Acute medicine

Question 1

hyperkalaemia
level?

treatment

ecg changes:

present?

Answer 1

K above 5.5mmol/L -6.5 severe

treatment

• Ca gluconate = cardioprotective within 10 mins
• insulin glucose infusion 50mls of 50% glucose
• Salbutamol neb 10-20mh over 20 mins
• Calcium resonin 15g oral (prescribe with lactulose

ECG: Tall Tented T waves aall over the ECG. widened QRS, reduced / lost p wave. AV dissociation.

presents: non specific - weakness, fatigue, sob, chest pain

Question 2

hyponatraemia
levels?

found?
rapid change cause?

chronic syx?

treatment:

Answer 2

• Na conc less than 135 mmol/ L - severe 125
  usually incidental finding on blood test
• rapid change in na levels can cause vomiting, drowsiness, headache, seizures and coma.
  can be serious as swelling of brain cells as water moves intracellularly and increase ICP

chronic syx can be gait instability, falls, concentration / congnitive deficits.

treatment: HYPERTONIC SALINE to restore serum Na conc.

Question 3

paracetemol overdose treatment

Answer 3

PARVOLEX

Acetylcysteine

Question 4

HYPERcalcaemia

syx:

Causes:

ixv:

tx:

Answer 4

NA conc above 2.65 mmol/L

syx: bone pain, drowsiness, fatigue, weakness, depression, nausea and vomiting, constipation, adbo pain, renal colic

“bones, stones, abdo groans and psychiatric moans”

Causes: primary hyperparathyroidism
malignancy - breast, lung, multiple myeloma
Less common: thiazide diuretics, lithium, CKD, addisons.

ivx: serum calcium and albumin concs.

treatment: rehydration IV saline
ZOLENDRONIC ACID= 4mg OVER 15 MINS

Question 5

LIFE THREATENING THORACIC INJURY

atom FC

Answer 5

Airway obstruction 
Tension pneumothorax
Open chest owund
Massive haemothroax
Flail chest
Cardiac tamponade

Question 6

On the floor and four more

Answer 6

External wounds- on the floor

1. Chest cavity
2. Pelvic cavity
3. Abdo cavity
4. Long bones