Brainscape's Knowledge GenomeTM

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


See full index

OSCE Y5 > Common ACUTE presentations treatments (ABCDE) > Flashcards

Common ACUTE presentations treatments (ABCDE) Flashcards

1
Q

PE with haemodynamic instability

A

Thrombolysis

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

Tension pneumothroax

A

Needle decompression 2nd intercostal space
mid-clavicular line

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

Pneumonia

A

CURB65 score

CXR - in intermediate or high-risk patients -> blood and sputum cultures, pneumococcal and legionella urinary antigen tests

CRP monitoring is recommend for admitted patients to help determine response to treatment

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

WHat makes up a CURB65 score

A

Confusion
Urea >7
Respiratory rate >30
Blood pressure <90 systolic
>65 yrs

Intensive care for those w/ score 3 or more

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

Cushing’s reflex - triad of:

A

Hypertension - widening pulse pressure
Bradycardia
Irregular breathing

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

Holding measure for increased intracranial pressure

A

Mannitol

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

Anaphylaxis - dose of adrenaline

A

0.5 ml/mg 1:1000 IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How often should adrenaline be repeated

A

Every 5 minutes

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

Adult bradycardia treatment:

A

Atropine 500 mcg
Repeat up to 6 times (3mg total)

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

Bradycardia if atropine not working:

A

Isoprenaline - 5 mcg IV
Adrenaline IV 2-10 mcg
Transcutaneous pacing

If these don’t work - transvenous pacing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Adult tachycardia w/ pulse:

A

Amiodarone - 300 mg IV over 10-20 mins
900 mg IV over 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Indications for AMIODARONE in tachycardia

A

Three failed DC shocks in unstable pt.
Regular BROAD COMPLEX TACHYCARDIA

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

When to use Adenosine in SVT

A

When vagal manoeuvres fail

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

Adenosine dose

A

6 mg IV
12 mg IV
18 mg IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

4Hs - reversible causes of cardiac arrest

A

Hypovolaemia
Hypo/hyperkalaemia (electrolyte)
Hypothermia
Hypoxia

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

4Ts - reversible causes of cardiac arrest

A

Tension pneumothorax
Tamponade
Toxins
Thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Cardiac arrest adrenaline dose

A

10 ml 1:10000 Adrenaline IV every 3-5 minutes

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

Paediatric BLS algorithm

A

start with 5 rescue breaths
Then 15:2 at a rate of 100-120 BPM

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

Lactate level in shock

A

> 2.2

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

Pre-operative period: when to stop ACEi/ARBs

A

1 day before surgery

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

When to stop Warfarin before surgery:

A

5 days before surgery

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

When to stop LMWH before surgery

A

24 hours prior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Anti-platets drugs: when to stop before surgery

A

7 days before surgery

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

What to do for anticoagulation if pt. is high risk after stopping warfarin (5 days)

A

Bridge with LMWH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Acute heart failure management

A

Upright position
O2
Loop diuretics
Morphine - do not give routinely but if necessary
nitrates if concomitant cardiac ischaemia (contraindicated in hypotension)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Ventricular tachycardia Mx. in pt. stable vs. unstable pt.

A

If stable: Antiarrhythmics may be used
If unstable (hypotensive, chest pain, heart failure, syncope) immediate cardioversion is indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Pre-eclampsia tx.

A

Referral to secondary care
Oral Labetalol
(Nifedipine if asthmatic)
Delivery is definitive management -> timing is situation dependent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Acute asthma - Ix.

A

Clinical diagnosis
CXR to rule out infection and pneumothorax
ABGs - usually normal
Bloods and sputum cultures if evidence of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

ACS investigations:

A

Bloods - FBC, UEs, LFTs, Mg, Ca, TROPONINS, Glucose, Coagulation profile, cross-match
O-
X - CXR (signs of heart failure)
E - ECG
S - specials = Coronary angiography

30
Q

Acute LVF investigations:

A

Bloods - FBC, UEs, LFTs, Mg, Ca, TROPONINS, Glucose, Coagulation profile, cross-match, phosphate, lipids, BNP
O -
X- CXR (ABCDE) kerley b-lines, alveolar shadowing etc.
E - ECG
Special tests: Echocardiography, BNP

31
Q

Ruptured AAA ix.

A

Bedside US if available
CT angiography

32
Q

Gallstones Ix.

A

LFTs
Abdomonal USS
CT for surgical planning

33
Q

CBD stone Mx.

A

IV hydration (prevent renal injury)
ERCP

34
Q

Acute pancreatitis Mx.

A

Supportive
NBM
IV hydration - 1L/4 hours (Hartmann’s)
IV antibiotics only if infection/free air on AXR
May need ICU

35
Q

Acute pancreatitis Ix.

A

Amylase/lipase
Abdominal USS (exclude other causes/ check for cause stones etc.)
CT if diagnostic uncertainty
LFTs derranged
Apache II/Glasgow scoring

36
Q

Acute mesenteric ischaemia Ix.

A

VBG: Increased Lactate
Abdominal CT
Angiography

37
Q

Renal colic Ix.

A

Urine dipstick
CT KUB
X-ray KUB

38
Q

Renal colic Mx

A

Analgesia (IM Diclofenac)
<1 cm muscle relaxants
> 1 cm uteroscopy/ESWL
> 2 cm - in renal pelvis percutaneous nephrolithomtomy

39
Q

Ectopic pregnancy Ix.

A

bHCG urine
bHCG serum
Transvaginal US

40
Q

Ectopic pregnancy Mx.

A

Methotrexate if uncomplicated
Laparoscopic salpingectomy
Laparotomy

Anti-D prophylaxis

41
Q

Ovarian cyst rupture/torsion Ix.

A

Transvaginal or trans abdominal USS

42
Q

Pelvic inflammatory disease Ix.

A

Inflammatory markers raised
Gynaecological swabs

43
Q

Pre-eclampsia Ix.

A

BP
Urine dipstick: Proteinuria, HELLP
Cardiotocography Fetal USS

44
Q

Pre-eclampsia Mx.

A

Delivery is only definitive mx.
Labetalol for BP
Magnesium sulphate will prevent fits
Aspirin may be used for prevention

45
Q

Suspected TIA/stroke Ix.

A

CT head
ECG
Carotid artery dopplers
Coagulation profile

46
Q

CVA Mx.

A

Acute: Aspirin or thrombolysis/thrombectomy
Long term: clopidogrel + statin
BP control
Carotid endarterctomy if >50-70% stenosis (depending on criteria used)

47
Q

Definitive investigation Aortic stenosis

A

Echocardiograph

48
Q

Torsades de pointes Mx.

A

ABCD -
Magnesium sulphate

49
Q

Ventricular tachycardia mx.

A

Amiodarone if haemodynamically stable
DC cardioversion if not

50
Q

Atrial fibrillation mx. When to use rate

A

Rate control if >65 years w/ IHD and no Sx/not suitable for cardioversion

51
Q

Rhythm control - AF.
When can this be used

A

Acute setting if clear onset <48 hours ago
Otherwise, pt. must undergo 4 weeks of therapeutic anticoagulation and rate control

52
Q

Blood to consider in acute GI bleed

A

G&S crossmatch
FBC (Blood loss)
UEs (Increased urea in GI bleeds)
LFTs (varices risk)
Clotting (coagulopathy common in liver disease)
Glucose

53
Q

Acute variceal bleed mx.

A

Terlipressin
Prophylactic IV antibiotics
Endoscopic intervention (variceal band ligation)

54
Q

Non-variceal bleed mx.

A

IV PPI
Endoscopic intervention

55
Q

Hypoglycaemia blood glucose level

A

<4

56
Q

Hyperglycaemia blood glucose level

A

> 11

57
Q

Normal capillary ketones

A

<0.6

58
Q

Means of confirming diagnosis in suspected DKA

A

VBG
Capillary/URINE ketones (>3 mmol/L)
Glucose

59
Q

Insulin infusion rate and type for DKA

A

IV FIXED RATE 0.1 unit/kg/hour insulin from 50 units human soluble rapid-acting in 50 ml saline

60
Q

DKA - when capillary glucose is <14 mmol Mx.

A

Give 10% IV glucose at 125 ml/hour in addition to 0.9% saline

61
Q

When should insulin be given in HHS

A

IF glucose is not falling with fluids alone or there is ketosis

62
Q

HHS Insulin rate

A

0.05 units/kg/hour

63
Q

Hypoglycaemia Mx. unconscious

A

200 ml 10% glucose or 100 ml 20% glucose IV
1mg IM GLUCAGON if no IV access

64
Q

Hypoglycaemia Mx. conscious
Cannot swallow:
Can swallow:

A

Cannot swallow: 2 tubes 40% glucose gel around teeth
Can swallow: 15-20g fast acting carbohydrate plus long acting carbohydrate

65
Q

Stroke scoring system

A

ROSIER score

66
Q

Classifying life-threatening asthma severity mnemonic

A

33, 92 CHEST

67
Q

33, 92 CHEST Mnemonic components

A

33 = PEFR <33% predicted
92 = Sats <92%
Cyanosis
Hypotension
Exhaustion
Silent chest
Tachycardia

68
Q

Acute pulmonary oedema Mx.

A

POND
Position (sit up)
Oxygen (high-flow initially aim for 92-96%)
Nitrates (in SEVERE pulmonary oedema)
Diuretic if fluid overloaded (furosemide 40 mg IV)

69
Q

Further interventions if POND unsuccessful for pulmonary oedema:

A

CPAP - if hypoxaemic despite above interventions
Inotropes +/- intra-aortic balloon pump in ICU if in cardiogenic shock (hypotension + overload)

70
Q

Pulmonary oedema Ix.

A

B - baseline blood plus B-type Natriuretic peptide and Troponin PLUS ABG
O -
X- CXR
E - ECG and echocardiography
S - special tests = BNP, catheterise and implement strict fluid balance charting

71
Q

Anaphylaxis: specific component to ask for in blood test

A

Mast cell tryptase

72
Q

Pharmacological seizure management:
If seizure on going w/in
10 mins:
20 mins:
30 mins:
60 mins

A

10 mins: 4mg lorazepam IV or 10 mg DIAZEPAM PR
20 mins: repeat as above
30 mins: Phenytoin 20 mg/kg IV or Levetiracetam 40 mg/kg IV
60 mins: General anaesthesia in intensive care

OSCE Y5 (7 decks)

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