Acute Conditions Questions

Question 1

What are the steps in managing a Myxodemal Coma?

Answer 1

1. ITU/HDU care
2. IV T3/T4
3. 50-100mg IV hydrocortisone
4. Mechanical ventilation and oxygen - if hypoventilation
5. IV fluid - to correct hypovolaemia
6. Correct hypothermia
7. Correct hypoglycaemia
8. Treat any heart failure

Question 2

What is the treatment of ACS?

Answer 2

1. Aspirin 300mg PO
2. Antiplatelet Clopidogrel 300mg PO
3. if BP >90, use GTN spray 2 puffs for pain
4. IV Fluids if required, with Metoclopramide 10mg IV and Morphine 2.5mg-10mg IV
5. If STE-ACS -> angiography and PCI within 90-120min
6. If NSTE-ACS -> risk stratify with GRACE score

Question 3

What is the treatment of Pulmonary Oedema?

Answer 3

LMNOP
Loop Dieuretic - Furosemide 40mg IV
Morphine
Nitrates IV if BP >110 or GTN spray if BP >90
O2 15L via NRBM
Patient sat up

Question 4

What is the triad of Cardiac Tamponade?

Answer 4

Hypotension
Muffled heart sounds
Elevated JVP

Question 5

What is the treatment of Aortic Dissection?

Answer 5

Type A:
Cardiothoracic surgery
Type B:
- Morphine IV 2.5g-10g
- Consider anti-hypertensives
- Labetalol 50mg over 1 minute
- GTN spray 0.6 - 8mg/hour

Question 6

What is the index used to indicate poor prognosis in ruptured AAA?
+
What are the parameters?

Answer 6

**Hardman Index
**
+
Age >76
LoC
Hb <9g/dl
Cr 180
Signs of ischemia on ECG

Question 7

What is the treatment of cardiac tamponade?

Answer 7

echocardiography guided pericardiocentesis