Progress 3 (26-40)

mbch4kz2's version from 2016-05-07 16:21


Question Answer
What needs to happen before bone marrow transplantation and what agents are sued to do this?Old bone marrow must be killed using IV cyclophosphinide and total body irradiation
What is the action of interferons?Upregulates apoptosis
What consists of angina drug management?1. Aspirin + Statin 2. Sublingual GTN 3. Ca- channel blocker (verapamil or diltiazem) or B-blocker 4. Ca-channel and B-blocker (do not prescribe verapamil with B-blocker- use nifedipine instead)
What medication should be considered if the addition of a B-blocker or Ca-channel blocker 1. Long acting nitrate 2. Ivabradine 3. Nicorandil 4. Ranolozine
What should be done if a patient develops a tolerance to their nitrate therapy?Patients should take the 2nd dose of isosorbibe mononitrate after 8 hours as opposed to 12
Name 4 features that suggest legnionella infection (legionnaire's disease)1. Recent forge in travel (typically colonised water tanks- linked to air-conditioning systems) 2. Flu-like symptoms 3. Hyponatraemia 4. Pleural effusion (30%)
What is normal QT interval?<430ms in males <450ms in females
What is long QT syndrome and what may this lead to?Rare inherited or acquired disorder where delayed repolarisation of the ventricles increases propensity to ventricular tachyarrhythmias. This may lead to syncope, cardiac arrest, sudden death
What ECG features would be present in hypokalaemia?U waves, small or absent T waves, prolonged PR interval, ST depression, long QT
What are the 2 main types of ventricular tachycardia?Monomorphic; commonly caused by MI Polymorphic; Subtype is tosades de pointes (precipitated by long QT)
Name the 3 main causes of prolonged QT1. Congenital: Jervel-Lange-Nielsen syndrome (due to abnormal K channels), Romano-Ward syndrome Drugs: Amiodarone, sotalol, tricyclic anti-depressants, chloquinone, erythromycin Other: Hypocalcaemia, hypokalaemia, hypomagnaemia, acute MI, hypothermia, subarachnoid haemorrhage
What is the management of prolonged QT?If patient has adverse signs (systolic BP <90, chest pain, HF, HR >150) then immediate cardioversion is indicated If not then antiarrhythmics may be used
What drug treatment should be used for prolonged QT?Amiodarone (ideally through central line), lidocaine, procainamide
What drugs are used for rate control of AF?1. B-blocker 2. Or Ca-channel blocker 3. Digoxin- less effective controlling HR during exercise (preferred if patient has HF)
What drugs are used to maintain sinus rhythm in AF1. Sotalol 2. Amiodarone 3. Flecainide
What diameter of air in pneumothorax should be used to decide whether to aspirate?If rim of air >2cm then aspirate- all patients should be admitted for at least 24 hours
What is the management of primary pneumothorax?If the rim of air is <2cm and patient is not short of breath then discharge
What is the management of secondary pneumothorax?If the pneumothorax is <1cm then administer O2 and admit for 24 hours. If >1cm then aspirate
What is the management of iatrogenic pneumothrax?Less likelihood of recurrence than spontaneous. Majority will resolve with observation. Aspirate if treatment needed. Ventilated patients need chest drains- as may some patients with COPD

Recent badges