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Specialties > Acute Care > Flashcards

Acute Care Flashcards

1
Q

What are the three components of GCS?

A

Eye opening
Verbal response
Best motor response

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2
Q

Describe eye opening

A

Opens spontaneously
Opens to command
Opens to pain
No response

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3
Q

Describe verbal response

A

Orientated & talking
Confused
Inappropriate words
Incomprehensible sounds
No response

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4
Q

Describe motor response

A

Obeys
Localises to pain
Flexion and withdrawal to pain
Abnormal flexion to pain
Extension to pain
No response

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5
Q

What are the two keys types of head injury?

A

Primary
Secondary

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6
Q

What can cause secondary brain injury?

A

Inflammation
Cerebral hypoperfusion
Increased ICP

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7
Q

How do you calculate cerebral perfusion pressure?

A

MAP - ICP

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8
Q

What is Cushing’s reflex?

A

Hypertension
Bradycardia
Irregular breathing

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9
Q

How do skull base fractures present?

A

Subconjunctival haemorrhage
Bleeding from ear
CSF lead from nose/ear
Panda eye
Battle sign

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10
Q

What are the 4H’s?

A

Hypoxia
Hypovolaemia
Hypothermia
Hypo/hyperkalaemia

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11
Q

What are the 4 T’s?

A

Toxins
Thrombosis
Tamponade
Tension pneumothorax

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12
Q

What drugs can be given in cardiac arrest?

A

Adrenaline every 3-5 minutes
Amiodarone after 3 shocks

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13
Q

Name the four types of shock

A

Cardiogenic
Obstructive
Hypovolaemic
Distributive

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14
Q

What are the causes of cardiogenic shock?

A

MI
Arrhythmia
Cardiomyopathy
Overdose (BB/CCB)

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15
Q

What are the causes of obstructive shock?

A

PE
Tension pneumothorax
Cardiac tamponade

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16
Q

Describe the pathophysiology of obstructive shock

A

Reduced cardiac filling will reduce preload and thus contractility and output
Impaired emptying restricts contractility

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17
Q

What causes hypovolaemic shock?

A

Haemorrhage
Dehydration

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18
Q

Describe the pathophysiology of hypovolaemic shock

A

Decreased circulating volume reduces stroke volume

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19
Q

What causes distributive shock?

A

Sepsis
Anaphylaxis
Neurogenic

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20
Q

Describe the pathophysiology of distributive shock

A

Peripheral vasodilation reduced blood pressure and increased cardiac output

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21
Q

Describe the difference between acute overdose and toxic dose of paracetamol

A

Acute - >4g in last hour
Toxic - >150mg/kg

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22
Q

How soon after consumption can serum paracetamol levels be checked?

A

4 hours

23
Q

How is a paracetamol overdose treated?

A

Acetylcysteine

24
Q

If <8 hours since paracetamol overdose what can be given?

A

Activated charcoal

25
Q

How does an opioid overdose present?

A

Pin point pupils
Respiratory depression
Drowsiness/coma

26
Q

What is the antidotes for opioids?

A

Naloxone

27
Q

How does a benzo overdose present?

A

Ataxia
Dysarthria
Drowsiness/coma

28
Q

What is the antidote for benzo?

A

Flumazenil

29
Q

How does an aspirin overdose present?

A

Tinnitus
Vomiting
Dehydration
Hyperventilation

30
Q

How do you treat an aspirin overdose?

A

Supportive - fluids and bicarbonate infusion

31
Q

How does a beta blocker overdose present?

A

Bradycardia and QT prolongation

32
Q

What is given in a beta blocker overdose?

A

Glucagon

33
Q

How does a salbutamol overdose present?

A

Agitation
Tremor
Tachycardia, palpitations
Hypokalaemia

34
Q

What can be given in a salbutamol overdose?

A

Potassium infusion

35
Q

How does an ethylene glycol overdose present?

A

Ataxia, dysarthria, nausea, vomiting, convulsions, coma
Diagnosed - osmol gap on serum osmolality

36
Q

What are the antidotes to ethylene glycol?

A

Alcohol
Fomepozil

37
Q

What is the main treatment for carbon monoxide poisoing?

A

Oxygen

38
Q

How soon before surgery should warfarin be stopped?

A

5 days

39
Q

In high risk patients what is used when they come off warfarin?

A

Heparin

40
Q

What is classed as high risk in terms of cessation of warfarin?

A

AF, VTE, Metal heart valve, multiple valve replacements

41
Q

In INF is 1.6 or above what must be given

A

Vitamin K

42
Q

What are the three key principles of anaesthesia?

A

Sedation - induction agent e.g propofol, maintenance e.g fluranes
Muscle relaxant - rocuronium, vecuronium, suxamethonium
Pain relief - opioids

43
Q

How are muscle relaxants reversed?

A

Neostigmine - ACh inhibitor

44
Q

What are the key complications of a GA?

A

Bradycardia
Hypotension
Laryngospasm
Malignant hyperthermia
Mendelson Syndrome

45
Q

How is bradycardia mangaged?

A

IV atropine

46
Q

How is hypotension managed?

A

Vasopressors - metarminol/ephedrine

47
Q

How is laryngospasm managed?

A

Severe - suxamethonium

48
Q

How is malignant hyperthermia managed?

A

IV dantrolene and active cooling

49
Q

What is Mendelson Syndrome?

A

Inflammation of the lungs when under GA due to aspiration of stomach acid

50
Q

How is Mendelson Syndrome prevented?

A

Pre-op antacid

51
Q

What is TIVA?

A

Total Intravenous Anaesthetic

52
Q

What is the alternative to TIVA?

A

Use of fluranes

53
Q

What are the two types of muscle relaxant?

A

Depolarising - suxamethonium
Non-depolarising - atracurium/rocurium

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