Brainscape's Knowledge GenomeTM

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


See full index

Year 4 > Acute 2 > Flashcards

Acute 2 Flashcards

1
Q

FFP?

A
  • All factor in low concentration
  • Good in general bleeds or alcoholics
  • Universal FFP donor is AB+ (opposite of normal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cryoprecipitate?

A
  • Lots of factor 8 and fibrinogen
  • Good for DIC
  • Used in haemophilia A emergency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Prothrombin complex?

A
  • Antiwarfarin
  • Contains factors 10, 9, 7 and 2
  • Give with vit K
  • Also good in factor 10a inhibitors (DOACs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What needs to be given with VWF concentrate?

A

Desmopressin

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

Platelets?

A
  • Give to patients with thrombocytopaenia (<30) and significant bleed
  • Threshold <100 when bleeding at severe sites like CNS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the process of warfarin reversal?

A

1) Stop warfarin
2) Give vit K
3) Give FFP
4) Give prothrombin complex

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

What is the process of warfarin reversal?

A

1) Stop warfarin
2) Give vit K
3) Give FFP
4) Give hum prothrombin complex

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

What is part of the primary survey in trauma?

A
  • A-E as normal
  • FAST scan
  • CT polytrauma within 30mins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the signs of a BSF?

A
  • Panda eyes
  • Battle’s sign
  • CSF rhinorrhoea (suggests cribriform fracture) or otorrhoea
  • Retinal haemorrhage
  • Haemotympanum
  • Facial nerve palsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is in an AMPLE history?

A
  • Allergiess
  • Medications
  • PMH and pregnancy
  • Last meal
  • Events of trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most commonly injured organ in blunt injury?

A

Spleen

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

What is the most commonly injured organ in GSW?

A

Small intestine

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

What is the most commonly injured organ in children?

A

Kidneys

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

What can be done in raised ICP in acute setting?

A
  • Give mannitol (osmotic diuretic)
  • Controlled hyperventialtion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some acute life threatening MSK disorders?

A
  • Long bone fracture
  • Arterial haemorrhage
  • Traumatic amputation
  • Crush injury (rhabdomyolysis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some cute limb threatening injuries?

A
  • Complex open fracture
  • Degloving
  • Severe vascular injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the lethal 6?

A
  • Airway obstruction
  • Cardiac tamponade
  • Tension pneumothorax
  • Open pneumothorax
  • Massive haemothorax
  • Flail chest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the hidden 6?

A
  • Aortic injury
  • Tracheobronchial injury
  • Oesophageal injury
  • Pulmonary contusion
  • Cardiac contusion
  • Diaphragmatic hernia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If airway can’t be secured what should you do?

A

Cricothyroidotomy

20
Q

What is Beck’s triad of cardiac tamponade?

A
  • Raised JVP
  • Hypotension
  • Muffled heart sounds
  • (also pulsus paradoxus)
21
Q

What is the investigation for cardiac tamponade?

A
  • FAST scan usually
  • Echo is gold standard
22
Q

What are some signs of cardiac tamponade?

A
  • Electrical alternans on ECG
  • Absent Y descent in JVP
23
Q

Management of tamponade in peri-arrests?

A

Thoracotomy or pericardiocentesis

24
Q

Management of tension pneumothorax?

A

1) 2 wide bore cannulae in 2nd IC space mid-clavicular line
2) Insert chest drain in triangle of safety (4-6 IC space, lateral edge of lat dorsi and pec major)

25
Q

Management of open pneumothorax?

A

1) High flow oxygen and dressing with one side open
2) Chest drain

26
Q

How does massive haemothorax present compared to tension pneumothorax?

A

Presents the same except:
- Hypovolaemic
- Collapsed neck veins (distended in tension)
- Dull percussion (hyperreasonant in tension)
- White on CXR (black in tension)

27
Q

When does a haemothorax become massive?

A

When a third of blood volume is lost (approx 1500ml)

28
Q

Management of massive haemothorax?

A
  • Restore circulating volume before inserting drain (will cause CV collapse)
  • Insert chest drain (can dislodge a clot)
  • Thoracotomy if V large (>1500ml comes from chest drain) or a clot
29
Q

What are the complications of flail chest?

A
  • Pulmonary contusion (mainly)
  • Can cause pneumo- or haemothorax
30
Q

Management of flail chest?

A
  • Good pain management
  • Pain worsens respirations which worsens the problem
31
Q

How does aortic injury occur?

A

Shearing forces from blunt deceleration (e.g. RTA/fall)

32
Q

How does aortic injury present?

A

Similar to dissection

33
Q

What are the 2 main imaging modalities for aortic injury?

A
  • Contrast enhanced CT is best
  • X-ray
34
Q

What will an X-ray show in aortic injury?

A
  • Widened mediastinum
  • Loss of aortic knuckle
  • Filling of AP window
  • Elevated right main bronchus and depressed left one
  • Tracheal deviation
35
Q

What is the management of aortic injury?

A
  • Surgical graft repair
  • Permissive hypotension
36
Q

What are the signs of a tracheobronchial injury?

A
  • Hoarse voice
  • Haemoptysis
  • Surgical emphysema in neck, chest wall and mediastinum
37
Q

How is tracheobronchial injury diagnosed?

A

Bronchoscopy

38
Q

Management of tracheobronchial injury?

A
  • Airway protection
  • Surgical repair
39
Q

When should you consider cardiac contusion?

A

In sternal fracture (heart compression)

40
Q

What are the signs of cardiac contusion?

A

Tissue behaves like infarcted tissue:
- ST elevation
- Raised troponin
- Same complications ass MI

41
Q

What will a chest X-ray show in pulmonary contusion?

A

Serial CXR shows increased patchy consolidation

42
Q

Management of pulmonary contusion?

A

Supportive

43
Q

What does chest X-ray show in diaphragmatic tear?

A

Loops of bowel in chest or gastric bubble in thorax

44
Q

Management of diaphragmatic tear?

A

Surgical repair and gastric tube

45
Q

Signs of ARDS?

A
  • Rapid onset severe hypoxia
  • Think with unexplained tachycardia and hypoxemia post trauma
46
Q

Causes of ARDS?

A
  • 48 hours post trauma especially chest (pulm contusion 50% get this)
  • Sepsis (main cause)
  • Other - pneumonia, aspiration, pancreatitis, fat embolism, inhalation, transfusion and covid
47
Q

Management of ARDS?

A
  • ICU -> ventilation -> PEEP
  • Proning
  • Negative fluid balance - diuretics and fluid restriction
  • Reduce pulm pressure -> Nitrous oxide and prostacyclins

Year 4 (16 decks)

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