds with little to no exudate
    C. Can be packed into deep wounds
    D. Can be used in infected wounds if changed weekly
    • A. T
    • B. F (moderate to heavy)
    • C. T
    • D. F (changed daily)
  4. Hydrofibre dressings;

    A. Not as good as alginates for holding exudate
    B. Made of hydrocolloid fibres
    C. Can be used for infected wounds if changed daily
    D. Use for lightly exudating wounds
    • A. F (better)
    • B. T
    • C. T
    • D. F (moderate to heavy)
  5. Hydrogel dressing;

    A. Keep the wound moist
    B. Can be left for up to a week
    C. Don't have to change more often in infected wounds
    D. Able to absorb large amounts of exudate
    E. Can absorb and retain water
    F. Need a secondary dressing
    • A. T
    • B. F (3 days)
    • C. F (daily)
    • D. F (not suitable when wounds largely exudating)
    • E. T
    • F. T
  6. Polyurethane foam dressings;

    A. Can only be used on wounds with low amounts of exudate
    B. Thermal insulation
    C. Maintain moist environment
    D. Must be changed daily
    • A. F (all ranges, depending on product)
    • B. T
    • C. T
    • D. F (some can be left for up to 7days)
  7. Dressing brands;

    A. Intrasite is a hydrofibre dressing
    B. Sorbsan is an alginate
    C. Kaltostat is a hydrocolloid
    D. Tegederm is an alginate
    E. Opsite is a semi-permeable
    F. Granuflex is a hydrocolloid
    • A. F
    • B. T
    • C. F
    • D. F
    • E. T
    • F. T
  8. Venous leg ulcers;

    A. Are due to diabetes
    B. Are associated with varicose veins
    C. Are due to hypertension causing damage to capillaries
    D. Are shallow, irregular and confined to one part of the leg
    E. Can cause eczema and dermatitis
    • A. F
    • B. T
    • C. T
    • D. F (can extend round leg circumference)
    • E. T
  9. Arterial leg ulcers;

    A. Account for half of all leg ulcers
    B. Are associated with diabetes
    C. Are associated with poor blood supply
    D. Occur of fleshy parts of the leg
    E. have a "punched out" appearance with no evidence of tissue growth
    F. Limb often red and warm
    • A. F (10-15%)
    • B. T
    • C. T
    • D. F (bony parts)
    • E. T
    • F. F (cold and pale)
  10. Pressure ulcers;

    A. Are generally unpreventable
    B. Can cause partial or full thickness skin loss
    C. Are more likely to occur if the patient is immobile
    D. Are more likely to occur if the patient is incontinent
    E. Are more likely to occur if the patient is malnourished but not dehydrated
    F. Can erode into the deep layers
    G. Are not considered to be an ulcer unless skin is lost
    • A. F
    • B. T
    • C. T
    • D. T
    • E. F (more likely if dehydrated as well)
    • F. T
    • G. F (can be no skin loss but discoloured)
  11. Fungating malignant wounds;

    A. Are caused by a cancerous growth in the skin
    B. Don't produce a great amount of exudate
    C. Are malodourous
    D. Are generally small and circular
    • A. T
    • B. F (great amounts)
    • C. T
    • D. F (appearance varies)
  12. Inflammatory wound phase;

    A. Involve haemostasis only
    B. Chronic wounds don't stay in this phase
    C. Growth factors are released in this phase
    • A. F (inflammatory process too)
    • B. F
    • C. T
  13. Proliferative wound healing phase;

    A. Is the third phase
    B. Angiogenesis takes place
    C. Dermal repair takes place followed by epidermal regeneration
    D. Dermal repair causes the wound to fill with red, granular tissue
    E. Dermal repair is regulated by macrophages
    F. Macrophages also attack cell debris to get rid of the clot in the wound and release growth factors
    G. Epidermal cells can migrate through clots
    • A. F (2nd - 2-12 days after wound)
    • B. T
    • C. F (simultaneously)
    • D. T
    • E. T
    • F. T
    • G. F (have to burrow underneath 2-3 days longer)
  14. Maturation phase in wound healing;

    A. Can take up to a year
    B. Excess collagen can lead to keloid scarring due to lengthening of collagen
    C. Excess blood vessels destroyed
    • A. F (2 years)
    • B. F (shortening)
    • C. T
  15. Uric acid;

    A. We obtain 70% of our uric acid from our diet
    B. Uric acid can also be obtained as a breakdown product
    C. Uric acid is found in beer, marmite, sardines, shellfish
    D. A normal serum concentration of uric acid for a woman is 3.4 to 7.0 mg/dl and 5.4 - 10 mg/dl for men
    • A. F (30%)
    • B. T
    • C. T
    • D. F (2.4-6 mg/dl w; 3.4-7 mg/dl m)
  16. Hyperuricaemia;

