Acutely Ill Patient

Question 1

Give some examples of shock

Answer 1

Hypovolemic
Distributive
Cardiogenic
Obstructive

Question 2

Give causes of hypovolemic shock

Answer 2

Haemorrhage

Dehydration

Question 3

Give examples of distributive shock

Answer 3

Blood goes into third space etc e.g.
Sepsis - gross vasodilation, increased oxygen demand from other issues
Neurogenic - injury to nervous system

Question 4

Give examples of cardiogenic shock

Answer 4

Arrhythmia

Pump failure

Question 5

Give examples of obstructive shock

Answer 5

Tamponade

Pneumothorax

Question 6

Give some surgical conditions which can cause a patient to be acutely unwell

Answer 6

Appendicitis
Haemorrhage
Pancreatitis

Question 7

What are the types of conditions can cause a patient to become acutely unwell?

Answer 7

Infection/inflammation
Perforation
Obstruction
haemorrhage
Ischaemia
Trauma

Question 8

Examples of inflammation

Answer 8

Oesophagitis
Gastroenteritis
Pancreatitis
Appendicitis
Colitis
Diverticulits
Cholangitis

Question 9

Perforation of oesophagus can be caused by?

Answer 9

Boerhaave’s - vomiting against closed glottis

Malignancy

Question 10

Perforation of stomach can be caused by?

Answer 10

Gastric ulcer

Question 11

Perforation of duodenum can be caused by?

Answer 11

Duodenal ulcer

Question 12

Perforation of small bowel can be caused by?

Answer 12

Foreign body

Crohn’s

Question 13

Perforation of colon can be caused by?

Answer 13

Diverticulitis
Malignancy
Iatrogenic

Question 14

Perforation of gallbadder can be caused by?

Answer 14

Gallstone ileus

Question 15

Perforation of rectum can be caused by?

Answer 15

malignancy

Question 16

Ischaemia of small bowel can be caused by?

Answer 16

Thrombus

Embolus

Question 17

Ischaemia of colon can be caused by?

Answer 17

Watershed

Question 18

What are the classifications of post-op complications?

Answer 18

Direct - procedure specific complications

Indirect - general complications

Question 19

Examples of direct consequences resulting from the procedure

Answer 19

Leakage after GI resection and anastomosis
Biliary tree injury after cholecystectomy
Haemorrhage ischaemia after AAA repair

Question 20

General post-op lung complications

Answer 20

Atelectasis - collapse of lung basses
Pneumonia
PE
Pneumothorax

Question 21

General post-op renal complications

Answer 21

acute renal failure

Question 22

General post-op endo complications

Answer 22

Glucose derangement
Addisons
Drugs
Withdrawal

Question 23

General post-op cardiac complications

Answer 23

MI
Arrythmia
Tamponade

Question 24

What is the systematic approach you take if someone seems to have a complication?

Answer 24

ABCDEFG

Question 25

What are you looking out for when doing airway asssessment?

Answer 25

Look Listen Feel Are they speaking to you? Is there anything in their mouth? Stridor? Gurgling? Excess fluid production

Question 26

Airway - what would you do if there was a problem?

Answer 26

Headtilt Jawthrust Gadelle Give high flow oxygen

Question 27

Breathing

Answer 27

Rate Expansion Percussion Breath sounds

Question 28

What would you do if there was a tension pneumothorax?

Answer 28

needle decompression - midclavicular line if tension pneumothorax

Question 29

Circulation - things to check

Answer 29

Perfusion Cap refill HR BP THINK ABOUT WHETHER THEY ARE LOSING BLOOD VIA ABDOMEN

Question 30

Circulation - things you might give

Answer 30

IV cannula Bloods Fluid

Question 31

Disability - what are you looking at

Answer 31

Limbs | Neuro

Question 32

Exposure - what are you looking out for?

Answer 32

Check for injuries and rashes, potentially anaphylaxis

Question 33

What else might you do?

Answer 33

``` Pregnancy test (ectopic) Urine (urosepsis) ECG Blood gas FBC, kidney function Clotting Group and stain CXR mobile ```

Question 34

Young pt with peritonitis and epigastric pain

Answer 34

Pancreatitis | Ruptured duodenitis

Question 35

Old pt with peritonitis and epigastric pain

Answer 35

Pneumonia

Question 36

AAA presentation

Answer 36

Groin strain | Back pain

Question 37

What's the word for air in the peritoneum?

Answer 37

Pneumoperitoneum

Question 38

What is chilaiditi's sign

Answer 38

Air in viscus between????