Term
| how to work out alcohol units? |
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Definition
1 unit of alcohol is = 10ml of alcohol
strength of alcohol = ABV
sum: multiply the millilitres x ABV and divide by 1000
eg 175ml of 12% wine =
175 x 12 /1000 = 2.1 = ~ 2 units |
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Term
| limits for men and women? |
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Definition
no more than 14 units a week
spread this over 3 days or more |
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Term
what is audit questionnaire?
audit-c is the short version consisting of 3 questions. |
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Definition
10 items
min score = 0
max score is 40
score of 8 or > in men
7 or > in women
indicates strong likelihood of hazardous drinking
15 or > in men
13 or > in women
alcohol dependence |
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Term
what are the 3 questions in aUDIT C? to ID hazardous drinkers or have active alcohol use disorders
out of 12
in men 4 or > = positive
women 3 or > = positive |
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Definition
how often did you have a drink containing alcohol in the last year? 0-4
how many drinks did you have on a typical day when you were drinking in the past year? 0-4
how often did you have 6 or more drinks in the past year on one occasion? 0-4 |
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Term
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Definition
lifestyle: weightless, mindfulness, CBT
avoidy spicy food, caffeine, sleep in cooler room, wear lighter clothing
alcohol may trigger hot flushes.
SSRIs and snris: VENLAFLAXINE |
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Term
herbal remedies for menopause
look for the Tradiational Herbal Remedy logo, this means its high quality and you can be sure of the dose |
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Definition
red clover
black cohosh: member of the buttercup family
st johsn wort
dong quai: female ginseng
ginseng : one of the 11 species of plants thought to help with those who are having a bad nights sleep due to menopause symptoms |
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Term
| what does direct access mean in suspected cancer referral? |
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Definition
| when a test is performed and primary care retain clinical responsibility throughout including acting on the result |
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Term
?lung cancer.
refer using 2 week wait for lung cancer if? |
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Definition
CXR findings suggest lung cancer OR
aged 40 or > with unexplained heamoptysis |
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Term
you should offer an urgent CXR within 2 weeks to asses for lung cancer in people who are 40 or > if they have 2 of the following symptoms OR
if they have ever smoked, 1 or more of the following unexplained symptoms |
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Definition
weight loss
appetite loss
cough
fatigue
SOB chest pain |
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Term
a 42 year old man, former smoker presents with weight loss
what do you do? |
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Definition
| refer for urgent CXR to look for lung cancer within 2 weeks |
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Term
in people aged 40 or over with the following symptoms how could you proceed?
persistent recurrent chest infection
finger clubbing
thormbocytosis
chest signs consistent with lung cancer
persistent anterior cervical lymphadenopathy or supra clavicular lymphadenopathy |
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Definition
| CONSIDER urgent CXR within 2 weeks |
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Term
oesophageal cancer.
offer urgent direct access for upper GI endoscopy to be done within 2 weeks assessing for oesophageal cancer in pts who? |
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Definition
have Dysphagia OR
aged 55 or > with weight loss AND the following:-
upper abdo pain
reflux
dyspepsia |
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Term
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Definition
refer 2 week pancreatic cancer pathway
in those aged 60 or over with weightloss and other symptoms suggestive of pancreatic cancer, consider urgent direct access CT or USS if CT not available within 2 weeks for pancreatic cancer.