    A. High levels of uric acid stimulate it's own excretion
    B. Can cause gout
    C. Can cause tubular necrosis and other renal problems
    D. Can cause hard deposits on joints (tophus)
    E. Can increase cell turnover by decreasing purine precursor synthesis
    • A. F (reduce)
    • B. T
    • C. T
    • D. T
    • E. F (increase)
  17. Symptoms of gout;

    A. are usually worse in the day
    B. include inflammation of joints like toes, knees, elbows
    C. Joints look red and shiny
    D. Tiredness and a lack of appetite can also be seen
    E. There is no fever
    F. Lasts about 3-10 days
    • A. F (night - peak in a few hours)
    • B. T
    • C. T
    • D. T
    • E. F (mild fever)
    • G. T
  18. Gout risk factors include;

    A. Being female
    B. Having a family history
    C. Drinking alcohol
    D. Renal impairment
    E. Taking diuretics
    F. Being underweight
    G. Eating fruit
    • A. F (male)
    • B. T
    • C. T
    • D. T
    • E. T
    • F. F (obese)
    • G. T
  19. Treatment of an acute attack of gout;

    A. NSAIDs help with reducing inflammation
    B. Colchicine can be taken if NSAIDs are contraindicated
    C. Allopurinol should be started immediately
    D. Oral prednisolone can be used to treat
    E. Patient should be told to do RICE
    F. Patient should keep their fluid intake high
    G. Aspirin can also be used
    H. Start NSAIDs high dose and gradually reduce
    I. Colchicine is most effective several days after the attack
    • A. T
    • B. T
    • C. F
    • D. T
    • E. F (R.I.E only)
    • F. T
    • G. F (avoid use if possible)
    • H. T
    • I. F (first few hours gives greatest effect)
  20. Long term gout management;

    A. Pharmacological prevention should be given to all patients
    B. Patients should attempt to lose weight and take up exercise and keep hydrated
    C. Patients should avoid dairy as it is high in uric acid
    D.Cherries can reduce uric acid
    E. Allopurinol stimulates xanthine oxidase production to break down uric acid
    F. Avoid allopurinol in renal failure
    G. Sulfinpyrazone and probenecid can be used in renal impairment
    H. Sulfinpyrazone and probenecid block tubular reabsorption of urate and so need to keep up fluid intake
    I. Start treatment 2-3 weeks after attack
    • A. F (only if >3 attacks p/a, damage, family history)
    • B. T
    • C. F (dairy increases excretion of uric acid)
    • D. T
    • E. F (inhibits it, to prevent formation)
    • F. F (reduce dose)
    • G. F (avoid)
    • H. T
    • I. T
  21. Creatinine clearance;

    A. Tends to underestimate renal function due to tubular reabsorption
    B. Normal creatinine doesn't mean normal renal function
    C. Can quantify the amount of protein and sodium in the urine
    • A. F (overestimate due to tubular secretion)
    • B. T
    • C. T
  22. GFR and eGFR

    A. Normal renal function is usually around 100ml/min
    B. Can only be done using Cockcroft and Gault equation
    C. Can be measured accurately
    D. Uses serum creatinine, age, gender and weight to calculate
    • A. T
    • B. F (can also be done via MDRD)
    • C. F (estimated)
    • D. T
  23. CKD;

    A. Affects 20% of the population
    B. Is asymptomatic until function severely reduced
    C. Can lead to blood vessel calcification
    D. Defined as GFR <60 ml/min/1.73m2 with or without kindey damage for 3/12
    E. Structural and functional abnormailities are not considered to be CKD unless GFR is <60ml/min
    • A. F (10%)
    • B. T
    • C. T
    • D. T
    • E. F
  24. Acute renal failure is characterised by;

    A. Anaemia
    B. Unwell
    C. Good colour
    D. Reduced kidney size
    E. Normal bone x-rays
    • A. F
    • B. T
    • C. T
    • D. F (normal)
    • E. T
  25. Chronic renal failure is characterised by;

    A. Anaemia
    B. Unwell
    C. Pigmentation of skin
    D. Bone disease
    • A. T
    • B. F (may seem well for level of function)
    • C. T
    • D. T
  26. CKD stages;

    A. Stage 1 is the most severe with eGRF <15
    B. Stage 3 is 30-59 ml/min
    C Stage 4 is 60-89 ml/min
    D. Stage 2 is 15-29ml/min
    E. Stage 5 is >90ml/min
    • A. F
    • B. F
    • C. T
    • D. F
    • E. F
  27. Blood pressure control in CKD

    A. Aim to get the BP 120/80mmHg
    B. 3 or more antihypertensives is normal
    • A. F (<130/80mmHg or <125/80mmHg is proteinurea)
    • B. T
  28. Anaemia in CKD;

    A. The risk of GI bleeding is increased in CKD
    B. Appetite is reduced due to N&V
    C. Iron absorption remains unchanged
    D. Decreased EPO production
    E. Impaired bone marrow response to EPO
    F. Haemoglobin levels should be 14 g/dl in the normal range
    • A. T (due to uraemia)
    • B. T
    • C. F (reduced)
    • D. T
    • E. T
    • F. F (10.5-12g/dl - lower than normal)
  29. Treatment of anaemia in CKD

