12/6 Flashcards
Go over what you do in an ABCDE
A
- patent?
- obstructed -> suction and left lateral position
- if C-spine injury = jaw thrust only
- Oropharngeal tube can be used in unconcious pts
- Nasopharngeal tube can be used in unconcious and semi-concious
B
- O2 sats
- resp rate
- central cynaosis
- tracheal deviation
- chest expansion
- percussion
- ascultate
?CXR
C - cap refill
- pulse
- BP
- wide bore cannulas (grey) and bloods
-> FBC, UE, LFTs, CRP, clotting, group n save, lactate, amylase, bHCG and ABGs - maybe blood cultures (take 3)
- JVP
- apex beat
- heart sounds
ONTO ABDO
- quick palpation of the abdo
D
- DEFG
- temp
- pupillary reflex
- ACVPU
- urinary catheter
- can you move your limbs for me
- DRUG CHART
E
- everything else
- expose adequately
- bleeds and check for peripheral oedema/swelling
and repeat ask for updates on interventions the whole way along
In SLE, what can be used to monitor active disease?
C3/4 are low during active disease/flares
Chlaymdia and gonorrhoea vs septic and reactive arthritis?
What would you find on joint aspiration in reactive?
Chlaymdia = reactice
Gonorrohoea = septic
Nothing - just a reactive response
If pt is older and less mobile with hip fracture what is offered?
HEMIarthoplasty
What is congestive heart failure?
When Left-sided HF leads to pulmonary congestion -> RV failure -> peripheral oedema
Congestive = both R and L sided HF sx
How to remember the NYHA grading of HF
I - normal
II - some sx
III - happy at rest
IV - all the time
What heart sound can be heard with heart failure?
S3 - particularly left sided
Extreme pain post trauma that is exacerbated even on passive movements - how is it managed?
Diagnose = intracompartmental pressure measurements >40 = diagnostic
Manage
- keep limb at same level , O2, fluids and analgesia
- fasciectomy
How can you differentiate encephalitis and meningitis?
Encephalitis more likely to present with altered mental state
Most common type of melanoma?
Superfical spreading
Area of worsening painful eczema = ?
Early sign of eczema herperticum
How long should courses of treatment for acne be tried for?
What is adapalene?
What oral antibiotics can be used in acne?
3 months
Topical retinoid
Oral lymecycline/doxycyline
Hx for derm
S - where is it?
O - when did you first notice it and how?
C - what does it feel like when you touch it? how many are there? what shape?
R - spreading anywhere
A - assoc sx inc. itch/bleeding/swelling
T - changed over time? anything like this in the past? - how was it managed them
E - anything making it better/worse? how managing it rn?
S - how much is it impacting you rn? how severe do you think it is?
TINA
Travel/infectious contacts
Infection sx + systemic review
N - weight loss, fevers, night sweats, fatigue and inflammed lymph nodes and neurological sx
A - joint pains, eye sx
Sun exposure
- “would you say you are someone who spends a lot of time in the sun”
- ever been burnt so bad you’ve been blistered
- outdoor jobs/hjobbies
- do you tan?
- do you use sunbeds?
Rest as normal
Diet important and all creams and soaps being used
Go over how you would describe a rash
Distrubution
- symmetrical or not
- what areas of disturbtion
- what actual areas are affected
Configuration (shapes and size)
- discrete vs coalescing vs confluent
- arragement e.g. annular, discoid, target, linear
Morphology
- describe in better detail
- remember to comment on colour and border
How would you describe each of the following descriptions:
- affecting hands and feet
- obvious individual lesions but some joining together
- whole area affected
- ring-like
- coin shaped
- purple area that doesn’t blanche
- same as above but only 1-2mm big
- flat red area <1cm? >1cm?
- raised area <0.5cm? >0.5cm?
- compressible dermal swelling
- nodule containg semi-solid material
- pus filled
- signs of scratching
- acral
- coaelscing
- confulent
- annular
- discoid
- purpura
- petechiae
- <1cm = macule >1cm = patch
- <0.5cm = papule >0.5cm = nodule
- wheal
- cyst
- pustule
- excorations
