Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

med > A & E > Flashcards

A & E Flashcards

1
Q

What preparations should be made for an admission of a major trauma case?

A

Inform trauma team
Prepare resuc room
Prepare fluids and O -ve blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Who forms the trauma team?

A

Anaesthetist
Surgeons
Orthopaedics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a fast scan?

A

rapid bedside USS assessement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What BP should you aim for in trauma patients?

A

Aim for 90 systolic (permissive hypotensive resuscitation) - helps blood to clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When might you not want to follow permissive hypotensive resuscitation and bring the BP up more?

A

hx HTN/ cardiac disease

hx cerebrovascular disease, carotid artery stenosis, poor renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define shock

A

Medical emergency in which organs and tissues are not receiving adequate perfusion of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is MAP equation?

A

Diastolic + (Systolic-diastolic)/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the minimum MAP needed to perfuse your organs?

A

70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How are CO, BP and SVR linked?

A

BP= CO X SVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What sats do you aim for in COPD?

A

88-92%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the criteria for anaphylaxis?

A

1) Sudden onset, rapid progression of sx
2) Life threatening airway/breathing/circulation problem
3) Skin/mucosal changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What test can be used post-anaphylaxis to confirm dx?

A

Tryptase (1-6h post anaphylaxis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the dose of adrenaline for anaphylactic shock?

A

0.5mg IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What drugs do you give following adrenaline in anaphylactic shock?

A

Chlorphenamine IV and hydrocortisone IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What dose of adrenaline is used in cardiac arrest?

A

1mg IV (between second and third shock)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What drug is used to tx a patient in VT who is not displaying adverse features?

A

Amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What drugs are used to control AF in primary care?

A

beta blocker

CCB (diltiazem, verapamil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which three things make up cushings triad?

A

1) Altered respirations (decreased)
2) Widening pulse pressure (systolic htn)
3) Bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is cushings reflex?

A

Physiological response to raised ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is first line tx for angina control?

A

Beta blocker and/or CCB

and aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ECG findings in PE

A

Tachycardia
RBBB
R axis deviation
S1Q3T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tx for hypothermia

A

Warm fluids/ O2
Bladder/peritoneal lavage
Bear hugger device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What value is a marker of carbon monoxide poisoning?

A

Carboxyhaemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which cardiac enzymes can be measured as markers of ACS?

A

Troponin T
CKMD
(AST, CK)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What drug can be given IV as part of the major blood loss protocol?

A

Transexamic acid (if less than 3h from injury)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the criteria for PCI in STEMI?

A

Present within 12h of sx onset
and
PCI available within 2h of first medical contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What drugs do you give initially in STEMI?

A 
Aspirin 300mg
Ticagrelor
Morphine
GTN spray
O2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What score can be used to risk assess pts with NSTEMI?

A

GRACE score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Mx for severe pulmonary oedema

A

O2
Diamorphine IV
Furosemide IV
GTN spray (unless BP less than 90)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the most common cause of broad complex tachycardia?

A

VT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What should you do in unstable VT?

A 
DC cardioversion (X3)
Then amiodarone followed by more shocks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How do you manage torsades de points if caused by congenital long QT?

A

Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How to tx torsades de pointes caused by acquired long QT?

A

Stop predisposing drugs
Correct hypokalaemia
Give magnesium sulphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What can precipitate AF?

A

Hyperthyroidism

Alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How do you manage SVT?

A

Vagal manoeuvres

Adenosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How do you treat a bradycardic pt with adverse signs?

A

Atropine IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What factors would make you consider a bradycardic patient at risk of asystole?

A

Recent asystole
Mobitz II AV block
Complete heart block with broad QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How would you treat a bradycardic patient deemed at risk of asystole or is unstable and hasn’t responded to initial atropine?

A

Repeat atropine
Transcutaneous pacing
Consider adrenaline
Seek expert help to arrange transvenous pacing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Which Ix are essential in asthma?

A 
PEF
ABG
CXR
FBC
U&E
40
Q

What are the markers of severe asthma?

A

Unable to complete sentences
RR>25
PR>110
PEF 33-50% predicted

41
Q

What are the markers of life-threatening asthma?

A 
PEF < 33% predicted
Silent chest
Hypotension
Exhaustion
Normal/high PaCO2 on ABG
42
Q

What tx would you initially instigate in severe asthma?

A

Salbutamol nebs
Ipratropium nebs (Atrovent)
Hydrocortisone IV

43
Q

What treatment could be considered if asthma is responding poorly to nebs and steroids?

A

IV MgSO4

IV salbutamol

44
Q

What are target o2 sats in copd?

A

88-92%

45
Q

What is important to do later when starting COPD pts on O2?

A

ABG within 1 hour

46
Q

What signs indicate a PTX?

A

Reduced expansion
Hyperesonance
Decreased breath sounds

47
Q

Which ix is essential in PTX and when would you not do it?

A

CXR

Don’t do it if suspect tension PTX as need urgent tx

48
Q

What ix do you need to do if suspect PCP?

A

Bronchoalveolar lavage

49
Q

Outline CURB score?

A 
Confusion
Urea > 7
RR >= 30
BP< 90/60
Age>=65
50
Q

What are you target sats in asthma?

A

94-98

51
Q

In a patient displaying signs of meningism, what drug is given alongside abx?

A

IV dexamethasone

52
Q

Which virus is most likely to cause encephalitis?

A

HSV-1

53
Q

How to manage raised ICP?

A

1) Raise head of bed 40 degrees
2) If intubated - hyperventilate to decrease pCO2 which decreases ICP
3) Mannitol
4) Consider steroids and fluid restriction

54
Q

Triad of features px in DKA?

A

Acidaemia
Hyperglycaemia
Ketonaemia

55
Q

How should you manage DKA?

A

1) Fluids - 1L NaCl over 1 hour (bolus if systolic <90)
2) Insulin (0.1U/kg/hr)
3) Check potassium and glucose

56
Q

What is the risk of overhydration in DKA?

A

Cerebral oedema

57
Q

What are the ECG signs of hypokalaemia?

A

PR prolonged
ST depression
Flattened T wave
Prominent U wave after T

58
Q

What are the signs of hyperkalaemia on ECG?

A

Tall tented T waves
Small P waves
Wide QRS
VF

59
Q

What are the three features of HHS?

A

Hypovolaemia
Marked hyperglycaemia
High osmolality

60
Q

How should you treat HHS?

A

Rehydrate slowly over 48hrs with 0.9% saline

Give prophylactic LMWH

61
Q

What is the first line tx for thyrotoxic storm?

A

Beta blockers

62
Q

What bloods are essential to take in Addisons crisis?

A

Cortisol
ACTH
U & Es

63
Q

What is the initial tx for Addisonian crisis?

A 
Hydrocortisone IV stat
Fluid bolus (repeat if necessary)
64
Q

Outline the mx for phaeochromocytoma

A

1) alpha blocker (e.g. phentolamine)

2) long acting alpha blocker and beta blocker given once BP controlled

65
Q

Antidote for BDZ poisoning

A

Flumazenil

66
Q

Antidote for beta blocker poisoning

A

Glucagon + glucose or

atropine

67
Q

How does digoxin posioning px?

A

yellow-green visual halos

68
Q

What is antidote for digoxin poisoning?

A

Digifab

69
Q

What is antidote for iron poisoning?

A

Desferrioxamine

70
Q

How do you determine whether a paracetamol poisoning pt needs referral for liver transplant?

A

Kings college criteria

71
Q

What abnormalities on an ABG does aspirin poisoning cause?

A

Resp alkalosis followed by metabolic acidosis

72
Q

What chart is used to determine the surface area of burns?

A

Lund and Bowder

73
Q

Outline the rule of 9s regarding burns

A 
Arm 9%
Front trunk 18%
Back trunk 18%
Leg 18%
Head and neck 9%
74
Q

What is the threshold for referring a burns victim to a specialist centre?

A

> 25% partial thickness burns

75
Q

How do you initially manage a burns patient?

A 
Manage airway
IV fluids
IV morphine
Simple saline gauze
Ensure tetanus immunity
76
Q

What sign on ECG indicates hypothermia?

A

J wave

77
Q

In what instance would you warm a hypothermia pt rapidly?

A

If cardiac arrest/instability

78
Q

What is the BLS ratio of compressions to breaths in resuscitation?

A

30:2

79
Q

What are the reversible causes of cardiac arrest?

A

Hypoxia, hypovolaemia, hyper/hypokalaemia, hypothermia

Tension PTX, tamponade, toxins, thromboembolism

80
Q

What is the name for ACS with no ST elevation and no troponin rise?

A

Unstable angina

81
Q

Where is the ST elevation in a posterior STEMI?

A

V7-9

82
Q

Define NSTEMI

A

Trop positive ACS without evidence of ST elevation

83
Q

What ECG changes may be seen in NSTEMI?

A

ST depression

T wave inversion

84
Q

What is the most common cause of IE?

A

S.viridans

85
Q

What criteria are used to dx IE?

A

Duke criteria

86
Q

Which type of aortic dissection requires surgical repair?

A

Type A (ascending aorta)

87
Q

What is a life threatening DDx of renal colic?

A

AAA

88
Q

What are the comps of pericarditis?

A

Effusion
Tamponade
Myocarditis

89
Q

DDx for upper GI bleed

A 
PUD
Gastroduodenal erosions
Oesophagitis
VARICES
Mallory-Weiss tear
Upper GI malignancy
90
Q

What score is used to risk stratify patients with an upper GI bleed?

A

Rockall score

91
Q

Mx for upper GI bleed

A

1) Protect airway and keep NBM
2) Insert two large bore cannulae and take bloods
3) Give IV fluids
4) Consider blood transfusion if Hb<7
5) Correct clotting abnormalities (e.g. vit K, FFP, platelets)
6) If varices - TERLIPRESSIN IV and broad spectrum abx
7) Catheterize
8) Notify surgeons for ENDOSCOPY

92
Q

What drugs do you give if varices bleed?

A

IV terlipressin and broad spectrum abx

93
Q

What drug is used as primary prophylaxis of varices in liver disease?

A

Beta blocker or endoscopic banding

94
Q

Define status epilepticus

A

Generalized seizure lasting longer than 5 mins

95
Q

When should you take troponin levels?

A

As soon as take bloods and at 6 hours

96
Q

What is a Thomas splint?

A

Used to stabilise and prevent bleeding from a femoral fracture

97
Q

What’s a normal urine output?

A

1ml/kg/hr (less than 0.5 is concerning)

med (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions