Brainscape's Knowledge GenomeTM

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


See full index

Phase 3B > ACC > Flashcards

ACC Flashcards

1
Q

What equipment may be required when preparing for the arrival of a seizing patient?

A 
Airway adjuncts (nasopharyngeal and oropharyngeal airways)
ET tubes
Suction
Oxygen
Cannula bloods and fluid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the initial medical treatment of the seizing patient?

A

Buccal midazolam at home
PR 10mg diazepam
IV lorazepam

Maximum of two doses, including pre-hospital treatment

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

What is the second line treatment of status epilepticus if benzodiazepines fail to control cease seizures?

A

IV phenytoin bolus

Could also use Keppra (levotiracetam)

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

What should be checked before administering phenytoin?

A

Check the patient is not in respiratory depression

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

If phenytoin does not work, what is the next step in management?

A

Call anaesthetist for rapid sequence induction with sodium thiopentol

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

Give five causes of status epilepticus.

A 
Hypoglycaemia
Meningitis
SAH and brain injury
Eclampsia
Alcohol/drug withdrawal/overdose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some complications of status epilepticus?

A 
Aspiration
Hypoxia and brain damage
Death from airway occlusion
Rhabdomyolysis
Metabolic lactic acidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are features of early alcohol withdrawal?

A

Shakiness
Insomnia
Nausea
Tachycardia

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

What is delirium tremens and how is it treated?

A

Acute confusional state, tremor, and vivid/disturbing abnormal perceptions secondary to alcohol withdrawal

Chlordiazepoxide

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

How can you assess alcohol dependence?

A

AUDIT

CAGE

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

What are five non-ACS causes of chest pain?

A 
Pericarditis
Aortic dissection
Oesophageal spasm
Pulmonary embolism
Costochondritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which troponin is more specific?

A

Troponin I > C

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

When do troponins peak after myocardial infarction?

A

12-24 hours

Therefore tested 6-12 hours after pain

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

What is the diagnostic criteria for MI?

A

2/3 of:

Consistent history
Raised enzymes
Abnormal ECG

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

What other investigations are required in MI?

A

CXR and/or echo
Angiogram
Myoview

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

How can you tell the difference between anterior ischaemia and posterior infarction (ST depression in anterior leads)?

A

Do posterior leads

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

What is the subsequent management of an ACS patient?

A

PCI within 90 minutes of diagnosis, if unavailable IV alteplase with heparin

Glycoprotein IIb/IIIa inhibitor (abciximab, tirofiban, eptifibatide)

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

What is the most important test to do for the unconscious patient?

A

Blood glucose

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

Which methods can be used for applying painful stimuli?

A

Sternal rub
Supraorbital pressure
Trapezius squeeze

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

What are 6 causes of decreased consciousness?

A 
Hypoglycaemia
Sepsis
Addisonian crisis
Meningitis
Cardiovascular syncope (tamponade, arrhythmias)
PE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the treatment of an opiate overdose?

A

IV naloxone 0.4-2mg adult

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

What is found on examination in opiate overdose?

A

Pinpoint pupils
Decreased respiratory rate
Hypotension
Tachycardia

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

What does blood in the external auditory canal suggest and what measures should be taken?

A

Fracture of base of the skull

Stabilise C-spine and CT scan

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

What is the ATMIST mnemonic for trauma?

A 
Age
Timing (incident and arrival)
Mechanism
Injuries
Signs
Treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which team members are in the trauma team?

A

Anaesthetist
Radiologist
General surgery
Trauma and orthopaedics

26
Q

What additional equipment is required in a trauma call?

A

Pelvic binder, collar and block, trauma mattress

27
Q

What is a good indicator of blood volume and whether the pelvic fractures are stable or not?

A

Blood pressure

28
Q

What causes tachycardia in traumas?

A 
Shock
Collapsed lung
Bleeding from fractures
Pain
Anxiety
29
Q

What is a FAST scan?

A

Looks for free fluid around abdominal organs and cardiac tamponade

30
Q

What is the pathophysiology of a tension pneumothorax?

A

Injury to lung, inhalation causes indrawing to lungs. On exhalation, the injury (valve) closes so air cannot escape.

31
Q

How does a tension pneumothorax cause cardiac arrest?

