A+E Flashcards
GCS?
654 MoVE
Eye opening
4. Spontaneous
3. To speech
2. To pain
1. None
Verbal response
5. Orientated
4. Confused
3. Words
2. Sounds
1. None
Motor response
6. Obeys commands
5. Localises to pain
4. Withdraws from pain
3. Abnormal flexion to pain (decorticate posture)
2. Extending to pain
1. None
Acute pulmonary oedema initial Mx
Sit up, IV loop diuretic
Can also give oxygen and or vasodilators if clinically approrpiate
Tension pthx Mx
Immediate needle decompression
How to decide whether to give acetylcysteine when u have g of paracetamol
Divide mg of paracetamol by their weight in KG
If above 150 then give
What is the adrenaline dose in anaphylaxis and cardiac arrest
Anaphylaxis= 0.5mg= 0.5ml 1:1000- give IM
CA= 1mg= 1ml 1:1000 IV- give IV
Which blood test to confirm anaphylaxis
Serum mast cell tryptase
Rises following an acute episode
How do you manage someone having a cardiac arrest (e.g. VT) when they’re already hooked up to a monitor
Up to three successive shocks
Looks like the type of CA doesn’t matter here
How to manage alcoholic ketoacidosis
IV 0.9% NaCl
IV thiamine also which prevents Wernicke’s encephalopathy
Ketones in urine as they are made as a byproduct of fat metabolism (due to starved body)
What GCS to intubate
Less than 8- intubate
How would a patient present in VF
VF causes immediate loss of consciousness and requires resuscitation
Life-threatening arrhythmia leading to cardiac arrest
In contrast in torsades des pointes they may be conscious with an irregular pulse and neurological Sx and palpitations
Commonest viral cause of encephalitis and meningitis
Encephalitis = HSV 1
Meningitis = Enterovirus e.g. Coxsackie B virus)
How to assess someone with major trauma
C-ABC
normal abcde but with C-spine/ catastrophic haemorrhage first
What type of cells to give in major haemorrhage
Red cells
fresh frozen plasma
Give these in a ratio of 1:1
And then give 1 unit of platelets for every 4 units of the other two
Trauma triad of death
Coagulopathy leads to increased lactic acid in blood leading to acidosis
Acidosis leads to decreased heart performance which leads to low body temperature
Low body temp leads to decreased coagulation which leads to coagulopathy
Definitive management for theophylline toxicity
Haemodialysis
How does oesophageal perforation present
Boerhaave syndrome
Perforation due to forceful vomiting
Triad of:
- vomiting
- severe retrosternal chest pain radiating to the back
- subcutaneous emphysema (suprasternal crepitus)
What are thiazolidinediones e.g. pioglitazone CI in heart failure
Can cause peripheral oedema
Also can cause weight gain, liver impairment and bladder cancer
Epididymo-orchitis management if unknown organism
Single dose IM ceftriaxone and 10-14 days of doxycycline
Which travel disease presents with two phases with remission in between
Yellow fever
‘It can present very quickly with non-specific symptoms and it has an incubation period of 2-14 days
Which antibiotic to give in MRSA
Vancomycin
Teicoplanin
Linezolid
What CSF results in subarachnoid haemorrhage
Do it hours (6?) after CT scan
Bilirubin in the CSF (xanthchromia)
And normal/ raised opening pressure
Anterior middle and posterior cerebral artery stroke what presentation
Leg weakness pretty much only on the contralateral side
Middle cerebral artery causes more arm symptoms as well as contralateral homonymous hemianopia and aphasia
Posterior cerebral artery causes contralateral homonymous hemianopia with macular sparing (no limb involvement?)
How many doses of IV Loraz can you give in status epilepticus
2 doses! Usually of 4mg
After that give a second-line e.g. levetiracetam or sodium valproate or phenytoin
How does investigation change in epididymoorchitis change depending on age
Younger men more likely to be chlamydia so arrange urine sample for NAAT
In older men more likely to be enteric E.coli so arrang mid-stream sample for microscopy and culture
Obvs do NAAT test if likely in history
