ACC

Question 1

What is the MOA for neuromuscular blocking drugs REVERSAL AGENTS

Answer 1

Acetylcholinesterase inhibitor

Inhibit break down -> more Ach -> compete for post synaptic receptors -> impulse passes

Question 2

Where to LA work in the cell

Answer 2

Block Na channels so stop action potential

Question 3

Overdose associated with tinnitus

Answer 3

Asprin

Question 4

ABG following aspirin OD

Answer 4

Initially respiratory alkalosis then metabolic acidosis

Question 5

Initial and then long term management of an ischaemic stroke in a pt with af

Answer 5

2 weeks of aspirin the DOAC

Question 6

Management of ischaemic stroke

Answer 6

Aspirin (2 weeks) +/- alteplase
Clopidogrel (DOAC if AF) mono therapy
Statin (not started immediately)

Question 7

CK for rhabdomyolysis

Answer 7

> 10000

Question 8

Treatment of subarachnoid haemorrhage

Answer 8

?coils

Nifedipine for prevention against vasospasam

Question 9

Blood pressure support in acute heart failure

Answer 9

Inotrope

Such as dobutamine or ephedrine

Question 10

What type of drug is noradrenaline

Answer 10

VASOPRESSOR (some inotrope action)

Question 11

What types of drugs are phenylephrine and metaraminol

Answer 11

Vasopressors

Question 12

5 CXR signs of HF

Answer 12

Cardiomegaly
Venous diversion

Pulmonary effusion
Fluid in interlobular fissuers
Kerley B lines (fluid in septal lines)

Question 13

Would you use an inotrope or vasopressor in HF

Answer 13

Inotrope as cardiac issue

Question 14

What is NIHSS

Answer 14

Likely clinical outcome in a person having a stroke

score >26 seen as a contraindication to thrombolysis

Question 15

Score that should be accessed at TIA clinic

Answer 15

ABCD2
Likelyhood of going onto have a stroke
Confusion over if recognised by NICE

Question 16

Imaging of choice in TIA

Answer 16

MRI

Question 17

When would a TIA patient be admitted

Answer 17

Crescendo TIA
Severe stenosis
Vunerable (no one to watch them)
Anticoagulated

Question 18

BP control guidelines in active stroke

Answer 18

Ischaemia: almost never except above 185 and going for thrombolysis

Bleed: above 150, aim for 140 but reach it slowly

Question 19

Only part of heamostatis that should be strictly controlled in a ischaemic stroke

Answer 19

BM 4-11

BP only if >185 and thrombolysis

Question 20

How is the majority of heat lost from the body

Answer 20

Radiation (40%)

Question 21

First change in anaphylaxis

Answer 21

Hypotension