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Year 2 - Emergency Medicine > CASE STUDIES > Flashcards

CASE STUDIES Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

46 YO MALE

Intoxicated
Fallen full flight of stairs
Conscious
RR 22
BP 70/40 HR 40 CR 4 sec

What are your priorities?
What is the cause?

A

Neurogenic Shock

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2
Q

Patient attends with:

Shocked/low BP
Distended neck veins
? Muffled HS ? Inaudible
High RR
Unilateral reduced AE
Hyper resonant unilaterally
Deviated trachea

What is this signs of ?

A

Tension pnuemothorax

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3
Q

Patient attends with:

Low BP
Distended neck veins
Muffled heart sounds
Previous surgery

What are your concerns

A

Cardiac Tamponade

Becks +ve

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4
Q
A
  • Take a full history
  • NEWS2
  • ABCDE
  • Cannula + Bloods. 2 x large bore.
  • Analgesia - Gotta give IV due to patient being sick.
  • Antiemetics
  • Fluids
  • 12 x lead ecg.
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5
Q

What does this ABG show?

How do you calculate the anion gap?

What are the two categories of metabolic acidosis?

A

Metabolic acidosis

The equation is as follows: (Na+ + K+) – (Cl- + HCO3-) = Anion Gap.
The positive ions minus the negative ions.

High anion gap and normal anion gap.

Normal 3 - 11

High 11+

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6
Q

What are the causes of a metabolic acidosis with a high anion gap ?

A

Methanol is a toxic alcohol that is used industrially as a solvent, pesticide, and alternative fuel source.

Uremia - Renal failure

DKA

Paraldehyde - Med used for epilepsy.
Phenformin - Antidiabetci drug.

Isoniazid is used to treat tuberculosis (TB) or prevent its return (reactivation).

Lactic acidosis.

Ethylene Glycol -
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Ethylene glycol is a colourless, sweet-tasting liquid commonly found in antifreeze but occasionally used for other purposes, such as industrial solvents.

Salicylates - Asprin

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7
Q

What are the causes of a metabolic acidosis with a normal anion gap ?

A
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8
Q

What are the causes of Acute Pancreatitis?

How to diagnose?

Why is serum lipase also measured?

A

Traditionally diagnostic with relevant history + amylase 3x normal +/- imaging. CT during admission.

If the cells of your pancreas are damaged, they will release larger amounts of increased lipase can also be seen in numerous other conditions eg ectopic pregnancy, mumps, salivary gland blockage, medication.
SO MEASURE LIPASE AND AMYLASE.

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9
Q

What are the complications of acute Pancreatitis ?

A

Early <1 week
Resp - Pulmonary Odema
Pleural effusions

CVS
Shock
Hypovolemia

Metabolic
Hyperglycaemia
Hyperlipidemia
Hypocalcemia
Hypomagnesia

Late >1
Psuedocst
Abscess

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10
Q

What level to test for if you suspect pregnancy in a female?

A

HCG

Blood or urine.

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Year 2 - Emergency Medicine (12 decks)

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