Tute 5 Notes PDF

2808NRS Tutorial 5 – Exam Buster! Student notes. Final exam overview: MCQs: You will answer 50 MCQs on a mark sense card. Bring a 2B pencil and eraser. SAQs: Write your short answer question (SAQ) answers directly onto the exam paper. You can make notes on the paper,...

2808NRS Tutorial 5 – Exam Buster! Student notes. Final exam overview: MCQs: You will answer 50 MCQs on a mark sense card. Bring a 2B pencil and eraser. SAQs: Write your short answer question (SAQ) answers directly onto the exam paper. You can make notes on the paper, but it will stay with us for marking. Duration: 10 minutes to read the paper and 2 hours to complete the exam. You cannot write anything during reading time. Key study tips: Traffic Light system: Use this system to guide your study. The study guide is only a guide, and the exam may cover amber light topics, for example endocrine content. Practice exams: Use the SAQ practice sent to you via announcements and the MCQ practice for additional review. Key concepts from each question we unpacked during the exam buster: 1. Acute Pancreatitis vs Peptic Ulcer: o Concept: Differentiating between these two conditions involves recognizing key symptoms and lab findings. Elevated serum amylase and lipase are indicators of acute pancreatitis, not typically seen in peptic ulcers. Pain patterns are important but can overlap, so lab values are useful for accurate diagnosis. 2. Furosemide action (loop diuretics):  o Concept: Furosemide is a loop diuretic that reduces volume by promoting the excretion of sodium and water. This reduces fluid retention and helps manage conditions like heart failure and hypertension. Understanding how diuretics work helps in managing patients with fluid overload. 3. Hypertension treatment (angiotensin ii receptor blockers - ARBs): o Concept: ARBs are a common treatment for hypertension. They block the action of angiotensin II, a hormone that causes blood vessels to constrict, thus relaxing blood vessels and lowering blood pressure. Knowing the different drug classes is important in your practice. 4. Compensation in respiratory acidosis: o Concept: In conditions including chronic respiratory acidosis, the body compensates by increasing bicarbonate production in the kidneys. This helps buffer the excess acid (H+ ions) in the blood, restoring pH balance. This mechanism is important for you to understand in managing patients with COPD or other chronic respiratory conditions. 5. Orthopnoea (shortness of breath while lying flat): o Concept: Orthopnoea is a common symptom in conditions such as heart failure and COPD, where patients experience difficulty breathing when lying flat. It’s relieved by sitting or standing up. 6. Left-sided heart failure symptoms: o Concept: Terms like pulmonary oedema, orthopnoea, and paroxysmal nocturnal dyspnoea (PND) are important to understand when managing left-  sided heart failure. These symptoms are due to the heart’s inability to pump blood efficiently, leading to fluid buildup in the lungs and difficulty breathing. 7. Wheezing in lower respiratory obstruction: o Concept: Wheezing is a key sign of obstruction in the lower respiratory tract, such as in conditions like asthma or COPD. Understanding this clinical sign helps in identifying respiratory conditions that affect the bronchi or bronchioles. Need to understand difference between upper and lower respiratory structures. 8. Diuretics (loop and thiazide diuretics): o Concept: Diuretics like loop diuretics (e.g., furosemide) and thiazide diuretics (e.g., hydrochlorothiazide) promote diuresis by acting on different parts of the kidney. Loop diuretics act on the loop of Henle, while thiazides act on the distal convoluted tubule. These drugs help manage conditions including heart failure and hypertension by reducing fluid volume. 9. Atherosclerosis patho: o Concept: Atherosclerosis involves the buildup of fatty plaques in the arteries, leading to narrowing and hardening of the arteries. This can reduce blood flow and lead to serious conditions like heart attacks or strokes. Major risk factors include high blood pressure, high cholesterol, and smoking. 10. Diabetic Ketoacidosis (DKA): o Concept: DKA occurs due to a lack of insulin, leading to elevated blood glucose levels (hyperglycaemia) and the breakdown of fat into ketones. This  causes metabolic acidosis, which can be life-threatening. Signs include fruity breath due to acetone and dehydration from increased urination. 11. Pyelonephritis (kidney infection): o Concept: Pyelonephritis is an infection of the kidney's pelvis, usually caused by a UTI that has ascended to the kidneys. o Remember the anatomy of the kidney. 12. Hepatic encephalopathy: o Concept: In liver failure, toxins like ammonia build up in the blood, leading to hepatic encephalopathy. This condition causes confusion and alters mental status and can progress to coma if untreated. 13. Diabetes Insipidus (DI) and Antidiuretic Hormone (ADH): o Concept: DI is caused by a deficiency in antidiuretic hormone (ADH), leading to excessive thirst and excretion of large amounts of dilute urine. This is different from diabetes mellitus, which involves blood sugar regulation. 14. Hormones of the anterior pituitary gland: o Concept: Hormones like growth hormone (GH), thyroid-stimulating hormone (TSH), and adrenocorticotropic hormone (ACTH) are produced by the anterior pituitary. However, antidiuretic hormone (ADH) is produced in the hypothalamus and stored in the posterior pituitary. 15. Salbutamol action (Beta-2 Adrenergic Agonist): o Concept: Salbutamol is a short-acting beta-2 adrenergic agonist (SABA). It works by stimulating beta-2 receptors in the airways, leading to bronchodilation. This makes it easier to breathe, especially in conditions such as asthma or COPD.