PreReg solution

26/07/2025

Definition:
Heart failure is a long-term condition where the heart struggles to pump enough blood due to structural or functional weakness.  

🔍 How to Spot It
• Symptoms: Breathlessness (especially with activity or lying flat), swelling in legs/ankles, fatigue, weight gain, dry cough 
• Signs: Raised JVP, crackles in lungs, peripheral edema, cardiomegaly, abnormal ECG 

➡️ Tests: NT‑proBNP levels, ECG, chest X‑ray, echocardiogram, and relevant bloods 

⸻

💊 Treatment Pathway for HFrEF (EF ≤ 40%)
1. First line: ACE inhibitors + beta‑blockers
2. Add: Mineralocorticoid receptor antagonist if symptoms persist
3. Specialists may initiate:
• Sacubitril‑valsartan
• SGLT2 inhibitors: Dapagliflozin & Empagliflozin added to optimized therapy

25/07/2025

Deficiency in vitamin B12 or folate leads to megaloblastic anaemia. This condition is characterized by abnormally large red blood cells (macrocytosis) with a mean cell volume (MCV) greater than 100 fL, caused by impaired DNA synthesis.

2. COMMON CAUSES

Vitamin B12 Deficiency:

Pernicious Anaemia: The most common cause of severe B12 deficiency in the UK.

Dietary: Vegan or malnourished diets.

Gastric Issues: Gastrectomy, Zollinger-Ellison syndrome.

Medications: Metformin, protein pump inhibitors (PPIs), H2-receptor antagonists.

Intestinal Issues: Crohn’s disease, ileal resection, malabsorption.

Folate Deficiency:

Dietary: Poor intake is a primary cause. Good sources include broccoli, chickpeas, and brown rice.

Increased Requirements: Pregnancy, malignancy.

Medications: Alcohol, methotrexate, trimethoprim, anticonvulsants.

Other: Liver disease, malabsorption (e.g., Coeliac disease).

22/07/2025

Emergency contraception.

💊

20/07/2025

20/07/2025

SSRI ( selective serotonin reuptake inhibitors)- this includes
Fluoxetine - considered safe in children
Sertraline - considered safe in MI patients
Paroxetine- risk of withdrawal
Citalopram- risk of QT interval prolongation.

All SSRIs → Risk of bleeding, hyponatremia, serotonin syndrome

19/07/2025

💊 How PPIs Work:
PPIs block the gastric H+/K+ ATPase enzyme (proton pump) in stomach lining cells. This reduces stomach acid production

19/07/2025

Proton Pump Inhibitors (PPIs) – Mechanism of Action

💊 How PPIs Work:
PPIs block the gastric H+/K+ ATPase enzyme (proton pump) in stomach lining cells. This reduces stomach acid production

PPI Examples:

Omeprazole

Esomeprazole

Lansoprazole

Pantoprazole

Rabeprazole

💊

17/07/2025

Fluoroquinolones (4-Quinolones)

Bactericidal (kill bacteria)

Broad-spectrum (Gram +ve & Gram -ve)

Inhibit DNA gyrase & topoisomerase IV → Block bacterial DNA replication

Generations & Spectrum:
1st Gen (e.g., Norfloxacin) – Mainly Gram -ve (UTIs)

2nd Gen (e.g., Ciprofloxacin) – Expanded Gram -ve + some Gram +ve

3rd Gen (e.g., Levofloxacin) – Enhanced Gram +ve & atypical coverage

4th Gen (e.g., Moxifloxacin) – Best Gram +ve + anaerobes

16/07/2025

🚀 Your Path to Success Starts Here!
✨ Join PEE-REG Solution Today & Dominate Your Exams!

04/07/2025

top 3 treatments for nocturnal enuresis (bedwetting) in children:
1. Behavioral Strategies – Encourage regular toilet trips, limit fluids before bedtime, and use reward systems for dry nights.
2. Bedwetting Alarms – Devices that wake the child when wetting begins, helping train bladder control over time.
3. Medication – Desmopressin is commonly used to reduce nighttime urine production in older children, especially for short-term relief (e.g., sleepovers).

.

( please note: this is for educational purpose only )

04/07/2025

Top 3 treatments for nocturnal enuresis (bedwetting) in children:
1. Behavioral Strategies - Encourage regular toilet trips, limit fluids before bedtime, and use reward systems for dry nights.
2. Alarms treatment - Devices that wake the child when wetting begins, helping train bladder control over time.
3. Medication - Desmopressin is commonly used to reduce nighttime urine production.

03/07/2025