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4th year > Acute care > Flashcards

Acute care Flashcards

1
Q

How long before surgery should aspirin be stopped?

A
  • 7 days prior
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2
Q

Normal fasting time for surgery?

A
  • 6hrs
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3
Q

How can warfarin for heart valves be bridged for surgery?

A
  • stop warfarin
  • LMWH injections
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4
Q

What must be done regarding diabetic medications for surgery?

A
  • normal up till day of surgery
  • first on surgical list
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5
Q

Define toxidrome?

A
  • toxin + syndrome
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6
Q

Patient presents with dry mouth, dilated pupils, increased HR. What toxidrome?

A
  • anticholinergic
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7
Q

Patient presents with increased saliva, blurry vision, pinpoint pupils. What toxidrome?

A
  • cholinergic
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8
Q

Slowed heart rate, slowed response rate, pin point pupils?

A
  • opioid
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9
Q

Increased heart rate, increased respiratory rate, dilated pupils?

A
  • sympathomimetic
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10
Q

Decreased HR and resp rate. Cold temp. What toxidrome?

A
  • sedative
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11
Q

What symptom may aspirin poisoning present with?

A
  • tinnitus
  • vomiting
  • double vision
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12
Q

What is the toxic metabolite of a paracetamol overdose?

A
  • NAPQI
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13
Q

When should bloods for a paracetamol overdose be done?

A
  • 4hrs post ingestion
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14
Q

What may mimic as an MI on ECG in a young person?

A
  • cocaine usage
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15
Q

What is given in a paracetamol overdose?

A
  • N-acetylcystine
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16
Q

Antidote for tricyclic antidepressants?

A
  • sodium bicarbonate
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17
Q

Antidote for beta blockers?

18
Q

Antidote for car defrost

19
Q

antidote for opioids

20
Q

antidote for benzodiazepines

A
  • flumazenil
21
Q

When should a synchronised DC shock be given on ECG and why

A
  • on the QRS complex
  • avoid over T wave as may cause VF
22
Q

Side effect of N-acetylsystine

A
  • anaphylactic like side effects
23
Q

Treatment of ventricular tachycardia

A
  • IV Amiodarone
  • DC cardioversion
24
Q

Treatment of SVT

A
  • Vagal manoeuvres
  • IV Adenosine
25
How does adenosine work?
- Blocks the AV node temporarily
26
What are the harmful effects of under-treated pain
-tachycardia - hypertension - MI - Decreased lung volumes - Anxiety and fear
27
What is the pain assessment scored from?
- 0-3 0 = no pain at rest or movement 1 = no pain at rest, slight on movement 2 = intermittent at rest, moderate on moving 3 = continuous at rest, severe on movement
28
What pain killers should be avoided in renal failure?
- avoid NSAIDs
29
How does paracetamol work?
- inhibits prostaglandin synthesis in the CNS
30
How does NSAIDs work?
- inhibit the enzyme COX-1
31
What are the contraindications for NSAIDs?
- GI bleed - peptic ulcer - coagulopathy - renal impairment
32
What must you ask asthmatics before giving NSAIDs?
- ask about NSAID sensitivity - especially if has nasal polyps
33
Where is morphine metabolised?
- metabolised in the liver - excreted by the kidneys
34
What drugs are good for neuropathic pain?
- anticonvulsants and antidepressants
35
What is the typical dose for PCA?
- 1mg morphine with a 5 min lockout - max 12mg morphine/hr - takes 45 mins to receive 20mg morhpine
36
How long does it take for the patient to receive 20mg morphine PCA?
- 45mins
37
What is the antiemetic given in trauma?
- ondansetron ( caution due to prolonged QT)
38
When is dexamethasone given?
- chemotherapy patient, anti-emetic
39
Side effects of hyoscine?
- anti-cholinergic - tachycardia and dry mouth
40
What antiseptic can be used in Parkinsons and why?
- domperidone - doesn't cross the blood brain barrier
41
What makes up Cushing's triad?
- Bradycardia - irregular breathing - hypertension
42
Protocol for CT head within 1hr?
- GCS less than 13 - GCS less than 15, 2hrs post injury - suspected base of skull fracture - neurological deficit - more than 1 episode of vomiting - post trauma seizure

4th year (4 decks)

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