Acute Management

Question 1

COPD exacerbation management?

Answer 1

Oxygen
Salbutamol
Prednisolone
Ipatropium
Antibiotics if sign of infection
Consider BIPAP

Question 2

PE Investigations + management?

Answer 2

Wells score - D-dimer +/- CTPA

Apixiban or Rivaroxaban - 1st line
LMWH - 2nd line

Massive PE - thrombolysis (Alteplase)

Question 3

ACS acute management?

Answer 3

MONA + C
M - morphine (10mg titrated to pain)
O - oxygen
N - nitrates (if not hypotensive)
A - aspirin 300mg

C - anticoagulant - clopidogrel / ticagrelor

Question 4

Acute pulmonary oedema management?

Answer 4

POND

P - position (sit up)
O - oxygen
N - nitrates (only if not hypotensive)
D - Diuretics (IV furosemide 40mg)

Question 5

Anaphylaxis management?

Answer 5

adrenaline 0.5mg IM (0.5ml of 1:1000) - repeat every 5 mins

Question 6

Acute asthma management?

Answer 6

O - oxygen
S - salbutamol 2.5mg-5mg NEB
H - hydrocortisone 100mg IV
I - Ipatropium 500mcg NEB
T - aminophylline infusion
M - magnesium sulphate 2g

Question 7

Variceal bleed management?

Answer 7

• Terlipressin
• IV antibiotics
• OGD for variceal band ligation

Question 8

Non-variceal bleed management?

Answer 8

IV proton pump inhibitor
endoscopc intervention

Question 9

Upper GI bleed scoring systems?

Answer 9

Glasgow-Blatchford (pre-endoscopy)
Rockall score (post-endoscopy)

Question 10

How much insulin to give in DKA?

Answer 10

0.1unit/kg/hour - max 15 units per hour.

Question 11

Hypoglycaemia management?

Answer 11

100ml 20% glucose IV STAT or Glucagon 1mg IM

glucose gel if patient conscious

Question 12

TIA management?

Answer 12

aspirin 300mg PO STAT + specialist review

Question 13

Stroke management?

Answer 13

1. CT head +/- angio (exclude intracranial bleed)
2. thrombolysis (if <4.5hours) or thrombectomy

Question 14

4H’s and 4T’s?

Answer 14

H - hypoxia
H - Hyperkalaemia / Hypo
H - Hypovalaemia
H - hypothermia
T - Tamponade
T - tension pnuemothorax
T - Toxins
T - thrombosis