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Medical > Care Pathway > Flashcards

Care Pathway Flashcards

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USMLE® Step 1 flashcards
1
Q

Gastric irritants (drugs)

A

Non-steroidal anti-inflammatories (NSAIDs), steroids, bisphosphonates.

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2
Q

Headache (causes)

A

Primary: occur spontaneously or the patient has Hx e.g. migraine, cluster, tension etc.

Secondary: are pathological or caused by injury e.g. head trauma, infection, haemorrhage etc.

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3
Q

Procoagulant medication

A

Oral contraceptive pill, hormone replacement therapy (HRT).

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4
Q

ALS Drugs

A

Adrenaline 1mg/10ml

Non-shockable rhythms: ASAP after access is achieved.

Shockable rhythms: After 3rd shock and then after every other loop.

Amiodarone Hydrocloride 300mg/10ml

Shockable rhythms: If unresponsive, administer after 3rd shock. Further bolus after 5th shock if unresponsive VF or pVT.

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5
Q

Gastrointestinal (Alimentary) symptoms

A

Symptoms: Abdominal pain, dysphagia, heartburn, vomiting, haematemesis, diarrhoea, constipation, rectal bleeding.

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6
Q

MJ THREADS Ca (Past Medical History)

A
  • *M**yocardial infarction (MI)
  • *J**aundice
  • *T**uberculosis
  • *H**ypertension
  • *R**heumatic fever
  • *E**pilepsy
  • *A**sthma
  • *D**iabetes
  • *S**troke
  • *C**ancer (and treatment if so)
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7
Q

Psychiatric symptoms

A

Depression, anxiety, psychosis, suicidal thoughts.

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8
Q

Gastrointestinal haemorrhage (red flags)

DDx

S/S

A

DDx: ? Gastroenteritis, ?GI haemorrhage, ?duodenal ulcer, ?malignancy ?toxins/drugs.

S/S: Pain, hyporvolemia, infection, pyrexia.

ABCDE compromise.

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9
Q

Genito-urinary (GUM) symptoms

A

Dysuria, discharge, lower urinary tract symptoms.

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10
Q

Haemoptysis

DDx

S/S

A

DDx: ?chronic bronchitis, ?tuberculosis (TB), ?malignancy, ?pneumonia, ?bronchiectasis.

S/S: Cough, pyrexia, Hx.

?pseudohaemoptysis (not blood, not from the lungs etc).

ABCDE compromise.

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11
Q

Headache (key points)

A

Headaches with different or unusual characteristics are significant (not normal for the patient)

Do not exclude based on normal neuro exam (Hx is key)

Migraines increased risk of intracranial events

Check BP (and Temp)

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12
Q

Cardiovascular symptoms

A

Chest pain, palpitations, peripheral oedema, paroxysmal nocturnal dyspnoea (PND), orthopnoea.

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13
Q

Risk factors for pneumothorax

A

Tall, thin men in particular
Known connection tissue disease (e.g. Marfans)
Smoking history

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14
Q

Limb pain and/or swelling (red flags)

DDx

S/S

A

DDx: ?Trauma, ?anaphylaxis, ?cardio.

S/S: SOB, laryngeal oedema, pyrexia.

ABCDE compromise.

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15
Q

Abdominal, loin, scrotal, pain (red flags)

DDx

S/S

A

DDx: ?Testicular torsion, ?pyelonephritis, ?renal colic, ?appendicitis.

S/S: Oedema, infection, temp, severity.

ABCDE compromise.

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16
Q

Neurological symptoms

A

Numbness, weakness, tingling, blackouts, visual change (GCS or behaviour change reported by 3rd party).

17
Q

Vomiting (red flags)

DDx

S/S

A

DDx: ?Head injury, ?cardio, ?anaphalaxis ?sepsis, ?ICP, ?toxins/drugs.

S/S: Haematemesis, rash, oedema, temp.

Any ABCDE compromise.

18
Q

SOCRATES

A
  • *S**ite
  • *O**nset (time of onset. sudden/gradual, etc)
  • *C**haracter of pain
  • *R**adiation of the pain
  • *A**ssociations signs and symptoms associated with the pain
  • *T**ime course (Does the pain follow any pattern)
  • *E**xacerbating/Relieving factors
  • *S**everity (e.g. 1-10, paeds = Wong-Baker faces)
19
Q

SAMPLE (Presenting Complaint)

A

Signs and Symptoms (S/S) of the presenting complaint

Allergies (particularly to medication, food allergies might be relevant)

Medications (DH)

Past medical history (PMH)

Last oral intake

Events that led to current illness or injury

20
Q

Neck and back pain ‘non-trauma’ (red flags)

DDx

S/S

A

DDx: ?Meningococcal meningitis, ?septicaemia, ?MSK

S/S: Photophobia, infection, pyrexia.

ABCDE compromise.

21
Q

Respiratory symptoms

A

Cough, shortness of breath (and exercise intolerance), haemoptysis, sputum production, wheeze.

22
Q

Headache (red flags)

DDx

S/S

A

DDx: Head trauma (<3 months), ?sepsis, ?meningitis, ?narrow angle glaucoma.

S/S: Reduced GCS (<15 without Hx), >temp, rash, stiff neck/photophobia, nausea/vomiting, visual disturbance, red-eye, neurological/cognitive/personality change, neuralgia or palsy.

Triggered by exercise, cough, posture or Valsalva.

Sudden-onset, thunderclap or vertex headache.

ABCDE compromise.

23
Q

ATMIST

(trauma survey)

A

Age

Time of incident

Mechanism of injury

Injuries

Signs and symptoms

Treatment given / immediate needs

24
Q

Risk factors for cardiovascular disease

A

Hypertension

Hypercholesterolemia

Diabetes

Smoking

Family history (heart attack under 60 years old, familial hypercholesterolemia)

25
Q

Social history (SAL)

A
  • *S**moking history (packs/years)
  • *A**lcohol intake (units per week)
  • *L**ifestyle/exercise
26
Q

4 Hs & 4 Ts

(reversible causes of cardiac arrest)

A

Hypoxia

Hypovolemia

Hypo/Hyperkalemia (metabolic)

Hypothermia

Thrombosis (cardiac or pulmonary)

Tension pneumothorax

Tamponade (cardiac)

Toxins

27
Q

Confused state (red flags)

DDx

S/S

A

DDx: ?Diabetes, ?neurological aetiology, ?toxins/drugs, ?DKA/AKA.

S/S: Infection, pyrexia, pain.

ABCDE compromise.

28
Q

CRANE MU

A

Cardio

Respiratory

Alimentary (GI)

Neurological

Endocrine

Musculoskeletal (MSK)

Urinary (GUM)

(S/S, injuries, surgery, PMH/DH?)

29
Q

FLAPS TWELVE

(chest trauma)

A

Feel

Look

Auscultate

Percuss

Search sides and back

Tracheal deviation

Wounds, bruising or swelling

Emphysema (surgical)

Laryngeal crepitus

Venous engorgement

Exclude open/tension pneumothorax, flail chest or massive haemothorax.

30
Q

Visual disturbance/red eye (red flags)

DDx

S/S

A

DDx: ?Narrow angle glaucoma, ?neurological aetiology, ?foreign object.

S/S: Non-reactive pupil, pressure/pain over the eye, nausea/vomiting.

ABCDE compromise.

31
Q

Risk factors for DVT/PE

A

Recent surgery (under three months), malignancy, immobility

Relevant medications (e.g. oral contraceptive pill/HRT)

Inherited coagulopathy (e.g. protein C or S deficiency)

32
Q

Cardiac medications

A

Alpha/Beta/Calcium-blockers, diuretics, antiplatelet agents (warfarin, clopidogrel ect), GTN spray.

33
Q

METHANE (Major Incident)

A
  • *M**ajor Incident Declared
  • *E**xact location
  • *T**ype of incident
  • *H**azards
  • *A**ccess
  • *N**umber and type of casualties
  • *E**mergency services present and required
34
Q

Cushing’s Triad

A

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35
Q
A

Medical (3 decks)

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