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CP1 revision > Additional > Flashcards

Additional Flashcards

1
Q

Cannulation complication - infiltration`

A

Diffusion or accumulation of fluid into subcutaneous tissue

See swelling, slow infusion rate, discomfort and coolness of skin

Prevent bu selecting appropriate site and device, and proper stabilisation

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2
Q

Cannulation extravasation

A

Infused substance damages tissue through irritation

Causes pain, burning stinging, haematoma, reduction in flow rate

Prevented by regular VIP scoring ti avoid occurence. and good site selection

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3
Q

VIP score in cannulation

A

Visual infusion phlebitis score, 0-5 where 0 is healthy and 5 is extensive damage

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4
Q

oesophagitis

A

Can have candidiasis.
Dysphagia, inflammation, heartburn, chest pain, acid brash, haematemesis, melaena.

Can occur in excessive reflux, prolonged gastric intubation, irritant ingestion, uraemia, bacterial, viral, fungal infections or post radiotherapy

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5
Q

linitis plastica

A

Dffuse varient of signet ring cells infiltrating stomach wall, causing rigid, less mobile stomach that can’t expand as much.

Type of gastric cancer

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6
Q

Comparison of CD and UC

A

Crohn’s can be any part of GI tract, transmural infiltration, skip lesions, strictures, fissuring ulcers, granulomas, fat wrapping, adhesions, perforations and raised cancer risk

UC is colon/rectum, mucosal infiltration, continuous pattern. bowel has thin wall and is dilated. No fissures, strictures are rare. No granulomas, no fat wrapping, no adhesions. Can get haemorrhage,e electrolyte loss, toxic megacolon, systemic effects. High cancer risk

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7
Q

Plummer vinson syndrome

A

Iron deficiency and webbing of the oesophagus. Pre malignant condition that needs removal. Suspect in older woman with koilonychia and dysphagia

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8
Q

Tpa bladder cancer

A

Confined to urothelial wall, but doesn’t need to have invaded the BM to be carcinoma in bladder. Can gte flat carcinoma in situ with high grade potential

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9
Q

Lacunar infarct development

A

HTN causes thickening and inelasticity of small arteries and arterioles. Gives hyanilisation which can cause occlusion.
Commonly in basal ganglia, internal capsule, thalamus, hemispheric white matter

Can also make vessels more prone to rupture siwth haemorrhagic stroke.

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10
Q

Xanthochromia

A

Yellow CSF found in SAH LP (can only do if CT scan inconclusive and no raised ICP concerns). Fresh blood is not indicator as can be traumatic tap.
Xanthochromia can be confirmed by measuring CSF bilirubin, but needs LFT for comparison

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11
Q

Effects of subfalcine herniation

A

Local infarction (cingulate gyrus).

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12
Q

Effects of transtentorial herniation

A

Can compress cerebral peduncle (hemiparesis), stretch occulomotor nerve (loss of pupil reaction), compress posterior cerebral arteries (infarct of visual cortex)

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13
Q

Effect of cerebellar tonsilar herniation

A

Coning. Compress lower medulla dn causes resp arrest

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14
Q

4-2-1 rule

4 heart related emergencies

A

ACS, aortic dissection, pericarditis/myocarditis, pericardial effusion/tamponade

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15
Q

4-2-1 Lung pathologies

A

PE and pneumothorax

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16
Q

4-2-1 oesophagus

A

Eosophageal perforation

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17
Q

Intrascapular pain

A

MI pain, MSK pain, gallbladder pain, pancreatic pain

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18
Q

Retrosternal pain

A

MI pain, percardial pain, oesophageal pain, aortic dissection, PE, mediastinal lesion

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19
Q

Left lower/anterior chest pain

A

Intercostal neuralia, PE, myositis, pleurisy/pneumonia, splenic infarct, splenic flexure syndrome, subdiaphragmatic abscess, precordial catch syndrome, injury

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20
Q

How long post MI for T wave to invert

A

Days

21
Q

Most common coronary occlusion sites

A

LAD, right coronary artery, circumflex,

22
Q

Non ischaemic causes of cardiac injury

A

myocarditis (can be toxic, immune or infectious, cardiomyopathy, radiation induced, iatrogenic via surgery, trauma, sepsis (cytokine mediated), CKD (toxic uraemia, mechanical stress)