A

Pressure on the mediastinum and vena cava reduces cardiac output and preload resulting in hypotension and tachycardia

32
Q

What are signs of tension pneumothorax?

A

Reduced breath sounds, tracheal deviation, apex beat deviation, resp distress, cyanosis

33
Q

What is the treatment of tension pneumothorax?

A

Needle decompression large bore cannula 2nd IC space, mid clavicular line, above the rib to avoid neurovascular bundle

Followed by chest drain in 5th IC space mid clavicular line

34
Q

What is ARDS?

A

Non-cardiogenic pulmonary oedema leads to respiratory failure

35
Q

What are the signs of ARDS?

A

Cyanosis
Bilateral fine inspiratory crackles
Peripheral vasodilation

36
Q

What is the treatment of ARDS?

A

CPAP, unless mechanical ventilation is required

37
Q

What is permissive hypotensive resuscitation?

A

Intentional lowering of blood pressure during fluid resuscitation until definitive surgical control of bleeding occurs

38
Q

What is contained in a massive transfusion pack?

A

Platelets, FFP, clotting factors

39
Q

What type of hypersensitivity reaction is anaphylaxis?

A

Type 1

Rapid release of stored histamine

40
Q

Give five symptoms of anaphylaxis from different body systems.

A 
Hypotension
Bronchospasm (wheeze)
Laryngeal oedema (stridor)
Vomiting
Urticarial rash
41
Q

What is the treatment of an acute allergic reaction?

A

PO/IV chlorphenamine
Fluids
Oxygen

42
Q

What is the treatment of anaphylaxis?

A

IM adrenaline 500mcg
Hydrocortisone IV or PO
Prednisolone

Can be repeated after 5 minutes

IV adrenaline after two attempts

43
Q

How long does it take for paracetamol to reach plasma concentration after ingestion?

A

One hour

44
Q

When does hepatic toxicity of paracetamol overdose occur?

A

24-72h

45
Q

What is the pathophysiology of paracetamol overdose?

A

Metabolism of paracetamol results in toxic metabolite NAPQI.

NAPQI is inactivated by glutathione.

When glutathione stores are depleted to <30%, NAPQI leads to necrosis of the liver and kidney tubules

46
Q

When is blood taken in paracetamol overdose?

A

4 hours post overdose - indicates whether liver damage will occur

47
Q

Which patients are at higher risk of liver damage?

A

Malnutrition
HIV positive
Alcohol or other liver disease

48
Q

Which patients should receive N-acetyl cysteine?

A

Timed plasma paracetamol level plotted above the graph

Any doubt about timing of ingestion or a staggered overdose

49
Q

What is NAC?

A

Glutathione analogue

50
Q

Name three side effects of a spinal anaesthetic.

A

Hypotension
Low pressure headache (better when lay down)
High spinal block (limb/respiratory weakness)

51
Q

Which airway adjunct reduces the risk of aspiration of stomach contents into the lungs?

A

Tracheal tube

52
Q

For a short operation in a diabetic patient, what should be done about their medications?

A

Omit sulfonylureas
Continue metformin
Usually depends on their blood glucose whether they will need a sliding scale

53
Q

What are the indications for a sliding scale in surgery for diabetics?

What are the fluids of choice for the insulin infusion?

A

On insulin
BM>12mmol/L

<14 run in 10% dextrose; BM>14 run in saline

54
Q

What is a risk of emergency surgery from an anaesthetic point of view?

A

Increased aspiration risk

55
Q

In DKA, what rate of insulin is required after fluid resuscitation?

A

Fixed rate, as background level of insulin is required to suppress ketosis
0.1IU/kg/hr

56
Q

Which coagulation pathways are represented by PT and APTT?

A

PT: extrinsic –> warfarin
APTT: intrinsic –> heparins and NOACs

57
Q

What are five differentials for hypoglycaemia?

A 
Addison's disease
Undiagnosed T1DM
Paracetamol overdose
Alcohol consumption
Pituitary failure
Insulinoma
58
Q

What are the normal agents for rapid sequence induction (non fitting patient)?

A

Suxamethonium/rocuronium

With propofol

59
Q

What is the treatment of DIC?

A

Cryoprecipitate

60
Q

What are the indications for dialysis?

A 
Acidosis
Electrolytes e.g. hyperkalaemia
Intoxication
Overload
Uraemia

Phase 3B (20 decks)

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