    A. Oral or i.v iron
    B. Folic acid used
    C. Vitamin C increases absorption
    D. Blood transfusions are popular
    E. Erythropoesis stimulating agents (eprex)
    • A. T
    • B. T
    • C. F (vitamin B12)
    • D. F (sensititising - reduces successful transplant)
    • E. T
  30. Acidosis in CKD;

    A. Need bicarbonate levels >22mmol/l
    B. Correct with sodium bicarb caps/tabs
    • A. T
    • B. T
  31. High phosphate levels in CKD

    A. Produced by reduction in phosphate filtration by the kidney
    B. Can calcify blood vessels which reduces transplant chances
    C. Causes itching and gritty eyes
    • A. T
    • B. T
    • C. T
  32. Phosphate binders in CKD

    A. Can be calcium based like calcichew
    B. Can be aluminium based like aluminium hydroxide and phosex
    C. Renegal (sevlamer) and Fosrenol (lanthanum carbonate) are non ionic binders
    D. Must be taken after food
    E. Chance of medicines interactions
    • A. T
    • B. F (phosex is calcium based)
    • C. T
    • D. F (with or immediately before)
    • E. T
  33. Vitamin D in CKD;

    A. Needed to maintain normal calcium levels
    B. Alfacalcidol can be used
    C. Response to low calcium and high phosphate is secondary hypoparathyroidism
    D. Alfacalcidol/calcitriol suppresses parathyroid activity and inc calcium levels
    • A. T
    • B. T
    • C. F (hyper)
    • D. T
  34. Pruritis in CKD

    A. Is expected and only symptom control is used, such as antihistamines and topical preparations
    B. Increased dialysis can reduce puritis
    C. Caused by high phosphate or ureamia
    D. Increased dose of phosphate binders can help
    • A. F
    • B. T
    • C. T
    • D. T
  35. Treatment of hypertention in CKD

    A. Thiazides are useful in severe renal impairment
    B. Potassium sparing diuretics require careful monitoring if used
    C. Max dose of CCBs often required
    D. High dose frusemide can be used
    E. Only start ACEI or A2R in stage 3
    • A. F (ineffective)
    • B. T
    • C. T
    • D. T
    • E. F (stages 1 and 2)
  36. Haemodialysis

    A. Can cause cramps
    B. Can cause hypertension
    C. There's a risk of air embolisms
    D. Most effective electrolyte removal
    • A. T
    • B. F (hypo)
    • C. T
    • D. T
  37. Complications of dialysis;

    A. Too much fluid being removed too quickly can lead to hypotension, patient should omit their BP tablet
    B. Quinine can be used for cramps
    C. Weight must be assessed before HD
    D. HD can cause chest and back pain due to complement activation, this can be treated with paracetamol
    • A. T
    • B. T
    • C. T
    • D. T
  38. Peritoneal dialysis;

    A. Has a tight fluid restriction
    B. Renal function doesnt decline as rapidly as HD
    C. Electrolyte removal is as effective as HD
    D. Peritonitis is a big problem
    • A. F
    • B. T
    • C. F (less)
    • D. T
  39. Ciclosporin/tacrolimus/sirolimus immunosuppressants for transplant

    A. Have a broad TI
    B. Amiodarone, erythromycin and clarithromycin increase the levels of these drugs
    C. Rifampicin, carbamazepine and nifedipine decrease the levels
    D. Fluconazole, progestogens, phenytoin and St John's Wort also decrease the levels
    E. Caution needed with different brands
    F. Therapeutic range changes over time
    • A. F
    • B. T
    • C. F (nifedipine increases)
    • D. F (fluconazole and progestogens increase)
    • E. T
    • F. T
  40. Prednisolone as an immunosupressant after transplant

    A. Can cause adrenal suppression
    B. Can induce diabetes
    C. Can cause problems with bones, eyes, skin and muscles
    D. Most commonly used
    • A. T
    • B. T
    • C. F (not muscles)
    • D. F (try to avoid)
  41. Mycophenolate mofetil and azathioprine

    A. Azathioprine is the most potent of the two
    B. Mycophenylate more selective
    C. Infection risk due to bone marrow suppression
    D. Mycophenylate can cause D&V but it doesnt restrict the dose
    E. Do not give allopurinol with mycophenylate - inhibits metabolism and can lead to bone marrow toxicity
    • A. F (mycophenylate is)
    • B. T
    • C. T
    • D. F (does restrict dose)
    • E. F (with azathioprine)
  42. Analgesics in CKD

    A. NSAIDs are first line
    B. Opioids use with caution
    C. Paracetamol is a good choice
    D. Topical preparations may be less risky
    E. Avoid morphine as it accumulates, oxycodone and fentanyl are better choices
    F. Codeine is metabolised to morphine
    • A. F (avoid NSAIDs where possible, short course only)
    • B. T
    • C. T
    • D. T
    • E. T
    • F. T
  43. Coughs and colds in CKD

    A. Sympathiomimetics are suitable
    B. Simple measures such as steam inhalations are first line
    C. May be immunocompromised so early referral needed
    • A. F (avoid due to bp)
    • B. T
    • C. T
  44. Dosing in children;

    A. Dose/weight takes development of the child into account
    B. Dose/age band is useful for narrow TI drugs
    C. Dose/SA is most accurate but difficult to measure
    D. Dose/age band has some indication of development
    • A. F
    • B. F (broad)
    • C. T
    • D. T
  45. LFT's

    A. Decreased ALT and AST is characteristic of hepatocellular damage
    B. Decreased conjugated billirubin is characteristic of colestatic picture
    C. Increased gamma GT and increased total billirubin are characteristic of hepatocellular damage
    D. Increased alk phos and total cholesterol are indicative of cholestatic picture
    E. Pruritis is common with hepatocellular damage
    • A. F
    • B. F
    • C. T
    • D. T
    • E. F (colestatic)
  46. Acute liver disease;

    A. Is usually permanent
    B. Doesn't exceed 4/12
    C. Most cases caused by drugs and acute viral hepatitis
    D. Involves inflammation or damage to hepatocytes
    • A. F (self limiting)
    • B. F (6/12)
    • C. T
    • D. T
  47. Acute liver disease;

    A. Acute hepatitis usually spontaneously resolves
    B. Patients with acute hepatitis present with jaundice
    C. Acute liver failure can become chronic liver disease
    D. Acute liver failure can cause hepatic failure with high mortality
    • A. T
    • B. T
    • C. T
    • D. T
  48. Chronic liver disease;

    A. lasts longer than 4/12
    B. Is usually caused by alcohol or hepatitis C
    C. Primary billiary cirrhosis and cancer are the only other two causes
    D. Autoimmune causes of chronic liver disease are not usually drug related
    • A. T
    • B. T
    • C. F
    • D. F
  49. Symptoms of liver disease include;

    A. Abdominal pain, particularly lower left quadrant
    B. Pruritis
    C. Jaundice
    D. General unwellness
    E. Dark stools and urine
    F. Bilirubin >50umol/L
    • A. F (upper right)
    • B. T
    • C. T
    • D. T
    • E. F (pale stools)
    • F. T
  50. Alcoholic liver disease;

    A. Steatosis is characterised by decreased GGT +/-AST
    B. Cirrhosis is characterised by high PT and albumin
    C. Hepatitis is characterised by decreased bilirubin
    • A. F (elevated GGT)
    • B. F (low albumin)
    • C. F (elevated)
  51. Alcohol withdrawal and vitamin replacement treatment;

    A. Chlordiazepoxide has a short t1/2 and acts on GABA receptors to reduce withdrawal
    B. Vitamin B and Thiamine prevent Wernicke's psychosis
    C. Avoid pabrinex is NBM
    D. Use water soluble vitamin K preparation
    • A. F (long t1/2)
    • B. T
    • C. F (use)
    • D. T
  52. Pruritis treatment in liver disease

    A. Colestyramine binds to bile acids in the gut and can cause problems with water soluble vitamins
    B. Sedating antihistamines are preferred
    C. Topical treatments can include calamine and menthol
    D. Naltrexone is the most useful treatment
    E. Rifampicin can be used
    F. A possible cause of pruritis is bile salts in the blood
    • A. F (fat soluble)
    • B. F (non sedating - take care with sedating)
    • C. T
    • D. T
    • E. T
    • F. F (skin)
  53. Analgesics in liver disease;

    A. Paracetamol is contraindicated
    B. NSAIDs and antiplatelets increase the risk of bleeding
    C. Opioids have a higher chance of causing respiratory depression due to reduced clearance
    D. Tramadol can be used
    • A. F (caution - max 2g daily)
    • B. T
    • C. T
    • D. T
  54. Viral hepatitis;

    A. Hepatitis A can be treated with anti-virals
    B. Lamivudine and adefovir can be used to treat hepatitis A and B
    C. Interferon alfa 2a boosts the immune system and is usually used in combination with one of the above antivirals
    D. Lamivudine is expensive so adefovir is preferred
    E. Ribavirin is the drug of choice for hepatitis C, combined with interferon alfa 2a
    F. Pegylated interferon alfa 2b is given weekly due to a long t1/2
    G. Hepatitis D doesn't have a specific treatment and requires hepatitis C to infect
    H. Hepatitis E is self limiting but can cause chronic liver disease
    • A. F (supportive Tx only)
    • B. F (B only)
    • C. T
    • D. F (adefovir is expensive)
    • E. F (2b not a)
    • F. T
    • G. F (requires hep B)
    • H. F (doesnt cause chronic disease)
  55. A pharamcist can aid patients with liver disease through;

    A. Ensuring regular LFT monitoring
    B. Side effect counselling
    C. Advice on supportive therapy
    D. Awareness of commonly implicated drugs
    E. Taking full drug history
    • A. T
    • B. T
    • C. T
    • D. T
    • E. T
  56. Primary hypothyroidism;

    A. Causes an increase of thyroid hormones
    B. Affects the hypothalamus
    C. Is more common in women
    D. Can result from iodine imbalance, autoimmune disorders or previous treatment for hypothyroidism
    E. 1 in 4000 children is born without a thyroid gland, this is called congenital hypothyroidism
    • A. F (decrease)
    • B. F (level of thyroid gland)
    • C. T
    • D. F (Tx for hyper)
    • E. T
  57. Hyperthyroidism symptoms include;

    A. Lethargy
    B. Dislike of hot weather
    C. Memory loss
    D. Weight loss
    E. Gruff voice
    F. Depression
    G. Diarrhoea
    H. Hisuitism
    I. Dry, scaly skin
    • A. T
    • B. F (cold)
    • C. T
    • D. F (gain)
    • E. T
    • F. T
    • G. F (constipation)
    • H. F (hair loss)
    • I. T
  58. Thyroid function tests;

    A. Measuring T3 is the goldstandard
    B. TSH can be measured as there tends to be high levels in primary disease
    C. Unbound T4 can be measured
    D. Thyroid peroxidase antibody is only measured in hospital if diagnosis unclear
    E. Primary hypothyroidism leads to increased TSH and free T4
    F. Primary hyperthyroidism leads to decreased TSH and increased free T4
    • A. F (misleading as levels can be normal)
    • B. T
    • C. T
    • D. T
    • E. F (decreased T4)
    • F. T
  59. Hypothyroid treatment;

    A. Adults over 50 have 50-100 mcg daily initially and move to a maintenance dose of 100-200 mcg daily
    B. Adults under 50 should have their dose adjusted by 25-50 mcg every 3-4 weeks according to response
    C. In heart disease start off with a dose of 25 mcg od, and adjust by 25 mcg every 3-4 weeks according to response
    D. Congenital hypothyroidism dose is 10-15 mcg/kg initially (max 50mcg) adjusted by 5 mcg/kg
    E. Usual maintenance dose for children is 50-200 mcg depending on weight
    F. TSH should be monitored after 8-10 weeks and yearly thereafter
    G. Thyroxine must be titrated up because it can cause angina attacks
    • A. F (under 50)
    • B. T
    • C. T (and O50's)
    • D. T
    • E. F (depending on age)
    • F. T
    • G. T
  60. Hypothyroidism patient counselling;

    A. Thyroxine has to be taken life long
    B. Thyroxine dose is split into two daily doses
    C. Avoid taking calcium and iron preparations at the same time
    D. There are three tablet strengths
    E. TSH needs to be monitored
    F. Medically exempt
    • A. T
    • B. F (od)
    • C. T
    • D. T
    • E. T
    • F. T
  61. Hyperthyroidism;

    A. Is more common than hypothyroidism
    B. Usually has an autoimmune cause (Grave's disease)
    C. Leads to an increase of thyroid hormones
    D. More common in men
    E. Antibodies stimulate the gland into producing more hormones
    • A. F
    • B. T
    • C. T
    • D. F (2% women, 0.2% men)
    • E. T
  62. Hyperthyroid symptoms;

    A. Anxious
    B. Palpitations/bradycardia
    C. Weight gain
    D. Goitre
    E. Warm moist skin
    F. Prefer cold weather
    • A. T
    • B. F (tachycardia)
    • C. F (loss)
    • D. T
    • E. T
    • F. T
  63. Hyperthyroidism treatment;

    A. Surgery is the first line treatment
    B. Thionamides preferred for children, pregnancy and uncomplicated disease in young adults
    C. Drug treatment is needed prior to surgery
    • A. F
    • B. T
    • C. T
  64. Carbimazole in hyperthyroidism;

    A. Is the first choice Tx
    B. Starts at a low dose and is titrated up
    C. Starting dose is 15-40mg od
    D. The starting dose is maintained until TFTs are normal (4-8 weeks)
    E. Treatment is always life long
    • A. T
    • B. F (starts high dose before moving to lower maintenance dose)
    • C. T
    • D. T
    • E. F (maintenance for 12-18 m, though some relapse and do need lifelong threatment)
  65. Block and replace treatment in hyperthyroidism;

    A. Can shorten treatment length
    B. Involves blocking patients own thyroxine with 40-60mg carbimazole and replacing it with thyroxine 50-100mcg
    C. Both should be started simultaneously
    D. Lasts for 6-12 m usually
    E. Not for use in pregnancy as only thyroxine crosses placenta
    F. Can cause agranulocytosis but this is not monitored for as it's so rare
    • A. T
    • B. T
    • C. F (thyroxine started after 4 weeks)
    • D. T
    • E. F (only carbimazole crosses)
    • F. T
  66. Propylthiouracil in hyperthyroidism;

    A. Usual dose is 200-400 mg od
    B. 50mg tds maintenance dose
    C. Contraindicated in pregnancy
    D. Used when a patient is unable to tolerate carbimazole
    E. Can cause agranulocytosis
    • A. F (divided doses)
    • B. T
    • C. F (safer than carbimazole)
    • D. T
    • E. T
  67. Carbimazole patient counselling in hyperthyroidism;

    A. Report rashes, sore throats and mouth ulcers
    B. Need regular blood tests
    C. Single daily dose
    D. Tapering to maintenance dose
    E. Duration
    F. Regular review and relapse management
    • A. T
    • B. F
    • C. T
    • D. T
    • E. T
    • F. T
  68. Radioactive iodine in hyperthyroidism;

    A. Is used after patient fails to respond to drug threatment
    B. Can be used after relapse
    C. Can result in a patient becoming hypothyroid
    D. Don't use in acute phase
    • A. T
    • B. T
    • C. T
    • D. T
  69. Surgery in hyperthyroidism;

    A. Usually if a large goitre present which is causing oesphageal obstruction
    B. Can't tolerate drugs treatment
    C. Young
    D. Can be done in acute stage
    E. Can relapse as parts of thyroid gland present afterwards
    • A. T
    • B. T
    • C. T
    • D. F (thyroid storm)
    • E. T
  70. Beta blockers in hyperthyroidism;

    A. Symptomatic treatment only
    B. Usually propranolol, atenolol and nadolol
    C. May need to be given 3-4 times daily due to increased metabolism
    D. Only needed when symptomatic
    • A. T
    • B. F (not atenolol0
    • C. T
    • D. T
  71. Drug induced thyroid disease;

    A. Iodine can cause hypothyroidism due to supressing T3/T4 production/release
    B. Iodine deficiency can cause hypothyroidism
    C. Amiodarone can cause hypothyroidism by inhibiting synthesis and release of T4 and T3
    D. If hypothyroidism occurs with amiodarone, withdraw immediately and start carbimazole
    E. Lithium can cause hypothyroidism by inhibiting iodine uptake and preventing T3/4 release
    F. TSH levels need to be monitored while on lithium and T4 supplmentation given if clinical
    G. Lithium can cause paradoxical hyperthyroidism
    • A. T
    • B. T
    • C. T
    • D. F (only in severe - if not severe T4 supplementation only)
    • E. T
    • F. T
    • G. T
  72. Drug measurement in the urine;

    A. Amphetamines take 24h to be detected
    B. Midazolam a very short acting benzodiazepine takes 12h
    C. Short acting benzodiazepines take 24h
    D. Temazepam an intermediate benzodiazepine takes 48-72h
    E. Diazepam, a long acting, takes 7 days or more
    F. Cocaine takes 2-3 days
    G. Methadone in a maintenance dose takes up to a week
    H. Codeine/morphine takes 48 h
    I. A single use of cannabinoids takes 3 days
    J. Moderate use takes 4 days
    K. Heavy use takes up a week
    L. Chronic use can take up to a month
    • A. F (48h)
    • B. T
    • C. T
    • D. T
    • E. T
    • F. T
    • G. F (7-9 days)
    • H. T
    • I. T
    • J. T
    • K. F (10 days)
    • L. F (21-27 days)
  73. Common symptoms of poisoning include;

    A. Nausea and vomiting
    B. Confusions/unconsciousness
    C. Seizures
    D. Coma
    E. Death
    F. Weakness
    G. Dizziness
    H. Hallucinations
    I. Agitation
    • A. T
    • B. T
    • C. T
    • D. T
    • E. F
    • F. T
    • G. T
    • H. T
    • I. T
  74. Paracetamol overdose;

    A. 50% of all O/D
    B. 75% are deliberate
    C. Second most common cause of liver failure
    D. Symptoms don't tend to appear until 48h after administration
    E. GI symptoms, liver tenderness, oligouria, coagulopathy
    F. More than 12g potentially fatal
    G. Over 250mg/kg likely to cause severe damage
    H. Death likely from liver failure 4-14 days later
    • A. T
    • B. F (85%)
    • C. F (1st)
    • D. F (24-72h)
    • E. T
    • F. T
    • G. T
    • H. T
  75. Risk factors for liver damage from paracetamol;

    A. Enzyme inhibitors
    B. Carbamazepine, phenytoin, izoniazid, rifampicin, omeprazole, dexamethasone, St John's wort
    C. Alcohol
    D. Eating disorders, CF, HIV, starvation
    • A. F (inducers)
    • B. T (inducers)
    • C. T
    • D. T
  76. Paracetamol O/D treatment;

    A. NAC is the treatment for o/d
    B. Initial dose is 150mg/kg in 250ml glucose over 15 min
    C. 50mg/kg in 500ml glucose over next 4 hr
    D. 100mg/kg in 1000ml glucose over next 16h
    E. If caught early can try to reduce absorption using charcoal
    • A. T
    • B. T
    • C. T
    • D. T
    • E. T
  77. Opiate O/D;

    A. Characterised by dilated pupils, respiratory depression and coma
    B. Treat with naloxone
    C. Given either iv or im
    D. Nalaxone has a short t1/2
    E. Respiratory support is needed (ventilation not intubation)
    • A. F (pinpoint pupils)
    • B. T
    • C. T
    • D. T
    • E. T
  78. Benzodiazepine O/D

    A. Benzodiazepine O/D has mild symptoms unless mixed with other CNS depressants or conditions such as COPD
    B. Flumenazil, a benzodiazepine antagonist is first line treatment
    C. Supportive care required
    • A. T
    • B. F (should only be rarely used)
    • C. T
  79. NSAID O/D;

    A Symptoms include n&v, gastric pain, tinnitus, GI bleeding
    B. May cause alkalosis and an increase in INR
    C. Can cause acute hepatic failure
    D. Can exacerbate asthma
    E. Modified release preparations can be counteracted with charcoal or if caught early
    F. Forced alkaline diuresis is of benefit
    G. Symptomatic treatment only if too late for charcoal
    • A. T
    • B. F (acidosis)
    • C. F (renal)
    • D. T
    • E. T
    • F. F (protein bound so limited excretion)
    • G. T
  80. Tricyclic antidepressant O/D

    A. Frequent
    B. Symptoms made worse by alcohol
    C. Anticholinergic and cardiac symptoms
    D. Treatment is symptomatic unless caught in the first couple of hours in which charcoal can be used
    E. TCAs are highly protein bound
    F. Can cause widened QT interval
    G. Dry mouth, dilated pupils, blurred vision, confusion, respiratory depression
    • A. T
    • B. T
    • C. T
    • D. T
    • E. T
    • F. T
    • G. T
  81. Beta blocker O/D

    A. Bradycardia, hypotension, pulmonary oedema
    B. More water soluble may cause CNS effects
    C. Glucagon is used to treat hypotension and bradycardia in a dose or 10mg over 5-10 mins
    D. Nausea indicates adequate trial of glucagon
    • A. T
    • B. F (lipid)
    • C. T
    • D. T
  82. Digoxin O/D

    A. Risk factors include; increased age, female, heart disease, renal failure
    B. Symptoms include; anorexia, arrhythmias, hyperkalaemia
    C. High or low K+ should be treated
    D. Atropine for bradycardia
    E. Digiband can be used if lifethreatening
    • A. F (male)
    • B. T
    • C. T
    • D. T
    • E. T (digoxin specific antibodies)
  83. Cocaine O/D

    A. Symptoms include; confusion, hypoxia, CNS haemorrhage, MI, convulsions
    B. No antidote
    C. Treatment supportive
    D. Oral diazepam to reduce spasm and anxiety
    E. Iv diazepam for seizures
    F. Reduce core temp
    • A. T
    • B. T
    • C. T
    • D. T
    • E. T
    • F. T
  84. Ecstacy O/D

    A. Symptoms; hallucination, convulsions, hypotension, MI, hypothermia
    B. No antidote, supportive treatment only
    C. Reduce core temperature
    D. Aspirin and thrombolytic for MI
    E. Adenosine for tachyarrhythmias
    F. Diazepam for convulsions
    • A. F (hyper)
    • B. T
    • C. T
    • D. T
    • E. T
    • F. T
  85. Ketamine O/D

    A. Symptoms; hypotension, tachycardia, aggression, enhanced perception
    B. No antidote
    C. Supportive treatment only
    • A. F (hyper)
    • B. T
    • C. T
  86. Amphetamine O/D

    A. Symptoms; dilated pupils, headache, chest pain, hyperpyrexia, delusions
    B. Treat with sodium bicarb
    C. Reduce core temperature and sedate
    • A. T
    • B. T
    • C. T
  87. GHB O/D

    A. Symptoms; constipation, dizziness, amnesia, incontinence, euphoria, hyperthermia
    B. Supportive Tx only
    C. Effects potentiated by alcohol
    • A. F (diarrhoea, and hypo)
    • B. T
    • C. T
  88. Carbamazepine in epilepsy

    A. Is suitable for tonic clonic seizures and partial seizures
    B. Inhibits it's own metabolism
    C. Blocks Na channels
    D. No dose adjustment is needed in the elderly
    E. Side effects include; dizziness, n&v, headache, double vision, blurred vision, rashes
    • A. T
    • B. F (induces)
    • C. T
    • D. F (reduce initial dose)
    • E.
  89. Phenytoin in epilepsy

    A. First line treatment for partial seizures
    B. Mechanism not fully understood
    C. Small increase in dose leads to large inc in plasma conc
    D. Serum concentrations prevent toxicity and show effectiveness
    E. Side effect include; n&v, rash, gingival hyperplasia, hisuitism, liver damage, ataxia
    • A. F (2nd line)
    • B. T
    • C. T (above a certain dose)
    • D. T
    • E. T
  90. Sodium valproate in epilepsy;