eg 60 with weight loss and new onset diabetes |
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Term
| upper abdominal mass consistent with stomach cancer, what pathway? |
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Definition
2 week stomach cancer pathway
urgent direct access for endoscopy within 2 weeks for those with
DYSPHAGIA or
55 or more with weight loss and:-
dysepsia
reflux
upper abdo pain |
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Term
| referral for CRC 2 week wait for 60 or more |
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Definition
aged 60 or > and
iron deficiency anaemia or
changes to bowel habit or
FOB shows changes |
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Term
| referral for CRC 2 week wait for those aged 50 or > |
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Definition
| aged 50 or more with unexplained rectal bleeding |
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Term
referral for CRC 2 week wait
for those aged 40 or more |
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Definition
aged 40 or more with
unexplained weightloss and abdominal pain |
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Term
| breast cancer 2 week referral for those aged 30 or over? |
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Definition
| unexplained breast lump, with or without pain |
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Term
| breast cancer 2 week wait referral for those aged 50 or more? |
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Definition
following symptoms in one nipple only:
discharge
retraction
other changes of concern |
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Term
| you identify ascites and a pelvic mass in a women who is more than 18. the mass is not due to fibroids, what do you do? |
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Definition
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Term
| when ca125 is greater than what ?.. do we worry? |
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Definition
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Term
| when to refer for prostate cancer 2 week pathway |
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Definition
if prostate feels malignant on DRE
or if PSA are above range for their age |
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Term
| 2 week bladder cancer pathway |
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Definition
45 or more with
unexplained heamaturia w/o UTI or
visible blood that persists after successful rx of UTI or
aged 60 or > and have unexplained non visible heamaturia and either dysuria or raised WCC on a blood test |
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Term
| renal cancer 2 week pathway referral criteria? |
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Definition
45 or >
unexplained visible blood or
visible blood that persists even after successful rx of UTI |
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Term
skin cancer 2 week referral. if they have a skin pigmented lesion with a weighted 7pt checklist score of 3 or more
whats the check list? |
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Definition
major features opts each
size
shape
colour
minor features 1 pt each
diameter 7mm or >
inflammation
oozing
change in sensation |
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Term
| laryngeal cancer 2 week referral |
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Definition
aged 45 or > with
persistent unexplained hoarseness or
unexplained lump in neck |
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Term
| oral cancer 2 week referral |
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Definition
unexplained oral ulceration for > 3 weeks or
persistent unexplained lump in neck |
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Term
| you find hepatosplenomegaly and suspect leukaemia in primary care. what would you request? |
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Definition
| very urgent blood test within 48 hours |
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Term
| you find an upper abdominal mass consistent with an enlarged liver in GP. what would you request? |
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Definition
| consider urgent direct USS to be done within 2 weeks |
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Term
| in GP you find upper abdo mass consistent with an enlarged gall bladder. what do you do? |
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Definition
| consider urgent direct access USS to be done within 2 weeks |
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Term
| upper abdo ass consisted with stomach cancer what do you do? |
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Definition
| refer 2 week for stomach cancer |
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Term
| abdominal distension: persistent or frequent particularly > 12 times in women > 50 years. what would you do? |
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Definition
| Ca125. if > 35 then ix further/refer |
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Term
| abdominal pain with rectal bleeding aged 50? you should consider suspected cancer pathway within 2 weeks. what if they have abdominal pain WITHOUT rectal bleeding and are aged 50 or more? |
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Definition
offer occult faecal occult blood tests
FOB screening offered to those 60-74 |
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Term
| alcohol induced lymph node pain. what are you suspecting? |
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Definition
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Term
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Definition
breast cancer
ca125 ovarian
19.9 pancreatic
these are all monoclonal antibodies |
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Term
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Definition
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Term
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Definition
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Term
| small cell lung cancer, neuroblastoma, gastric cancer. which antigen might be raised? |
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Definition
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Term
| most common cause of death in men under 50? |
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Definition
trauma
in over 50 it is heart disease |
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Term
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Definition
50-59 = 3
60-69 = 4
70 > =5 |
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Term
| what can you say about the PSA test specificity and sensitivity? |
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Definition
| it has poor specificity and poor sensitivity |
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Term
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Definition
an enzyme made by normal and abnormal cells of the prostate
can be raised in conditions that are not prostate cancer
as you get older you produce more.
the test is not sensitive or specific. this means that people with prostate cancer may have normal PSA levels whilst only a proportion of those with raised PSA will be found to have prostate cancer. |
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Term
| rx for epididymoorchitis from ecoli? |
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Definition
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Term
| what is phrens sign? which condition is it found in? |
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Definition
| it is found in epidydimoorchitis but not in torsion. it is when lifting the testicle relieves the pain. |
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Term
| around what % of men have prostate cancer with a normal PSA? |
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Definition
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Term
| how to test for late onset hypogonadism? |
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Definition
do 2 x morning tests of testosterone.
if levels are < 8 you can rx with testosterone.
if levels are >12 then it is not considered hypogonad.
inbetween 8-12 consider a trial of testosterone |
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Term
you have done 2 x morning testosterone samples checking for hypogonadism.
what result would allow you to rx?
