Acute Care

Question 1

What do you give to a patient whose heart rate is low - Medication?

Answer 1

Atropine

Question 2

What is the long term treatment of bradycardia?

Answer 2

Pacemaker

Question 3

What would you use for a patient with tachycardia?

Answer 3

Beta-blockers

Question 4

What are 3 potential triggers of sinus tachycardia?

Answer 4

Alcohol
Caffeine
Nicotine

Question 5

What to give to a patient to increase contractility of their heart?

Answer 5

Adrenaline
Noradrenaline
Positive Inotropes

Question 6

What could you give to decrease heart contractility?

Answer 6

Labetalol - cardiac specific beta blocker

Question 7

What will increase systolic and diastolic BP and preload?

Answer 7

FLUIDS

Question 8

What drug would be used to decrease systolic BP?

Answer 8

Calcium Channel Blocker

Question 9

What could be used to decrease diastolic BP and preload?

Answer 9

Diuretics

Question 10

What are the 3 main brain bleeds?

Answer 10

Subarachnoid
Subdural
Extradural

Question 11

What is the common cause of a subarachnoid haemorrhage?

And what is the treatment?

Answer 11

A ruptured brain aneurysm

Coil or clip the aneurysm

Question 12

Subdural haemorrhages can be acute or chronic. How would you diagnose a subdural haemorrhage on a CT brain.

Answer 12

Banana shape.
Acute - hyperdense - lighter
Chronic - Hypodense - darker

Question 13

What is the common cause of chronic subdural haemorrhage?

Answer 13

Older person on anti-coagulant who has had a minor fall or head injury or a alcoholic.

Question 14

What is the management for subdural haematoma? (large, small, acute and chronic)

Answer 14

If small and asymptomatic then would want to observe and treat conservatively.

If larger, symptomatic or has midline shift then want to do surgery.
If chronic then want to do burr holes to drain.
If acute want to do a craniotomy.

Question 15

What is the common cause of a acute subdural haematoma?

Answer 15

serious high speed head injury

e.g. car crash, fall or violent assault

Question 16

On a CT head there is a haematoma the shape of a lemon. What is the name of this?

Answer 16

Extradural haematoma

Question 17

What is the main cause of extradural haematoma?

Answer 17

Skull fracture - trauma

Question 18

What artery is most commonly responsible for a extradural haematoma?

Answer 18

Middle meningeal artery

Question 19

What is the management for a extradural haematoma?

Answer 19

Initially stabilise the patient

Burr holes or craniotomy dependent on severity and time scale of bleed.

Question 20

What is the adrenaline dose for anaphylaxis in a adult?

Answer 20

1:1000 concentration

500 mcg IM (0.5ml)

Question 21

What is the adrenaline dose for anaphylaxis in a child between 6-12?

Answer 21

1:1000

300mcg (0.3ml)

Question 22

What is the adrenaline dose for anaphylaxis in a child between 6 years to 6 months?

Answer 22

1:1000

150mcg (0.15 ml)

Question 23

What is the adrenaline dose for anaphylaxis in a child under 6 months old?

Answer 23

1:1000

100-150mcg (0.1-0.15 ml)

Question 24

What is the adrenaline dose for cardiac arrest?

Answer 24

1:10000
100mcg/ml
10ml to give 1mg

Question 25

What is the sepsis 6?

Answer 25

``` Give fluids Give oxygen Give IV antibiotics Take a urine sample Take a lactate Take blood cultures ```

Question 26

What are the 5 potential causes for shock?

Answer 26

``` Cardiogenic Septic Neurogenic Hypovolaemia Anaphylactic ```

Question 27

What are the potential causes of cardiorespiratory arrest? | 4H's and 4T's

Answer 27

Hypoxia Hypovolaemia Hyperkalaemia/Hypokalaemia Hypothermia Tension Pneumothorax Cardiac Tamponade Drug toxicity and therapeutics Thromboembolism

Question 28

What drugs should be stopped in AKI as they may worsen renal function? NAAAD?

Answer 28

``` NSAID (except aspirin at 75mg) Aminoglycosides ACE inhibitor ARB Diuretics ```

Question 29

What drugs should be stopped in AKI due to increased risk of toxicity? (3)

Answer 29

Lithium Metformin Digoxin

Question 30

What ECG changes are shows with Hyperkalaemia?

Answer 30

Tented T waves Loss of P waves broad QRS complexes Sinusoidal wave pattern

Question 31

What can be given to manage hyperkalaemia?

Answer 31

Calcium gluconate | Dextrose/insulin

Question 32

What ECG changes are shown in hypokalaemia?

Answer 32

``` U waves Small or absent T waves Prolonged PR interval ST depression Long QT ```