An Acutely Unwell Patient Flashcards
Symptoms of urinary sepsis
Dysuria
Lower abdo pain
Loin pain
Fever rigors
Respiratory sepsis
Cough productive of green sputum
Breathlessness
Pleuritic chest pain
Fever
Rigours
Symptoms of Meningococcal septicaemia
Headache
Meningism
Photophobia
Sore neck
Confusion
Exam findings of sepsis
Fever
Tachycardia
Hypotension
Delayed cap refill
Rash
Crackles at lung bases
Tests for sepsis
FBC WCC UE LFT CRP
Lactate
Glucose
Clotting panel - look for DIC
Blood culture
Urine culture
CXR
ECG
Symptoms of UGI bleed
Haematemesis
Melaena
Epigastric pain
Nausea
Vomiting
Fatigue
Hypotension
Causes of upper GI bleed
Mallory Weiss tear
Oesophageal cancer
Gastric cancer
Oesophageal varices
Oesophageal rupture
Perforation
Symptoms of anaphylaxis
Cough
Throat closing
Swollen tongue
Difficulty swallowing
Breathlessness
Wheeze
Stridor
Lightheadedness
Clammy
Confused
Rash - hives / urticaria / flushing
Angioedema
Nausea and vomiting
Is anaphylaxis type 1 or 2 resp failure
Type 1
Treatment of anaphylaxis
IM adrenaline 500 micrograms 1/1000
Repeat after 5 mins
IV fluid challenge
Hydrocortisone IV 200mg
Chlorphenamine (an antihistamine) IV 10mg
Prerenal causes of AKI
Dehydration
Sepsis
Hypotension
Shock
Heart failure
Renal causes of AKI
NSAIDs
ACEi
ARBs
Glomerulonephritis
Contrast
Myeloma
Postrenal causes of AKI
Urinary Obstruction
Prostate enlargement
Renal calculi
SALFORD acronym for AKI
Sepsis?
ACE/ARB - stop them
LABS - repeat UEs
Fluid - give them, and measure output
Obstruction - USS to check for obstructive cause
Renal referral
Dip urine
Symptoms of DIC
Evidence of bleeding - epistaxis from sites bleeding from gums haematuria Gi bleed
Cough
Dyspnoea
Fever
Confusion
Petechiae
Ecchymosis
Hypotension
Oliguria
Signs of thrombosis
