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1
Q

Asthma Tx

A

O2
Salbutamol NEB 5mg (back to back max 10mg/hour)
Ipratropium NEB 500mcg (4-6 hourly)
Hydrocortisone IV 100mg (6 hourly)/ Pred PO 40mg (OD)
Mg Sulphate 2mg infusion over 20 mins

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2
Q

PE treatment

A

LMWH

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3
Q

Tension pneumothorax decompression

A

2nd intercostal space mid clavicular line

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4
Q

Abx for COPD

A

Doxycycline PO 200mg loading then 100mg 12 hourly

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5
Q

ILS drugs

A

Adrenaline 10mls 1:10,000 = 1mg IV 3rd shock then every alternate shock (or ASAP then every alternate cycle)
Amiodarone 300mg IV 3rd shock

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6
Q

Defib charge

A

150J

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7
Q

4Hs

A

Hypothermia, hypoxia, hyperkalaemia, hypovolaemia

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8
Q

4Ts

A

Tension pneumothorax, Toxins, Tamponade, Thrombosis (PE / MI)

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9
Q

Mental state exam

A 
Appearance + behaviour
Speech
Mood (affect = objective + subjective)
Thoughts (form + content)
Perceptions
Cognition (memory, concentration, confusion)
Insight
\++++ RISK
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10
Q

Seizure

A

15L O2
Recovery position
IV access
IV Lorazepam 4mg / PR Diazepam 10mg

20 mins repeat
30 mins Phenytoin

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11
Q

Life threatening asthma

A

33 92 CHEST

PEFR <33% predicted
Sats < 92%

Cyanosis
Hypotention
Exhaustion
Silent chest
Tachycardia
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12
Q

ACS Tx

A

Morphine 10mg in 10mls 1ml at a time IV titrated
+ antiemetic
O2 if sats <94%
Nitrate GTN 2 puffs (watch for hypotension)
Aspirin 300mg PO
Clopidogrel 300mg PO

+ ACEI (Ramipril 2.5mg)
+ b blocker (Bisoprolol 2.5mg)
+ Statin (Atorvsatatin 80mg)
+ LMWH (Fondaparinux) 5 days

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13
Q

Meningitis Tx

A

IM Ben Pen
IV Ceftriaxone
PO Ciprofloxacin 500mg once

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14
Q

LVF + pulmonary oedema acute Tx

A 
PODMAN
Position
O2
Diuretic (Furosemide 40mg IV)
Morphine
Anti emetic
Nitrate (GTN 2 puffs)
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15
Q

LFV + pulmonary oedema chronic Tx

A

ACEI, b blocker, Diuretic

+ spironolactone) (+ digoxin

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16
Q

ABG ranges

A 
Ph 7.35-7.45
Po2 11-13
Pco2 4.5-6
HCO3 22-26
Lactate <2
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17
Q

Spirometry for lung diseases

A

Obstructive - FEV <80% FVC normal, FEV:FVC <0.7

Restrictive - FEV <80% FVC <80%, FEV:FVC >0.7

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18
Q

CURB 65

A 
Confusion
Urea >7
RR >30
BP <90 sys / <60 dias
65
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19
Q

Acute Tx alcohol withdrawal

A

Chlordiazepoxide

Pabrinex

20
Q

DKA Dx + Tx

A

Cap glucose >11
Cap ketones >3 (or ++ urinalysis)
Metabolic acidosis

1L 0.9% NaCl over 1 hour (then + K in subsequent bags)