what result would make you give a trial of testosterone
what result suggests there is no hypogonadism? |
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Definition
< 8 we rx
8-12 we give trial of testosterone
> 12 implies there is no hypogonadism |
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Term
ranges of the international prostate symptom score
they can be answer 0-5
0 = not at all
5 = almost always
out of 35
there is one quality of life question too |
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Definition
0-7 mild
8-19 moderate
20-35 severe |
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Term
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Definition
conservative; diet, avoid caffeine, smoking
medical: tamsulosin to relax bladder neck, finesteride decreases size overtime
sx: TURP |
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Term
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Definition
urinary retention
overflow
recurrent UTI
impaired renal fx
bladder calculi
haematuria |
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Term
| 20 y/o had cystoscopy now complaining of tender balls and swelling of scrotum. leucocytes positive. diagnosis? |
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Definition
epidydimoorchitis. Phrens sign will be positive
rx is with ciprofloxacin 500mg BD 10 days |
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Term
| 8 year old just recovered from viral illness affecting both parotids, presents with scrotal swelling. dx? |
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Definition
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Term
pea sized lump on testicle. located posterior to the testicle. diagnosis?
associated with? |
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Definition
epidydimal cyst.
diagnosed with US
associated with CF and polycystic kidney disease. |
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Term
| prostate cancer metastasise to which nodes? |
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Definition
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Term
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Definition
hypermobility score.
5 or > = hyper flexibility |
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Term
| bankhart lesions associated with which part of the rotator cuff? |
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Definition
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Term
| mx of 1st time dislocation? |
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Definition
sling for 3 weeks
recurrent: get them moving ASAP |
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Term
| causes of posterior dislocation of shoulder? |
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Definition
seizures
electricution
light bulb sign on X-ray
most useful X-ray is axial X-ray |
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Term
| which movement is affected most in adhesive capsulitis? |
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Definition
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Term
lasting power of attorney
two types
health and welfare
property and financial affairs
features |
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Definition
needs to be registered. there is a fee
health and welfare only start working once the pt is lacking capacity.
the other one can start once it has been registered |
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Term
| if a pt wants to refuse life sustaining treatment what needs to be done for advanced refusal? |
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Definition
| it needs to be written, signed and witnessed |
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Term
| best site to perform veneoucnture? |
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Definition
antecubital fossa
apply tourniquet 5-10 cm above site |
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Term
| potential complications of venepuncture? |
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Definition
infection
haematoma
bleeding
brusing
syncope
extravasation of injected medicines |
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Term
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Definition
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Term
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Definition
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Term
| monitoring of ACE in hibitors |
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Definition
BL measurements
2 weeks after
after dose change |
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Term
| what affect do beta blockers have on raynauds? |
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Definition
make it worse.
avoid propanalol in PVD it can worsen raynauds |
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Term
| dose of amitriptiline for neuropathic pain v depression |
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Definition
10-20mg neuropathic
75-150mg depression |
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Term
| difference between ISMN and ISDN? |
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Definition
ISMN is the active metabolite of ISDN
ISMN has a longer half life than ISDN and taken prophylactically in chronic stable angina |
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Term
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Definition
young age
low socioecomonic status
many sexual partners
lack of barrier method
IUCD in past 20 days
TOP |
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Term
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Definition
ofloxacin and metronidazole 400mg PO BD for 14 days OR
single dose ceftriaxone 500mg and doxycycline 100mg PO BD and metronidazole 400mg PO BD for 14 days |
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Term
| rx for cervical ectropian? |
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Definition
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Term
| what is the motor supply to the pyloric sphincter? |
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Definition
| vagus nerve AKA nerve of latter jay |
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Term
| what happens to back pain in uraemia pericarditis? |
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Definition
| when the pt lays supine the back pain gets worse but when they sit forward it gets better |
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Term
| if you just replace the ball of the hip joint what is this called? |
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Definition
hemi arthroplasty
total hip replacement is when you replace the ball and socket |
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Term
| DHS is used in what type of hip fractures? |
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Definition
| intra trochanteric ie extra capsular |
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Term
| what pred dose in exacerbation of COPD? |
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Definition
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Term
C diff
gram positive rod
mx? |
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Definition
metronidazole 400mg tds for 14 days
2nd line vancomycin 10-14 days |
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Term
| if a pt with c dif is NBM can you give IV metronidazole or vancomycin? |
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Definition
| you can give IV metronidazole but you cannot give IV vancomycin |
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