Acute Care

Question 1

What is meant by the anion gap?

Answer 1

The differencebetween primary cations (Na+ and K+) and anions (Cl- and HCO3-) The anion gap allows us to calculate the level of unmeasured ions (these are mostly anions)

Question 2

What is meant by a high anion gap?

Answer 2

There is lots of acid being produced by the body. This can be causded by:
Methanol
Uraemia (CKD)
Diabetic ketoacidosis 
Paracetamol
Infection
Lactic acidosis 
Ethanol 
Salicylate

Question 3

What is emant by a normal anion gap?

Answer 3

If patients have a normal aniongap it means that the main problem is the drop in HCO3. This is then compensated for by increasing chloride levels. This can be caused by:

1. Gastrointestinal loss (diarrhea)
2. Renal tubular necrosis
3. Addisons disease

Question 4

What causes a low anion gap?

Answer 4

Hypoalbuminaemia. Albumin is negatively charged and its loss results in the retention of other negatively charged ions such as chloride and bicarbonqte.

Question 5

What are the 5 main types of shock?

Answer 5

Septic 
Haemorrhagic 
Neurogenic 
Cardiogenic
Anaphylactic

Question 6

What is septic shock?

Answer 6

Infection + SIRS 
Criteria of SIRS is:
Temp outside 36 - 38
HR over 90 
RR over 20
WBC over 12000 or less than 4000

Question 7

What systolic BP is needed to generate a femoral pulse?

Answer 7

65

Question 8

What is the main cause of cardiogenic shock?

Answer 8

Ischeamic heart disease

Direct myocardial trauma

Question 9

What is spinal shock?

Answer 9

Loss of sympathetic outflow results in hypotension and bradycardia

Question 10

What is the becks triad for cardiac tamponade?

Answer 10

Hypotension
Muffled heart sounds
Raised JVP