Fixed rate 1U/kg/hour Actrapid infusion

+ LMWH

21
Q

Treatment of a hypo

A

150ml 10% dextrose IV STAT
or IM glucagon 1mg
= unconscious

Glucogel if can’t swallow

Glucotab / fruit juice + biscuit / toast

22
Q

Tx hyperkalaemia

A

IV Calcium Gluconate 10% 10mls

10 Units Actrapid + Glucose 50mls 50% IV

Salbutamol 10mg NEB

23
Q

Tx anaphylaxis

A

Secure airway + 15L O2

0.5mg IM Adrenaline
= 0.5mls 1:1000
x 3 Repeat every 5 mins

Hydrocortisone 200mg IV
Chlorphenamine 10mg IV

IV Fluids

Wheeze = 5mg Salbutamol NEB

24
Q

Stroke Tx

A

CT head to ensure ischaemia

Aspirin 300mg OD 2 weeks –> Clopidogrel 75mg

<4.5 hours = thrombolyse

<6 hours = thrombectomy

25
Tx AF / A flutter
>65 + IHD / no Sx / not suitable cardioversion = rate control --> Bisoprolol +/- rate limiting CCB +/- Digoxin (if sedentary) Rhythm control --> DC cardio version / flecanide / amiodarone + warfarin / DOAC
26
AF risk scoring
``` CHADSVASC = risk of stroke HASBLED = risk of bleeding ```
27
Stroke classification
TACS = hemisensory weakness, homonymous hemianopia, high cortical dysfunction (dysphasia) PACS = 2/3 LACS = 1/3 POCS = cerebellar / Cr N
28
Types of brain bleed
``` Subarachnoid = blood within fissures of brain Intercerebral = blood in brain tissue Extradural = lens shaped "lucid interval" Subdural = crescent shaped "fluctuating conscious level, evolving stroke" ```
29
BP drop postural hypotension
>20 SBP | >10 DBP
30
Meningitis examination
Brudzinskis = involuntary flexion hips and knees on flexion of the head Kernig's = pain on extending knee
31
Capacity requirements
Make, understand, act on, communicate + remember decision
32
Mental health act detention powers
EDC = 72 hours (Dr + MHO) SDC = 28 days (Psych + MHO) CTO = 6 months (Psych + MHO + Dr) ``` They have a mental disorder Because of it their ability to make decisions about its tx are impaired Tx is available It is necessary There is a risk to safety ```
33
Death confirmation
``` A = response to verbal stimuli B = Breath sounds (apexs + bases) 1 min C = Carotid pulse (both) 1 min, HS (apex) 1 min D = Pupillary reflexes (bilaterally fixed + dilated), response to painful stimuli E = signs of life total 5 mins ```
34
GCS
E 4 V 5 M 6 ``` E1 = no response E2 = opens eyes to pain E3 = opens eyes to voice E4 = opens spontaneously ``` ``` V1 = no response V2 = sounds V3 = confused words V4 = confused sentences V5 = responsive + oriented ``` ``` M1 = no response M2 = abnormal extension to pain M3 = abnormal flexion to pain M4 = withdraws from pain M5 = localises to pain M6 = obeys commands ```
35
STEMI ECG leads
I, II, aVF = inferior (RCA) V3-V4 = anterioseptal (LAD) V3-V4 + I + aVL = anteriolateral (LAD +/- L circumflex) I, aVL + V5-V6 = lateral (L Circumflex) V1 - V2 tall R wave + ST depression = posterior (L circumflex +/- RCA)
36
ALARMS
``` Anaemia Loss of weigh Anorexia Recent onset + progressive Malena Swallowing difficulty ```
37
First rank symptoms of schizophrenia
A - auditory hallucinations B - broadcasting thoughts C - control delusions D - delusional perceptions (anyone after you?, events relate to you?)
38
Core sx depression
Low mood, anhedonia Sleep disturbance, lack of energy Hopelessness, suicidal
39
Paeds history
BFGD Birth Feeding (+ toilet) Growth Development (school concerns) --> speaking + walking by 1 1/2 ++++++ IMMUNISATIONS
40
Alcohol dependance
3+ ``` Tolerance Withdrawal Cravings Continue to drink despite harmful consequences Neglects other interests (primacy) Difficulty giving up use ```
41
RA hands
``` Loss of knuckle guttering Z deformity of thumb Ulnar deviation Palmar subluxation Swan neck deformity Boutinerres deformity ```
42
OA hands + X-ray
Bouchards nodes Heberdens nodes Loss of joint space Osteophytes Subchondral sclerosis subchondral cysts
43
Ortho exam sequence
``` Look Feel Move (passive + active) Special tests Function ```
44
Present a CXR
Patient + hospital info PA / AP Quality - rotation, inspiration, exposure A - tracheal deviation B - lung fields (patchy, dense)(upper, lower, middle) C - heart size, aortic knuckle, deviated mediastinum D - flat / raised, costophrenic angles, free air E - bones + soft tissue Patchy = consolidation (can see bronchioles going into area) (pneumonia / oedema) Dense = effusion (meniscus, mediastinum shift away from effected side. Exudate = malignancy + infection, Transudate = congestive cardiac failure), collapse (no bronchioles, mediastinum shift to effected side) Pneumothorax
45
HF + pulmonary oedema CXR COPD CXR
``` Alveolar shadow (bats wing) B-lines Cardiomegaly Dilated vessels in upper lobe Effusion ``` ``` Hyperinflated chest Flat diaphragm Bulla Prominent hila Reduced lung markings ```

Y5 (2 decks)

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