ABCDE

Question 1

What is the treatment for CAP?

Answer 1

0-2 = Mild/mod = IV or PO Amoxicillin for 5 days
3-5 = Severe = IV Co-amox & PO Doxy for 5 days

Question 2

What is involved in the ‘sepsis six’ protocol?

Answer 2

Give 3 – Fluids, Oxygen, Antibiotics
Take 3 – Cultures, urine output, lactate

Question 3

Which antibiotics should be used for chest sepsis?

Answer 3

IV Co-amox and PO Doxy

Question 4

What is the treatment for meningitis?

Answer 4

Ceftriaxone + Dexamethasone (+ Amox if > 60 or immunocompromised)

Question 5

What is the treatment for urosepsis?

Answer 5

IV Amox & Gent

Question 6

What is the empirical Tx for intra-abdominal sepsis?

Answer 6

IV Amox, Met and Gent

Question 7

How does management of STEMI differ from NSTEMI/unstable angina?

Answer 7

STEMI - consider PCI
NSTEMI/unstable angina - PCI guided by GRACE score

Question 8

What is the time window for PCI?

Answer 8

if available within 2 hours of assessment and 12 hours of symptom onset

Question 9

NSTEMI with low risk GRACE - what is the management?

Answer 9

Medical

Question 10

NSTEMI high GRACE score - what is the management?

Answer 10

Angiography +/- PCI

Question 11

Which medications may be used in ACS?

Answer 11

o Morphine
o Oxygen (if hypoxic)
o Nitrates - GTN
o Aspirin 300mg
o Ticagrelor (not before PCI decision)

Question 12

How should DKA be managed?

Answer 12

o Ask for protocol!!!
o Usually IV fluid & insulin infusion until < 14 mmol/l

Question 13

What is the immediate management of hyperkalaemia?

Answer 13

o 10mls 10% calcium gluconate IV
o Insulin/dextrose infusion

Question 14

What is the most important step in managing stroke?

Answer 14

CT head to rule out bleed

Question 15

What are the definitive Tx options for acute stroke?

Answer 15

Thrombolysis and Thrombectomy

Question 16

Which investigation can be used to assess for suitability of thrombectomy?

Answer 16

CT contrast angiography

Question 17

What is the time limit for thrombolysis?

Answer 17

4.5 hours

Question 18

What is the usual time limit for thrombectomy?

Answer 18

6 hours

Question 19

What BM suggests hypoglycaemia?

Answer 19

< 4 mmol/l

Question 20

How should hypoglycaemia be managed if the patient is fully conscious and able to swallow?

Answer 20

Fruit juice or glucotabs

Question 21

How should hypoglycaemia be managed if the patient is semi-conscious?

Answer 21

Glucogel

Question 22

How should hypoglycaemia be managed in an unconscious patient?

Answer 22

IM 1mg Glucagon or 10% dextrose IV

Question 23

What should be given in hypoglycaemia once BM has returned to normal?

Answer 23

Long-acting carbohydrate eg. slice of bread

Question 24

What is meant by status epilepticus?

Answer 24

Seizure lasting > 5m or 3 in one hour

Question 25

How should status epilepticus be managed?

Answer 25

Community – 10mg buccal midazolam or PR diazepam
If IV access – IV 4mg lorazepam

Question 26

How should pre-eclampsia be managed?

Answer 26

Emergency secondary care assessment
In hospital, may get anti-hypertensive, MgSO4 and steroids

Question 27

What is the management for AF?

Answer 27

Rate control - beta-blocker or diltiazem

Question 28

What is the management for SVT?

Answer 28

Vagal manoevres –> Adenosine 6mg bolus

Question 29

What is the management for opioid overdose?

Answer 29

Naloxone 400mcg IM

Question 30

What is the immediate management for tension pneumothorax?

Answer 30

needle compression in 2nd IC space, mid-clavicular line

Question 31

What is the management for acute asthma?

Answer 31

OSHITMAN - Oxygen, Salbutamol, Ipratropium, Theophylline, Magnesium, Anaesthetics

Question 32

What is the management for acute COPD?

Answer 32

iSOAP - Ipratropium, Salbutamol, Oxygen, Antibiotics, Prednisolone