23
Q

Bridging coronary artery

A

Predisposes to MI in absence of coronary artery disease. Damages subendocardial region

24
Q

Caseating cardiac deposits

A

Seen in TB

25
Q

Non caseating cardiac deposits

A

Cardiac sarcoidosis. Granulomas. MAcrophage deposits

26
Q

ARDS

A

Interstitial lung disorder

27
Q

Direct lung injury ARDS causes

A

Pneumonia, gastric content aspiration. Can also be near drowning, fat embolism, inhalation injury,

28
Q

Indirect ARDS lung injury

A

sepsis, severe trauma with shock. Can be acute pancreatitis, drug overdose, uraemia

29
Q

Lung cancer complication: hoarseness

A

Recurrent laryngeal nerve palsy

30
Q

Lung cancer complication: Ptosis, miosis , anhidrosis

A

Horner’s syndrome, pancoast tumour

31
Q

Lung cancer complication : diarrhoea, flushing, cyanosis, tachycardia, hypotension, wheeze

A

Carcinoid syndrome, excess 5HT

32
Q

Lung cancer complication : weight gain, skin hyperpigmentation, hypertension

A

Cushing’s syndrome though ACTH production

33
Q

Lung cancer muscle weakness autoantibodies against neuronal calcium channels

A

Lambert Eaton myasthenic syndrome (LEMS)

34
Q

Distinguish between LEMS and MG

A

MG has antibody against AchR, associated with thymic tumours, worsens with movement, Has normal deep tendon reflex,. No autonomic dysfunction. REsponse reduces on repeated stimulation

In LEMS, antibody is against calcium channel, associated with SC lung cancer, improves on exercise, decreased deep tendon reflex, has autonomic dysfunction and also stimulation improves response

35
Q

Compartment syndrome causes

A

More commonly due to tibia fracture but also reperfusion injury after tx for acute lower limb ischaemia

36
Q

Identifying compartment syndrome

A

Extreme pain, worse on active/passive movement, not alleviated by opioids, pulses present

37
Q

Indicator of acute mesenteric ischaemia

A

Severe abdo pain (in absence of clinical findings), metabolic acidosis, bloody diarrhoea.

Should have CT angiogram

38
Q

Types of mesenteric ischaemia

A

Acute mesenteric ischaemia, chronic mesenteric ischaemia and colonic ischaemia

39
Q

Acute mesenteric ischaemia types

A

Embolic mesenteric ischaemia, thrombotic mesenteric ischaemia and venous mesenteric ischaemia

40
Q

Most common ischaemic bowel disease

A

colonic mesenteric ischaemia (and has best prognosis)

41
Q

Acute mesenteric ischaemia presentation

A

Sudden onset severe abdo pain, shock (rapid hypvolaemia) and lack ofabdominal clinical signs

Pain often central or RIF. OOP to clinical signs

If occured over hours then ? arterial, if over days then venous

42
Q

RF for acute mesenteric ischaemia

A

AF, hypercoagulable state, vasculitis, cocaine use.

43
Q

Acute mesenteric ischaemia biochem

A

leukocytosis, metabolic acidaemia, elevated serum amylase

44
Q

Acute mesenteric ischaemia imaging

A

Thumbprinting on AXR, mesenteric occlusion on angiography. Pneumoperitoneum if perorated.
Use contrast CT for msesnteric venous thrombosis

45
Q

Chronic mesenteric ischaemia presentation

A

Poorly localised pain, insidious. Repeated episodes occuring over months.
Worse after meals.

46
Q

Chronic mesenteric ischaemia RF

A

Age, smoking, atherosclerosis, peripheral vascular disease, sitophobia

47
Q

Diagnosis if chronic mesenteric ischaemia

A

Angiography.

48
Q

Colonic ischaemia

A

Often presents as lower left sided pain and bloody diarrhoea. OFten pyrexial, tachycardia and leukocytosis.

CP1 revision (16 decks)

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