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Year 4 > Acute Care > Flashcards

Acute Care Flashcards

1
Q

One essential investigation for chest pain

A

ECG

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2
Q

Indications for a CT chest (4)

A

Large PE
Aortic Dissection
Oesophageal Rupture
Major Trauma

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3
Q

Scoring System in PE

A

Well’s Scoring System

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4
Q

Three characteristics of acute pain

A

Sudden onset
Known cause
Usually responds well to analgesics

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5
Q

Oxygen taken in per minute (70kg man)

A

250ml/min

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6
Q

Triad of anaesthesia

A

Hypnosis
Paralysis
Analgesia

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7
Q

What is the functional residual capacity (average)?

A

2L - contains 400ml oxygen

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8
Q

Aspirin
Problem with surgery
Protocol before surgery

A

Blocks platelets irreversibly

Need to stop 7 days before surgery (half life of a platelet)

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9
Q

Warfarin

Protocol before surgery

A

AF - stop 5 days before surgery
Multiple DVTs or metal heart valve - consider bridging therapy: stop 5 days before and on day 3 onward give 24 hourly LMWH

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10
Q

Head Injury Grading

A

Graded according to GCS
13-15 mild
9-12 moderate
3-8 severe

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11
Q

AVPU ‘P’ response equates to…

A

GCS of 8

Need to consider intubation

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12
Q

Cushing’s Triad

A

= bradycardia, hypotension and irregular breathing

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13
Q

A CT head should be performed within 1 hour after risk factor being identified (7)

A 
GCS <13 on initial assessment 
GCS <15 more than 2 hours after injury 
Suspected skull fracture 
Any sign of base of skull fracture 
Post traumatic seizure 
Focal neurological deficit 
>1 episode of vomiting
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14
Q

A CT head should be performed within 8 hours of head injury if (4)

A

> 65 years old
Any history of bleeding or clotting disorders
Dangerous mechanism of injury
30 minutes retrograde amnesia

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15
Q

Suspected STEMI needing PCI anti-coagulant measures

A

5000 units heparin IV

Ticagrelor

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16
Q

Investigation of suspected appendicitis
Kids
Adults

A

Kids - USS

Adults - CT

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17
Q

NSAIDs good in what kind of pain

A

Renal colic

Musculoskeletal

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18
Q

Paracetamol antidote

Delivery

A

N-acetylcysteine
Given as three infusions across 20 hours: 1st infusion is a bolus over 1 hour
Co-prescribe an anti-emetic

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19
Q

Tricyclic antidepressants antidote

A

Sodium bicarbonate

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20
Q

Beta blockers antidote

A

Glucagon

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21
Q

Opioids antidote

A

Naloxone

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22
Q

When should assessment for effects of paracetamol overdose be done?

A

> 75mg/kg

Effects are unlikely to be seen unless >150mg/kg

23
Q

Presentation of paracetamol overdose

A

Acute - nausea, vomiting

Late - abdominal pain, jaundice, encephalopathy

24
Q

Contra-indication for nasopharyngeal airway

A

Base of skull fracture

25
Q

Oropharyngeal airway =

A

Guedel airway

26
Q

What level do you apply a pelvic binder at?

A

Greater trochanters

27
Q

Eye Opening GCS

A 
Out of 4 
4 - spontaneous eye opening 
3 - open eyes to sound 
2 - open eyes to firm pressure 
1 - doesn't open eyes
28
Q

Verbal Response GCS

A 
Out of 5 
5 - spontaneous, orientated speech 
4 - confused conversation 
3 - inappropriate speech 
2 - incomprehensible sounds 
1 - no response
29
Q

Motor Response GCS

A 
Out of 6 
6 - obeying commands
5 - localising to firm pressure 
4 - normal flexion to pressure 
3 - abnormal flexion to pressure 
2 - abnormal extension to pressure 
1 - no movement
30
Q

Findings in anti-cholinergic toxidrome

A 
Increased heart rate 
Increased temperature 
Dilated pupils 
Decreased bowel sounds 
Decreased sweating
31
Q

Anti-cholinergic antidote

A

Physostigmine

32
Q

Examples of cholinergics (3)

A

Organic compounds
Pilocarpine
Mushrooms

33
Q

Cholinergic antidote

A

Atropine
Pralidoxime
Benzodiazepines

34
Q

Findings in sympathomimetic toxidromes

e.g. caffiene, cocaine, metamphetamines, LSD

A

Increased heart rate
Increased temperature
Increased respiratory rate
Dilated pupils

35
Q

Sympathomimetics management

A

Benzodiazepines

36
Q

Benzodiazepines management

A

Flumenazil

37
Q

Biochemical abnormalities in aspirin poisoning

A

Initial respiratory alkalosis - due to hyperventilation

Metabolic acidosis

38
Q

Blood on CT scan

A

Old - black

New - white

39
Q

Fragility pelvic fractures

  • Seen in
  • Main ones (2)
A

Women
Superior and inferior pubic ramus
Intracapsular fracture

40
Q

Increased rib spacing on CXR

A

Hyperinflation e.g. COPD

41
Q

Shockable rhythms

A

Ventricular Fibrillation

Ventricular Tachycardia

42
Q

Management of anaphylaxis

A

IM adrenaline 0.5ml of 1:1000
IV fluid challenge (saline or Hartmann’s)
IV/IM 10mg chlorphenamine
IV/IM 200mg hydrocortisone

43
Q

Treatment of symptomatic bradycardia

  • 1st line
  • 2nd line
A

1: 500 micrograms atropine IV
2: transcutaneous pacing

44
Q

Management of tachycardia

  • 1st line
  • 2nd line
A

1: initially attempt vagal manoeuvres
2: adenosine 6mg IV bolus

45
Q

BZD used for sedation and amnesia

A

Midazolam

46
Q

Is lidocaine a short acting or long acting anaesthetic?

A

Short acting

47
Q

Examples of numbing creams (2)

A

EMLA

Ametop

48
Q

Purpose of premedication (2)

A
  1. Prevention of parasympathetic effects of anaesthesia

2. Reduction of anxiety or pain

49
Q

Examples of benzodiazepines used

A

Temazapam

Midazolam

50
Q

Examples of other hypnotics

A

Zopiclone
Zolpidem
Zaleplon

51
Q

Anti-emetic often used with anaesthesia

A

Droperidol

52
Q

Analgesic often used with anaesthesia

A

Fentanyl

53
Q

Common induction agent with anaesthesia

A

Propofol

Year 4 (27 decks)

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