Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MRCS Past Questions Knowledge > Critical Care > Flashcards

Critical Care Flashcards

1
Q

Layers of the adrenal gland and what is produced?

A

Adrenal cortex- ACE, GFR

Medulla- adrenaline/norad

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

Role of aldosterone?

A

Upregulate Na/K channels in DCT

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

Impact of steroids on surgery

Steroid SE

A

PUD, pancreatitis, poor wound healing, surgical site infections/other infections, increase risk of addisonian crisis

CUSHINGOID
Cataracts
Ulcers
Skin: striae, thinning, bruising
Hypertension/ hirsutism/ hyperglycemia
Infections
Necrosis, avascular necrosis of the femoral head
Glycosuria
Osteoporosis, obesity
Immunosuppression
Diabetes
Fuid retention- hypernatraemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Addisonian crisis presentation

A

Abdo pain, nausea, v, shock, HypoNa, HyperK

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

Method of action of insulin?

A

Increased glucose uptake by cells, glyogenosis, fatty acid synthesis
via Glut 4 transporter

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

Hyperglycaemia periop risks?

A

Poor wound healing
Infections
Poor cardiovascular status
HHS

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

How to Dx rhabo?

A

Massively raised CK

Urine dip for Hb/Myoglobin

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

Causes of pneumoperitoneum?

A

Rupture- peptic ulcer,
Post laparoscopy
Peritoneal dialysis
Pneumothorax/mediastinum

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

Why do you get variable BP in AF

A

Variable pulse pressures

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

Management of AF?

A

Haemodynamically unstable?
Investigate for causes and treat underlying
Treatment rhythm vs rate control
Long term VTE
Cardiovert- DC vs chemical (flecanide vs amiodarone)
Medics

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

Causes of AF?

A 
Cardiac- MI, HF, valvular disease
Pulmonary- PE/infection
Spetic
Electrolyte disturbances
Dehydration
Thyroid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is central cord syndrome?

A

Upper limbs worse than lower

Upper limbs corticospinal tracts run centrally, lower run peripherally

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

Hypothermia definition and causes?

A

<35oc
Pre hospital- Prolongued exposure, low exterior temperature, wet
Patient- unable to shive, hypotension, Alcohol
Pre op- exposure for examination, massive transufsion- blood/fluids
Op- anaesthetic, open stomach, cold theatre

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

Complications of hypothermia?

A

Coagulopathy, acidosis, hypothermia- trauma triad
Enzyme dsyfunction
Arrythimas- J waves, widened QRS
Decreased cerebral blood flow, coma
Decreased gut motility
Hypoxia- left shifting of curve leading to holding on ton O2
Death

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

Fluid resuscitation volume in kids?

A

20ml/kg for bolus

Crystalloid

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

Haematemesis management?

A 
A2E
Early intubation, resuscitate, access, correct coagulopathy
IV somatostatin/omeprazole
TXA
Abx
Endoscopy- banding/sclerotherapy
Balloon tamponade- minnesota/blakemore
Propanolol-2o prohylaxsis

Rockall/Blatchford

TIPSS
Shunt surgery
Liver transplant

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

What is the monoroe kelly doctrine?

A

Skull is a closed box, pressure within regulated by brain tissue, blood and csf

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

How to measure ICP?

A

ICP/LP opening pressure/doppler?

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

Aortic stenosis effect on heart?

A

Hypertrophied, increased O2 demand, decrease compliance, inability to adapt to changing BP, Increased hypotension/MI risk

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

Why AF/tachycardia leads to MI?

A

Shorter diastole time, less filling time for coronaries

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

Definition of TURP syndrome?

A

Excessive absorption of irrigation fluid during TURP

Leading to rapid hyponatraemia and fluid overload

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

How to treat TURP syndrome?

A

Stop irrigation
Avoid it- short op, haemostasis
Treat hyponatraemia- hypertonic saline- central line ITU
Treat overload- mannitor/furosemide

May need ITU and haemofiltration

23
Q

What is a pseudocyst?

A

GOO, abdo pain, vomiting, fullness

Leakage of pancreatic enzymes/fluid surrounded by fibrous/granulation tissue

24
Q

Why may amylase not be raised in pancreatitis?