    A. Can be used in all seizures
    B. Has multiple mechanisms including inhibiting GABA degrading enzymes, stimulating breakdown of glutamate and Na channel blockade
    C. Clear relationship between serum conc and seizure control
    D. Side effects include; hair loss, n&v, thrombocytopenia, hepatoxocity, pancreatitis, tremor
    E. Avoid use in children under 3
    F. Adjust dose in elderly
    • A. T
    • B. T
    • C. F
    • D. T
    • E. F (caution)
    • F. F (none needed)
  91. Lamotrigine in epilepsy

    A. For use in partial and generalised tonic clonic seizures
    B. It can be used as monotherapy or add on from age 2-12
    C. It can be used as monotherapy from ages 2-12 to treat absence seizures
    D. Can be started in any suitable patient
    E. Inhibits release of GABA
    F. Side effects include; rash, blurred vision, dizziness, n&v, headache
    G. Higher doses needed with inhibitors and lower needed with inducers
    • A. T
    • B. F (monotherapy 13+ and add on therapy 2-12)
    • C. T
    • D. F (only those who arent suited to the older drugs)
    • E. F (glutamate)
    • F. T
    • G. F (vice versa)
  92. Levetiracetam in epilepsy

    A. Monotherapy for generalised seizures age 16+
    B. Add on therapy for partial seizures (1 month+)
    C. Myoclonic and tonic clonic seizures add on therapy aged 12+
    D. Blocks Na channels
    E. Side effects; drowsiness, dizziness, weakness, headache
    • A. F (partial)
    • B. T
    • C. T
    • D. F (unknown)
    • E. T
  93. Levodopa for Parkinsons

    A. Sinemet is a brand of levodopa
    B. Should be take with carbidopa
    C. Should be initiated at diagnosis
    D. Most effective treatment
    E. Side effects include; n&v, orthostatic hypotension, hallucinations, movement disorders, urine discolouration
    • A. T
    • B. T
    • C. F (when symptoms are disabling)
    • D. T
    • E. T
  94. Duodopa in Parkinsons;

    A. Used for PD with severe motor fluctuations
    B. Intestinal gel
    C. Administered via PEG tube
    D. Trial with a NG tube first
    • A. T
    • B. T
    • C. T
    • D. T
  95. Oral dopamine agonists in Parkinsons;

    A. Non ergot include; ropinirole, pergolide, rotigotine, pramipexole
    B. Ergot include; lisuride, bromocriptine and cabergoline
    C. More long term problems than L-Dopa
    D. Can be used alone or with LDopa to reduce the off periods
    E. Side effects include; n&v, postural hypotension, psychiatric, gambling, hypersexuality, sudden sleep onset, fibrosis
    • A. F (pergolide = ergot)
    • B. T
    • C. F (less)
    • D. T
    • E. T
  96. Rotigotine in Parkinsons;

    A. Can be used orally or in a patch formulation
    B. Licensed for late stage PD only
    C. Weekly dose titration
    D. 24h patch
    • A. T
    • B. F (early and late)
    • C. T
    • D. T
  97. Apomorphine in Parkinsons;

    A. s/c admin only
    B. Dopamine agonist
    C. Bolus can have effects from 1/2 hr to 2 hrs
    D. ADRs; n&v (pre-treat domperidone), yawning, drowsiness, abcess
    • A. T
    • B. T
    • C. F (15 min - 1 hr)
    • D. T
  98. COMT inhibitors in Parkinsons;

    A. First line is tolcapone, and second line is entacapone
    B. Tolcapone crosses BBB
    C. Monitor LFTs
    D. Use in combo with co-careldopa
    E. Allows reduction in LDopa dose
    F. ADRs; dyskinesia, n&v
    • A. (vice versa)
    • B. T (both do)
    • C. T
    • D. T
    • E. T
    • F. T
  99. Amantadine in Parkinsons

    A.Glutamate agonist
    B. Treats dyskinesias in late disease
    C. Reduced efficacy over time
    D. ADRs; psychiatric, n&v, oedema, rash
    • A. F (antag)
    • B. T
    • C. T
    • D. T
  100. Treatment options for Parkinsons

    A. MAOB inhibitors are recommended first line for mild symptoms
    B. Older patients/severe symptoms should go to co-careldopa or co-beneldopa
    C. Young patients should start on an ergot DA agonist
    • A. T
    • B. T
    • C. F (non-ergot)
  101. MAO B inhibitors in Parkinsons

    A. Prevent degradation of DA
    B. Can only be used as an add on therapy
    C. Selegiline and rasagiline
    D. Last dose at 1pm otherwise insomnia
    • A. T
    • B. F
    • C. T
    • D. T

What would you like to do?

Home > Flashcards > Print Preview