11/6

Question 1

Paediatric asthma pathways

How does this differ if child <5

Answer 1

1. SABA
2. V.low dose (100mcg) ICS
3. • LTRA
4. STOP LTRA and + LABA
5. SABA + low-dose MART (nothing else)
6. SABA + mod-dose MART
7. specialist

If <5yrs
SABA + 8wk trial of mod-dose ICS
Then step 3 - if that fails specialist advice

Question 2

How hypoxic/acidoic do pts have to be to be eligible for LTOT

Answer 2

<7.3 for both - magic number 7+3=10

ALSO THE MAGIC NUMBER FOR LIVER TRANSPLANT IN PARACETMOL OD

Question 3

How are kids diagnosed with asthma?

Answer 3

PEFR and brochodilator reversiblity
- if normal -> FeNO

Question 4

Indications for starting steroids in sarcoidosis

Answer 4

PUNCH

Parenchymal lung disease (nodules)
Uveitis
Neurological involvement
Cardiac involvement
HyperCa

Question 5

What antibiotic for legionella?

Answer 5

Clarithromycin - (imagine Ella as a mice)

Question 6

What should follow all cases of pneumonia 6 weeks later?

Answer 6

CXR to assess clinical eolution q

Question 7

What med is given to CF pts

Answer 7

Lumacaftor/ivacaftor = orkambi

Question 8

What is included in S of asceptic

Answer 8

Tone
Volume
Quanitty
Fluency
Rate

Question 9

What can you ABSOULTELY NOT forget in psych hx

Answer 9

RISK ASSESSMENT !!!! - ASK IN INSIGHT

Question 10

What is the conservative management of COPD

Answer 10

COPD
Can you eat better?
Omit smoking
Pulmonary rehab
Drug - vaccinate

Question 11

How do you obtain a wound swab?

Answer 11

Rotate the swab several times over the ulcer with enough pressure to illict fluid if approriate

Question 12

What else needs to be asked in insight?

Answer 12

Taking risks esp in mania

Question 13

What associated sx are importnat to ask in anxiety?

Answer 13

• Panic attacks
• Intrusive thoughts - ever had unpleasant thoughts that enter your head that you can’t get rid of?
• Obssesive behaviours - any routines or rituals that you do to help manage worries?

GAD
Go on then do it! jump! = intrusive thoughts
Attack = panic attacks
Do it again, do it again = obsessive behaviours

Question 14

Define
- ruminating
- catastrophising

Answer 14

ruminating = constant thinking negative thoughts without solution
catastrophising = jump to worst possible conclusion

Question 15

What is schizoaffective disorder?

Answer 15

Psychotic and affective (depression or mania)

Question 16

Alcohol with paracetomol OD - good or bad?

Answer 16

Some studies have proven that acute alcohol intake is acc a protective factor!
Chronic on other hand is bad

Question 17

Ring-enhancing lesions in the brain in HIV pt

Answer 17

Cerebral toxoplasmosis

Question 18

Name a DPP4 inhibitor

Answer 18

-gliptin

Question 19

How are diabetes drugs managed?

Answer 19

1. Metformin - if struggling MR metformin. If cardiac risk + SU as well
2. dual oral therapy
3. insulin

Question 20

LADA vs MODY

Answer 20

LADA - more like T1DM - have antibodies but onset typically after 30

MODY - more like T2DM but onset in teenage and young adults

Question 21

What painkiller can cause serotonin syndrome

Answer 21

Tramadol

Question 22

Go over paracetomol OD chart

How quick is acetlycysteine given?

Answer 22

Over 1 hour

Question 23

What is the max dose of metformin?

Answer 23

500mg TDS

Question 24

Vision colour changes caused by what drugs:
- blue vision
- yellow-green

Answer 24

Blue = sildenafil = viagra
Yellow-green = digoxin

Question 25

When should albumin:creatine ratio be measured?

Answer 25

Early morning specimen

Question 26

What is the preffered way to feed MND patients?

Answer 26

PEG

Question 27

What is the cut-off for pregnancy-induced HTN?

Answer 27

20 weeks

Question 28

Go over the L of GALS

Answer 28

Knee extension and flexion feeling the joint Internal rotation of the hip Knee effusion Check the foot Squeeze the MTP

Question 29

Assess someones vision properly

Answer 29

Acuity Colour vision Acommodation and convergence - look at pen and wall Shine light in eyes H shape Visual fields