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FRACP > ED > Flashcards

ED Flashcards

1
Q

Neck xrays
What are the 4 lines to follow
How big should the retropharyngeal space be

A

Ant and post vertebral, spinolaminal and spinous process tips
< half a vert body at c2
< full at c6

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2
Q

Is c2/3 subluxation normal in children

A

Yes!

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3
Q

What is a c2 pedicel fracture otherwise called

How is it seen

A

Hangman fracture

Open mouth views

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4
Q

What happens in a Jefferson fracture

A

Burst fracture of c1

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5
Q

Do wedge fractures risk the spinal cord?

A

No!

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6
Q

What is the treatment for a scaphoid fracture

What are the 2 possible bad outcomes

A

Short arm cast with thumb extension

AVN or non union

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7
Q

How are epicondyle avulsion fractures seen

What is the mnemonic

A

Abnormal ossification centres

CRITOE

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8
Q

What upper arm fracture can damage the median nerve

A

Supracoldylar

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9
Q

What is seen on a monteggias fracture

Which line is lost?

A

Displacement of the radial head and ulnar fracture-

Lose radiocapitellar lines

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10
Q

What does a posterior fat pad indicate

A

Supracondylar fracture

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11
Q

What age does a sufe occur
If not obesity what rarely can cause it
How is it best seen on X-ray

A

12 years
Hypothyroidism or growth hormone deficiency
Loss of klein line

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12
Q

How does perches disease look differently to sufe on X-rays

What usually causes it

A

Klein line is normal, femoral head is irregular

Idiopathic

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13
Q

Where are they tender
Osgood schlater disease
Sinding larding johansen

A

Tibial tuberosity

Higher- inf patellar pole

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14
Q

Which toxins should not be given activated charcoal

A 
P- pesticides and petroleum 
H- hydrocarbons and heavy metal 
A- acids alcohol and alkali
I- iron 
L- lithium 
S- solvents
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15
Q

What should not be used in seizures with toxic ingestion

A

Phenytoin

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16
Q

What can hyperthermia predict in toxic ingestion

What should be done for a temp >39 degrees

A

Multi organ failure

Neuromuscular paralysis and intubation

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17
Q 
Name the antidote
TCA 
Organophosphate 
Lead 
Iron
A

Sodium bicarb
Atropine
Dimercalprol
Deferoxamine

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18
Q 
Name the antidote
Salicylates
Methanol 
Benzodiazepines 
Beta blockers 
Ca channel blockers
A 
Na bicarb
Ethanol 
Flumazenil 
High dose insulin 
Ca infusion and “
19
Q

What overdose might you use multi dose charcoal for?

A

Carbamazepine

20
Q

What ingestion might you use urinary alkinisation for

A

Salicylates

21
Q

What are the features of an anticholinergic toxidrome

What meds can cause it

A

Agitated confused and picking at objects. Dry. Tachycardic. Big pupils. Reduced or absent bowel sounds. Urinary retention

Antihistamines and TCAs

22
Q

What are the symptoms of a cholinergic toxidrome
What meds can cause it
What is the specific treatment. How much do you give

A

Copious secretions, lots of urine. Vomiting and diarrhoea. Eventual resp depression. Pinpoint pupils
Organophosphates, mushrooms, nerve agents

Atropine until the secretions stop!

23
Q

What are symptoms of a sympathomimetic toxidrome?

What meds cause it?

A

Tachycardia and sweating. Big pupils. Raised temp

Ecstasy, MDMA. Ritalin

24
Q

What are symptoms of serotin syndrome
What usually causes it
Give examples of meds

A

Clonus, agitation, big pupils and sweating
Swapping meds or multiple meds
SSRIs with fentanyl or tramadol

25
Q

How is neuroleptic malignant syndrome different to serotonin syndrome

A

Slower onset
No pupil change
More rigid with no clonus normally

26
Q

What three views are needed in a c spine series

A

AP and lateral neck views

PEG view

27
Q

Where are c spine injuries likely to be in
Infants
Older children

A

C1-3

C3-7

28
Q

What agents should be used for rapid sequence induction in trauma

A

Ketamine and rocuronium

29
Q

Trauma
What additional products are given to replace
Low fibrinogen
Prolonged APTT

A

Cryoprecipitate

FFP

30
Q

What is a common injury in the abdomen seen with handlebars

A

Duodenal perforation

31
Q

How much haematuria warrants a CT abdomen

A

> 30

32
Q

What is a likely organism seen in fight bites

Which is a good antibiotic to use

A

Eikinella

Augmentin

33
Q

Burns
How long should they be cooled for
What is different about the rule of 9s In babies
What is the ideal temp of water

A

20 mins
Babies heads are 18% not 9
18 degrees

34
Q

When is the biggest risk of bleeding from Eschar formation

A

2-3 weeks

35
Q

What is the biggest side effect of ketamine

Does proposal provide analgesia

A

Laryngospasm

No!

36
Q

What 4 scenarios make a foreign body unable to be conservatively managed

A

Batteries
Magnets
>$2 coin (>25mm)
Longer than 5cms

37
Q

What dose of adrenaline is given in cardiac arrest

What energy is given in J for defibrillation

A

10microgram/kg of 1:10000

4J/kg

38
Q

What strengh of adrenaline is given in anaphylaxis in community
In hospial? Dose?

What strength of adrenaline is used in resus? What dose

A

1: 1000
0. 1ml/kg 1:10000 or 0.01ml/kg of 1:1000 (always 5 zeros!!)

10 micro grams per kg of 1:10000

39
Q

What is the algorithm for vt with pulse and no shock
“With shock
What can amiodarone cause
If there is torsades what should be given

A

Amiodarone infusion then synchronised shocks
Shock 1j/kg then 2j/kg and amiodarone infusion
Hypotension
Magnesium sulfate

40
Q 
Catecholaminergic polymorphic VT 
What causes it 
What is seen on ecg
What happens with adrenaline 
What is the treatment
A

AD channelopathy
Frequent ventricular ectopics
Polymorphic VT
IV morphine

41
Q

What weight is a size 2 LMA useful for

A

<20kg

42
Q

How do you calculate estimated weight

A

(Age+4) x 2

43
Q

What age group should uncuffed ETTs be used

How are they measured

A

<8yrs

(Age/4) +4

44
Q

What physiologically happens In Paracetamol overdose

How does NAC help this

A

Depletes glutathione stores and builds up NAPQI

Replenishes your stores

FRACP (23 decks)

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