amk emergency teach 20/5

Question 1

fall from roof, pelvic fracture - low BP - unresponsive to voice
what is the most appropraite action

Answer 1

jaw thrust and assess airway
then adjuncts, supraglottic ariways, et tube ( protected airway) and then surgical airway

Question 2

when would you get anaethetists to monitor a persons airway

Answer 2

below 8 GCS
and bag valve mask to take over ventilation

DR - direct risk - castrophic haemorrhage comes before airway in then ABCDE

Question 3

non shcokable rhythm what do you do

Answer 3

cpr and IV img adrenaline
adrenaline very other cycle of cpr

Question 4

if shcokable rythhm what do you do

Answer 4

cpr and deliver shock
after 3 shcoks go IV 1mg adrenaline and IV 300mg amiodarone

Question 5

stemi damages what layer of the heart

Answer 5

subendocardial layer

Question 6

NSTEMI mx

Answer 6

MONAC and add sodium fondaparinux for NSTEMI

prasugrel - people who are gong to undergo stemi

Question 7

12 of sx and 2hr of medical conttact - PCI
after 2 hours - thrombolyissi

Question 8

mx of HF

Answer 8

OMFG sit up
beware of lluid bouses in hypotensioj ( maybe 250ml , consider iontrohes or vasopressors)

Question 9

what is an SVT

Answer 9

any narrow complex tachy ( below 120ms) originating from above the bundle of his
split into regulairty adn site ( either reg or ireegular and atrial ventricular)
most common is AVNRT ( also AF)

if unsatble HISS features ( syncope, low BP ) - syncrhonised shock on Q wave - low energy shock
* unsyncrohsied when you cant see naythign adn just shock anywhere with high energy)
if shock on t wave - precipitate v fib
cant see p wavss in SVT

if stable - modified valsalva
then adenosine large bore - 6,12,12

if asthamtic verapamil
if failed syncohrnised shock

risk of adenosine in SVT include

Question 10

asprin overdose does what to ear

Answer 10

tinnitus

intialyy get alkalaoossi and hyperventilate to compensate
once aspirin is metabolised get acidodotic picture

Question 11

digoxin causes what to vision

Answer 11

yellow green colourblind

Question 12

antifreeze ehtylene glycol mx

Answer 12

gastric lavage or NG aspriation within an hour , after that fomepizole or ethnaol

early intoxication, comiting and haematemsis, seizures and eventuually leads to kidney dysfunction

Question 13

aki damn drugs to stop

Answer 13

diuretics
ACEi and ARB
metfomin
NSAID

Question 14

indications for dialysis

Answer 14

AEIOU BLAST
acidosi below 7.2
electorlytes - hgih k
intoxication
odeoam and ureaemia

Question 15

infectious encephalitis

Answer 15

fever headache and altered mential state, convulsions, focal neural deficits

ct head and LP needed
managed with acyclovir and ceftrizxone

Question 16

autoimmune encephaltiis

Answer 16

same features as infectious - no fever
same ix
managed with IV ig and steriods
palsmaphresis

Question 17

urgent ct head 1hr

Answer 17

more than 2 vomit in head injru y
gcs below 13
post injyr seizures
base skull fractures
GCS below 15 after 2hr entering ed

Question 18

mx of addisonian crisis

Answer 18

cx by low cortisol and adrenal failur e

IV fluids, IV hydrocortisone, and correct complciations - low blood sugar - dextrose, low bp - fludorcortisone

swap back to oral 3 day slater

Question 19

mx of thyrotoxic storm

Answer 19

fx of thyroid disease
high outpu thf

managed with IV digoxin and propanolo, iv hydrocortisone and propylthiouracil

Question 20

mx of myxedema crisis

Answer 20

low temp, ow RR< low HR, glucose low and comatosed

caused by criticlal ylow T3 anf T4

orrect complciation give IV T3 and 4 and IV hydrocortisone

Question 21

MX of DKA

Answer 21

low insulin - raised glucagon creating ketosis and acidosis and hyperglyceami

comiting sweet smelling breath and abdo pain and shock and dehydration

fludi resis is key in 1 hour followed by fixed rat insulin infusion
aware of cx

Question 22

dotn give more than 10mmol of potasisium an hour