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4th Year > Acute Care > Flashcards

Acute Care Flashcards

1
Q

MI R/Fs?

A

HTN, Diabetes, hypercholesterolaemia, Smoking FH

If young: cocaine use

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2
Q

MI ECG findings?

A

2mm ST elevation in consecutive chest leads (1-6)

1mm in the limb leads (1-3 & avF)

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3
Q

MI diagnostic criteria?

A

ST elevation in correct leads

Reciprocal changes in opposite leads

New LBBB (W)

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4
Q

O/E someone with a PE?

A

RR will be increased, HR may be increased.

Chest sounds will be normal.

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5
Q

Abdo pain differential?

A
  1. Ectopic pregnancy
  2. abdo aortic aneurysm
  3. Pancreatitis
  4. testicular torsion
  5. hernias (inguinal, femoral and paraumbilical)
  6. Volvulus
  7. Appendicitis
  8. Ruptured ovarian cyst
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6
Q

Chest pain differential?

A
  1. STEMI
  2. NSTEMI
  3. Unstable angina
  4. PE
  5. Aortic dissection
  6. Pericarditis
  7. GORD
  8. Trauma
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7
Q

Headache differential?

A
  1. SAH
  2. Meningitis
  3. Temporal Arteritis
  4. Intracerebral venous thrombosis
  5. Extra dural haem
  6. subdural haem
  7. SOL
  8. Acute closed angle glaucoma
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8
Q

What should you administer with morphine?

A

Ondansetron - antiemetic

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9
Q

What are you really trying to avoid/worst complication of a PE?

A

Cardiac arrest

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10
Q

Precipitating events for DKA?

A

4 I’s

Infection
infarction
Intercurrent medical problems
Insulin lock up (forgot to take)

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11
Q

What are the potassium changes in DKA?

A

Insulin drives potassium into cells so in DKA when resuscitating, need to give K+

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12
Q

Types of Heart Block?

A

1st degree: fixed prolonged PR interval (>5ss)

Mobitz 1: PR interval slowly creeps up and up then a qrs is dropped

Mobitz 2: Fixed PR interval, with occassional dropped beats (these occur in regular patterns i.e. 2:1, 3:1)

Complete: P waves are not associated with QRS at all

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13
Q

What blood test result gives you one of the best predictors of arteritis?

A

ESR (>100)

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14
Q

Normal urine output?

A

> 1ml/kg per hour

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15
Q

Some things that may cause metabolic acidosis?

A

DKA
Poisoning
AKI

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16
Q

What is an anion gap, normal range?

A

Essentially the difference between the bloods cations and anions.

Generally subtract Chloride and bicarb from soidum and potssium (sometimes not included)

10-20 when including K+

8-16 when not

17
Q

Causes of an abnormal anion gap?

A

MUDPILES

M - Methanol
U - Uraemia
D - DKA
P - Paracetamol/antfreeze (propolene glycol)
I - Iron
L - Lactic acidosis
E - Ethanol/ethylene glycol (antifreeze)
S - Salicylates - aspirin
18
Q

Changes to the WCC, Neutrophils and temp in bacterial and viral infections/

A

Neutropaenia in Viral
Decreased WCC in Viral

Increased WCC in bacterial

Spiking temp in both, but maybe more in Viral

19
Q

Causes of a raised urea:creatinine ratio?

A

Dehydration
GI haemorrhage
Raised protein diet

20
Q

Causes of a lowered urea:creatinine ratio?

A

Liver dysfunction
SIADH
Malnutrition

21
Q

Unstable angina presentation?

A

Comes on rapidly - crescendo angina (as in suddenly getting worse)

22
Q

What may you see on a CXR in a PE?

A

Not much really:

You may see blacker lungs (radiolucent)
Pleural effusion
Infarct (wedge shaped)

23
Q

ECG changes in PE?

A

S wave in T1
RBBB
Inverted T waves
Sinus tachy

24
Q

What may cause people to have hypoglycaemia in diabetes?

A

They have probably taken too much insulin

25
Q

General rules for fluids?

A

Hartmans for resus

If risk of hyperkalaemia then normal saline

26
Q

What are the 4 H’s and 4 T’s as reversible causes of cardiac arrest?

A

H’s

Hypokalaemia
Hyperkalaemia
Hypoxia
Hypovolaemia

T’s

Tension pneumothorax
Tamponade
Toxins
Thromboembolic

27
Q

Clostridium perfringes causes what?

A

Gas gangrene

28
Q

SIADH presentation?

A

Hyponatraemia

29
Q

Presentation of an adrenal crisis?

A 
Malaise.
Fatigue.
Nausea or vomiting.
Abdominal pain.
Low-grade fever.
Muscle pains and cramps.
These are followed by dehydration, leading to hypotension and hypovolaemic shock.

There may be confusion. Loss of consciousness and coma may occur.

Hyponatraemia
Hyperkalaemia
Hypoglycaemia

30
Q

Sepsis six?

A

3 in 3 out

In

  • Broad spectrum Abx
  • O2
  • Fluid bolus 500ml-1L

Out

  • Blood cultures
  • ABG
  • Urine output

4th Year (15 decks)

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