A

Peaks at 48 hours- before/after

25
Causes of jaundice and obstructive jaundice?
Causes of jaundice- pre hepatic (haemolysis), hepatic (hepatitis) and post hepatic Obstructive jaundice causes- intraluminal, luminal and extraluminal
26
What is the enterohepatic circulation?
Process by which bile salts are reabsorbed and rescreted in bile 95% of them Liver to small intestine then back to liver
27
Where is ALP, AST, ALT and GGT produced?
AST produced by hepatocytes, heart, kidney, brain ALT- hepatocyctes ALP- biliary epithelium, bone, placenta GGT- hepatocytes and biliary epithelium
28
Role of bile salts in fat absorption?
increase surface area, globules to micelles
29
Composition of bile?
water, bile salts, bile pigment, cholesterol
30
Common organisms of cholangitis?
E.coli | Klebisella
31
Causes of LBO/SBO?
LBO- malignancy, volvulus, diverticulitis | SBO- hernia and adhesions
32
Types of nutritional delivery?
Oral, NG, NJ, PEG, Jejunostomy | Partial parenteral and TPN
33
Complications of TPN?
``` Venous access: • Pneumothorax • Air embolism • Bleeding • Venous thrombosis • Vascular injury • Line infections Metabolic abnormalities: • Refeeding syndrome in chronic alcoholic patients, and in patients who have nothing-by-mouth status (NPO) for more than 7 to 10 days • Hyperglycemia • Serum electrolyte abnormalities TPN Jaundice- hepatotoxic? ```
34
Components of TPN?
lipid emulsions, dextrose, amino acids, vitamins, electrolytes, minerals, and trace elements
35
Complications of enteral feeding?
``` Blockage Fistula Refeeding syndrome Aspiration Nausea/bloating/diarrhoea ```
36
Which drug improves gastric motility?
Metoclopramide
37
Why may you get a neutral pH on correctly sited NG?
PPI
38
Duke's criteria?
``` 2 major and 1 minor 1 major and 3 minor Confirmed- +biopsy Major- 2x +ve blood culture, +ve echo Minor- vascular/immunological phenomena Fever Predisposing factor- IVDU/Heart disease ```
39
ARDS definition?
Bilateral pulmonary infiltrates, non cardiogenic aetiology, with reduced lung compliance, PaO2<8 and PAWP >18
40
Causes of ARDS
Burns, SEPSIS, Pancreatitis, trauma, massive transfusion
41
How to calculate burns coverage?
Lund Bowder charts Rule of 9s-https://medical-dictionary.thefreedictionary.com/rule+of+nines Palm = 1%
42
What is CRP?
Acute phase protein released by the Liver in response to inflammation, activates complement
43
Blood pressure drops | What happens?
``` Decreased pressure in baroreceptors Fires to cardio centre in hypothalamus Fires off symphathetic nerve response Adrenaline/epinephrine Tachycardia/vascoconstriction ```
44
Fluid used in burns?
Hartmanns
45
Indications for surgery in hypoT?
Goitre with airway comprimise
46
Where is calcium stored?
99% bone- hydroxapatite Intracellular Albumin bound Ionised form in plasma
47
Hypocalcaemia symptoms?
``` Parasethesia, paralysis, cramps Chvosteks Trousseaus Arrythmias Seizures ```
48
What are the causes of gastric outlet obstruction?
Congenital- pyloric stenosis Benign- pseudocyst, peptic ulcer fibrosis Malignant- gastric/duodenal/pancreatic
49
In GOO why hypo K/Cl/Na? | Why aciduria?
Why hypokalaemic/chloraemic- loss from vomiting, aldosterone activated leading to K excretion to retain fluid and Na Hyponatraemia- kidneys secrete NaHCO3 to offset metbolic alkalosis, loss of sodium in vomit, no absorption due to vomiting Raised bicarb?- increased uptake in renal tubules due to loss of Cl- to maintain charge Aciduria?- paradoxical aciduria despite metabolic alkalosis, attempt to retain water, retain Na+ but secrete K+/H+ ions leading to aciduria
50
Describe the coag pathway What activates it? How to measure it
Extrinisic factor Exposure of basemement membranes- Kallikrein APTT- intrinsic PT- extrinsic
51
Pacemaker indications?
AV block- 3rd degree SAN dsyfunction Bundle branch blocks
52
Pacemaker operative considerations?
``` Model, indication and date of insertion Degree of HF Placed in basic mode Post op check Continous ECG monitoring Pacing available Limit monopolar- make sure current does not pass through monopolar ```
53
Sutures- ethilon, vicyl, silk, prolene, PDS, monocryl
Ethilon= nylon= non absorbable monofilament Silk= natural, braided, non absorbable Vicryl= braided, absorbable Prolene= unbraided, non absorbable PDS/Monocryl= absorbable monofilaments
54
How to reverse warfarin?
5 days then out of system | Vit k, FFP, beriplex

MRCS Past Questions Knowledge (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions