Brainscape's Knowledge GenomeTM

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


See full index

MRCS-Critical care > Deck 4 > Flashcards

Deck 4 Flashcards

1
Q

What counts as fully immunised for tetanus

A

5 doses

3 in the first months
2 boosters

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

What type bacteria is tetanus

A

Gram postive
Spore forming
Anaerobe

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

Necrotising fascitis mortality

A

30%

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

What drug used to support circulation during cardiogenic shock

A

Dobutamine

B1 increase contractility
B2 vasodilates, reducing peripheral resistance

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

What drug used to support circulation in septic shock

A

Norad

A1 -> vasoconstriction

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

How to calculate MAP without BP

A

(CO * SVR) + CVP

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

Hartmanns composition

A

Na 130
Cl 110
K 5
HCO3 29

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

Saline composition

A

150 Na

150 Cl

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

How much of a 1 L bag of saline remains intravascular

A

250mls

2/3 intracellular, 20% of extracellular stays intravascular

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

How much of 5% dextrose remains intravascular

A

85mls

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

Minute ventilation

A

Tidal volume = 7ml/kg

Minute ventilation = RR * tidal volume

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

Complications of ventilation

A

Immediate: trauma to airway and teeth
Early: Barotrauma eg pneumothorax
Late: Ventilator associated pneumonia, atrophy

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

When to wean someone off ventilator

A

Resolution of injury
Adequate oxygenation
Adequate resp drive

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

Cardiac output formula

A

HR * SV

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

Def of cardiogenic shock

A

Inadequate tissue perfusion due to cardiac dysfunction

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

How does Cardioplegic solution work

A

High amount of K
Ice cold solution
Depolarises the myoctes, doesnt allow repolarisation

Stops cardiac activity and metabolism

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

Effect of massive infusion of normal saline

A

Dilution of serum bicarb -> metabolic acidosis

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

Pre-op RFs for AF

A

Age
CVS disease
Alcohol

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

Post op RFs for AF

A

Sepsis
Hyoivolaemia
Hypoxia

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

Triad of acute mesenteric ischaemia

A

BG of AF
Sudden onset abdo pain
Diarrhoea/vomiting or both

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

Why femoral vein not used commonly for a central line

A

Increased risk of thrombosis and infection

21
Q

Why femoral vein not used commonly for a central line

A

Increased risk of thrombosis and infection

22
Q

How to remove central line

A
  1. check clotting and platelets
  2. Patient flat or head down (to avoid air embolus)
  3. Removal of suture and pulling.

If tunnelled, may need removal in theatre.
Tip cut off and sent to micro

22
Q

How to remove central line

A
  1. check clotting and platelets
  2. Patient flat or head down (to avoid air embolus)
  3. Removal of suture and pulling.

If tunnelled, may need removal in theatre.
Tip cut off and sent to micro

23
Q

Ischaemia def

A

Hypoxia or anoxia causing a reduction in oxygenation of tissue

24
Q

Percentage of reinfarction if major op performed within 1 month of MI

A

30%

25
Q

Percentage of re-infarction if major surgery performed after 6 months post op

A

5%

26
Q

Clopidogrel mech of action

A

Antiplatelet

Inhibits ADP receptor on platelet cell membrane reducing platelet aggregation

27
Q

Aspirin mech of action

A

Inhibits Cox1

Stops prostoglandin release which otherwise would be converted to thromboxane, causing platelet aggregation

28
Q

COX 2 inhibition effect

A

Analgesia
Anti-inflam
Anti-pyretic

29
Q

Blood loss percentage increase in patients with single or dual antiplatelets

A

15% single agent

30% dual agent

29
Q

Blood loss percentage increase in patients with single or dual antiplatelets

A

15% single agent

30% dual agent

30
Q

Intra-op techniques to minimise blood loss

A
  • cell saver
  • tourniquets
  • Physiological hypotension
31
Q

Systemic SEs of NSAIDs

A

GI: dyspepsia, ulcer
Renal: AKI
CVS: salt and water retention
Coagulopathy

31
Q

Systemic SEs of NSAIDs

A

GI: dyspepsia, ulcer
Renal: AKI
CVS: salt and water retention
Coagulopathy

32
Q

RFs for nec fascitiis

A

Age
DM
Immunocompromised
Obesity

33
Q

Causes of necrotising fascitis

A

T1- polymicrobial including s aureus
T2- monomicrobial eg strep pyogenes
T3- monomicrobial C perferinges
T4- fungal - candida

34
Q

Score for severity of nec fasciitis

A

LRINEC Lab risk indicator for nec fasciitis

35
Q

Metabolic response to injury

A

Ebb: everything slows down, hypothermia, low CO, decreased energy expenditure

Flow:
Catabolic: protein and fat broken down, wt loss
Anabolic: increase in protein and fat storage, wt gain

36
Q

Respiratory quotient

A

Ratio of CO2 produced to O2 consumed. Determines what cells are using during metabolism

Carbs 1
Protein 0.9
Fat 0.7

37
Q

NJ compare to NG tube

A

NJ:
+s = Avoids reflux
-s = smaller, kinks more easily, needs endoscopic placement (delays feeding)

37
Q

NJ compare to NG tube

A

NJ:
+s = Avoids reflux
-s = smaller, kinks more easily, needs endoscopic placement (delays feeding)

38
Q

Typical Patient controlled anaesthetic dose and setting

A

diamorphine 0.5 mg

Lock out period 5 minutes

39
Q

What dose of nalaxone to give

A

0.4mg repeat every 2-3 mins

Max dose of 10mg

40
Q

What anaesthetic used in epidural

A

LA: bupivacaine or lidocaine
+
Opiate: fentanyl

41
Q

Methods of drainage of pancreatic pseudocyst

A

Imaging guided percutaneous drainage
Endoscopic drainage through posterior wall
Open pseudocyst-gastrostomy or jejunostomy

42
Q

How long for pancreatic pseudocysts to develop

A

at least 4 wks

Should wait for 6-12 weeks before drainage in case self resolves (50% of cases)

43
Q

Young and Bergess classification use

A

Pelvic fractures

44
Q

Young and Bergess classification components

A
  1. Anterior-posterior compression (front to back force ->open book)
  2. Lateral compression
  3. Vertical shear: fall from height. Hemipelvis displaced superiorly
45
Q

Burgess and Young classification components

A
  1. anterior posterior (open book)
  2. Lateral compression
  3. vertical shear: fall from height. hemipelvis displacement
46
Q

Where should pelvic binder be applied

A

at greater trochanter level

47
Q

How to control haemarrhage secondary to pelvic fracture

A
  1. pelvic binder
  2. IR
  3. preperitoneal packing

MRCS-Critical care (10 decks)

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