Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CST Interview > Clinical > Flashcards

Clinical Flashcards

1
Q

Incidence of compartment syndrome in tibial fracture?

A

Up to 45%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Is compartment syndrome excluded in open injury?

A

No - There could be compression on another compartment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of compartment syndrome

A 
Fracture
Plaster compression
Burns
Crush injury
Bleeding
Haematoma
Postischaemic swelling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Compartments of lower limb

A

Anterior
Posterior
Deep posterior
Perineal (Lateral)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Signs and symptoms of compartment syndrome?

A

Main symptom I look out for is pain out of proportion to injury, despite adequate analgesia, and pain on passive stretch of a muscle.
Later signs may include pallor, paraesthesia and pulseless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Management of compartment syndrome

A

If in backslab —> Elevate, Cut the backslab on soft part to skin, or if full plaster then split, keeping it partially intact for support
Provide analgesia
Check distal pulse and sensation and skin
Keep NBM
If available could check compartment pressures
Inform my registrar what i have just done and check on patient again in 20 minutes
If settled, continue as is, if no better book for theatre, take bloods, inform anaesthetist and senior and mark consent for fasciotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Measuring compartment in CS

A
  • Sterile conditions
  • Probe inserted into each compartment
  • Within 5 cm of fracture site
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Normal compartment pressure?

A

0-10 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pressure indicative of CS?

A

within 30 of Diastolic BP or absolute pressure of >30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Signs of Critical Ischaemia

A 
Pain
Pallor
Pulseless
Paraesthesia
Perishingly cold
Paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Low urine output post op (AKI)

Causes?

A

Pre renal

  • Hypovolemia/haemorrhage
  • Renovascular

Renal

  • Acute tubular necrosis
  • Glomerulonephritis
  • Necrosis

Post renal

  • Obstruction
  • Extrinsic compression
  • Iatrogenic
  • Trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define acute tubular necrosis

A

Renal failure resulting from injury to the tubular epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Two types of Acute Tubular necrosis

A

Ischaemic

Nephrotoxic
E.g. drugs, toxins or myoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Medications that cause AKI

A 
NSAIDS
ACE-I
Diuretics
Antibiotics e.g. Gentamicin, trimethoprim
Paracetamol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Complications of AKI?

A

Hyperkalemia

Flash pulmonary oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Indications for dialysis?

A
  • Refractory or persistent Hyperkalemia
  • Metabolic acidosis
  • Refractory pulmonary oedema
  • Signs of uraemia encephalopathy
  • Signs of Uraemic pericarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Risk factors for UGI bleed?

A

Drugs - NSAIDS, anticoagulants
Oesophasgus - Vacrices, Mallory Weiss tear
Gastric - Ulcer, gastritis, drugs, malignancy
Duodenal - ulcer, drugs, malignancy, injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Scoring system for UGI bleed?

A

Rockall Score
- Pre and Post endoscopy

Age
BP
HR
Co-morbidity

Post endoscopy —> Diagnosis and signs of recent haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

High risk score for UGI Bleed?

A

> 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Types of Stoma

A

Colostomy

Ileostomy

End

Loop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Ileostomy

A

End of ileum to the abdomen.

Spouted.

Loop is double barrelled (diverts away from obstruction)

Greenish, loose product

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Crohns vs. UC

A

Crohns

  • Rose thorn ulcers
  • Skip Lesions
  • Throughout alimentary tracts
  • Can involve all layers of bowel wall
  • Deep ulceration
  • Fistula formation
  • Cobblestone appearance
  • Worsened by smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Consequence of multiple bowel resections?

A

Short gut syndrome.

Malabsorption.

Malnutrition.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Complications of Crohn’s?

A
  • Abscesses
  • Fistula
  • Small bowel obstruction
  • Toxic Megacolon
  • Short bowel
  • Malignancy
  • Primary Sclerosing Cholangitis
  • Gall stones
25
Q

Management of DKA

A

Fixed rate insulin infusion 0.1 units/kg/hr

IV Fluids 4-6 litres/24 hours

First 2 in 3 hours

26
Q

Resolution Criteria for DKA

A

pH >7.35

HCO3 >18

Serum Ketones <0.3

27
Q

Define HONK

A

Hyperosmolar Non-Ketotic Coma

Hypersomolar hyperglycemia

Hormone excess with relative insulin deficit

28
Q

Tests for HONK

A

Glucose >40

Electroluytes suggest dehydration

Serum osmolality >350

Normal ketones and ph

29
Q

Treat HONK

A

IV Fluids to correct dehydration

3-5 units/hr insulin

30
Q

Manage Hypoglycemia in conscious patient

A

Fast acting oral carbohydrate e.g. gel (20-30 grams)

31
Q

Manage hypoglycaemia in unconscious patient

A

IM Glucagon 1 mg

IV Dextrose (20%, 100 ml)

32
Q

Consequences of poorly controlled T2DM

A
  • PVD
  • Heart disease
  • Neuropathy
  • Retinopathy
  • Nephropathy
33
Q

AKI Classification

A 
R- Risk
I- Injury
F- Failure
L- Loss of function
E- End stage
34
Q

AKIN Criteria AKI

A

Stage 1 - 1.5x Cr

Stage 2 - 2x Cr

Stage 3 - 3x Cr

35
Q

Virchow’s Triad

A
  • Haemostasis
  • Endothelial Damage
  • Hypercoagualability
36
Q

Embolus vs. Thrombus

A

Embolus:

More acute
Painful
Risk factors e.g. AF, Surgery, Endocarditis, Prosthetic heart valves

37
Q

Left iliac fossa pain
Septic
61 year old
DDX?

A

Abdominal: AAA, Diverticulitis, Ischaemic bowel, Volvulus, Perforation
Gynae: ovarian torsion
Urinary: Renal calculus, Urine infection, Pyelonephritis

38
Q

SIRS

A

SIRS: Two or more of:

  • Raised or low WCC
  • Temp 38, < 36
  • HR >100
  • Tachynpneoa
  • Altered Mental State
  • BM >6.6
39
Q

Sepsis

A

SIRS with a known source of infection Severe when there is end organ dysfunction

40
Q

Septic Shock

A

Sepsis with refractory hypotension

41
Q

Sepsis Six

A

1) Take Cultures
2) Take Bloods inc. Lactate
3) Take urine culture
4) Give abx
5) Give O2
6) Give fluids

42
Q

Lethal Triad in ATLS

A
  • Metabolic Acidosis
  • Coagulopathy
  • Hypothermia
43
Q

Signs of Urological Injury in trauma?

A
  • Blood at meatus
  • Difficulty passing catheter
  • Suprapubic bruising
  • Extravasation of urine
44
Q

Metabolic Acidosis

A

Kidneys unable t excrete hydrogen ions or increased lactate

Body Compensates by increasing respiratory drive to blow off CO2

45
Q

Intra-operative findings of Nec Fasc

A
  • Necrotic tissue
  • Fascial oedema
  • Vessel Thrombosis
  • Dishwater-colour fluid
  • Pus
46
Q

Charcot Triad

A

RUQ Pain
Jaundice
Fever/Rigors

47
Q

Charcot Triad indicates?

A

Ascending cholangitis

48
Q

Glasgow score for pancreatitis

A 
PO2 <8
Age >55
Neuts >15
Ca <2
(Renal) Urea >16
Enzymes (LDH >600/AST >2000)
Albumin <32
Sugar >10
49
Q

Causes of acute pancreatitis?

A
  • Gall Stones
  • Ethanol
  • Trauma
  • Steroids
  • Mumps
  • Autoimmune
  • Scorpion venom
  • Hypothermia, hyperlipidemia, hypercalcemia
  • ERCP
  • Drugs (e.g. NSAIDS)
50
Q

Fat embolism

A

Fat molecule that enters the circulation, to a distant location. Often associated with trauma, fractures and limb surgery.

51
Q

Pneumothorax compromises Cardiovascular function

A

Obstructs venous return to the heart

52
Q

Investigating tension pneumothorax

A

ABG, Examination

NOT CHEST X RAY

53
Q

Risk factors for DVT

A
  • Previous DVT
  • Family history
  • Lower limb surgery
  • Prolonged period of immobility
  • Lower limb fracture requiring plaster cast and NWB
  • Malignancy
  • Medication e.g. Oral contraceptive pill
54
Q

Three factors for VTE

A

1) Hypercoagulability
2) Endothelial damage
3) Haemostasis

55
Q

Risks for secondary pneumothorax

A
  • Trauma
  • Ruptured bullae due to emphysema
  • Cystic fibrosis
  • infection
  • Malignancy
  • Iatrogenic
  • Asthma
56
Q

Ruptured bullae

A
  • Pressure changes
  • Trauma
  • Intubation
  • Iatrogenic
  • Infection
57
Q

CT Head indications in trauma

A
  • Focal Neurology
  • Evidence of base of skull fracture
  • Seizure
  • Vomiting (>1 episode)
  • GCS <13 on admission
  • GCS <15 after 2 hours
58
Q

GLASGOW Score severity

A

> 6 Severe, high mortality

59
Q

Signs of base of skull fracture

A
  • CSF Rhinorrhea
  • Otorhoea
  • Bilateral echymosis
  • Battle sign (Bruising around mastoid process)
  • Depressed skull fracture

CST Interview (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions