ACC Flashcards
in a presentation of diffuse abdominal pain consider … by looking for …
mesenteric ischaemia; AF
cushing’s triad of raised ICP
Increased blood pressure, bradycardia and irregular breathing
if on carbimazole be aware of
sepsis (BM suppression)
biochemical picture of hyperaldosteronism (Conn’s syndrome)
hypernatraemia + hypokalaemia with normal renal function
note on prescribing for px on PCA post-op
Do NOT prescribe to someone on PCA
how much opioid to prescribe a px who had epidural
Epidural infusions contain fentanyl - NO further opioids
malignant hyperthermia presentation & mx
(disorder of Ca metabolism)
rigidity, tachycardia, flushing, apparent myoglobinuria (with accompanying renal dysfunction) and a high creatine kinase (indicating rhabdomyolysis). hyperthermia is actually a late sign in this condition
increase in end-tidal pCO2
stop triggering agent & Dantrolene (ryanodine receptor antagonist // inhibits Ca release –> muscle relaxation)
Which antihypertensive drug should be avoided with an Epipen?
labetalol
definitive intervention for near-fatal asthma
mechanical ventilation
how much adrenaline in resuscitation
1mg as 10ml in 1:10,000
opioid withdrawal symptoms
flu-like symptoms (e.g., rhinorrhea, chills, diaphoresis, piloerection, and myalgias), gastrointestinal symptoms (e.g., nausea, vomiting, abdominal pain, and diarrhea), sympathetic hyperactivity (e.g., mydriasis, tachycardia, hypertension, and muscle cramps), and central nervous system stimulation (e.g., insomnia, irritability, anxiety, agitation, aggression, and yawning)
class of atropine
anticholinergic
(isoprenaline is a b-agonist)
effect of intubation, ventilation & CPAP on pneumothorax & how to mitigate
expand it –> chest drain first
most common finding in px developing anaphylactic reaction
hypotension
clue of anaphylaxis following intubation
difficulty hand ventilating due to bronchospasm
how is adequate filling (pre-load) measured in septic shock
central venous pressure
volume of circulating blood & significant blood loss definition
70ml/kg // >20%
most common cause of heat loss during surgery and how to minimise it
radiation - heat blanket
(conductionleast common)
operative factor associated with precipitation of sickle cell
tourniquet use
rapid correction of hyponatraemia may cause
permanent neurological disability
rapid correction of hyponatraemia may cause
permanent neurological disability
symptoms of lacrimation, salivation, vomiting, diarrhoea should make you think
autonomic (parasympathetic) stimulation
something is inhibiting acetylcholinesterase (organophosphoates/phosphoric acid) –> xs acetylcholine –> reverse of anticholinergic (eg atropine)
LA used for small wound closures
1-2mL 1% lidocaine
what are end arteries? do we use adrenaline with LA on areas of end arteries
eg digital, nasal & penile arteries
NO adrenaline –> vasoconstriction = necrosis
most comfortable method of immobilising the arm (useful when immobilising for pain relief)
broad arm sling
never change T1DM px insulin regimen without …
specialist review
if u see carbimazole think
bone marrow suppression –> BS abx
Ix if presenting with seizure
CT head, FBC, U&Es, Serum calcium, LFTs, ABG, Blood glucose, Urine tox screen
anesthetic agent used for GA to terminate seizures
Propofol or thiopental
bedside Ix for dissection
blood pressure difference of >20mmHg
defib can be used for
VF // pulseless VT
if px weight is less than 50kg in terms of having specific symptoms always consider
paracetamol toxicity/overdose (limit is 2g/day instead of 4)
orbital cellulitis abx if not co-amoxiclav
clindamycin with metronidazole
contraindications organ donation
active cancer // +ve HIV test
raised ICP tx
head elavation 30
IV mannitol
controlled hyperventilation
remove some CSF
diabetes meds to omit before surgery
hypo agents (SGLT2 inhibitors - flozins & gliclazide)
what can affect MAC
opioid increase it
age decrease it
wet, wobbly and wacky (weird) mx
normal pressure hydrocephalus (shunt)
