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CCE > ED+Epi+Misc > Flashcards

ED+Epi+Misc Flashcards

1
Q

Treatment of impetigo in endemic settings

A

Single IMdose of benzathine benzylpenicillin
Other option - oral bactrim

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2
Q

Pt with cellulitis, states previous prophylaxis to penicillin

A

Oral bactrim for 5/7

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3
Q

Pt with anaphylaxis, Rx steps + doses (6)

A
  1. Remove trigger
  2. Position flat or sitting
  3. Adrenaline
    - Adults: 0.5mg (0.5ml of 1:1000)
    - Paeds: 10mck/kg (0.01ml/kg of 1:1000)
  4. Rpt adrenaline 5mins if needed
    Shock
    • IV access
    • Fluid bolus
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4
Q

Mx Steps in ITP (5)

A
  1. Avoid anti-platelets or NSAIDs
  2. Advise retricting contact sports
  3. Advise present to ED if significant bleeding or severe headache
  4. Advise rpt FBE in 1wk
  5. Provide written information
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5
Q

DDx for UGI bleed/haematemesis (6)

A
  1. Bleeding peptic ulcer
  2. Ruptured oesophageal varice
  3. Erosive oesophagitis
  4. Mallory-Weis tear
  5. Gastric or oesoph cancer
  6. Angiodysplasia
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6
Q

When to stop DOAC prior to surgery

A

Any high risk/major op = Withhold for 48hrs (ie last dose 3 days prior to surgery)
- Recommence 48-72hrs post op

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7
Q

Snake bite in rural ED. Pt in shock. Immediate management (6)

A
  1. Seek urgent advice from poisons information or toxicologist
  2. Apply pressure bandage over entire limb
  3. Immobilise the patient
  4. Obtain 2x large bore cannula in cub fossa
  5. Administer fluids
  6. Appropriate analgesia
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8
Q

Non-pharma management options for IBS? (6)

A
  1. Use food diary to indentify triggers to avoid
  2. Refer to dietician for low FODMAP diet plan
  3. Refer to pyschologist for CBT
  4. Advise meal portion control
  5. > 30g fibre intake (if constipated)
  6. Refer to hypnotherapist for gut base hypnotherpay for refractory symptoms
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9
Q

What drug mistake to AVOID in anaphylaxis

A

Do not give anti-histamine
Can drop BP

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10
Q

38M with T21 brought in by carer. Been aggressive recently. DDx (7)

A
  1. Mental illness - depression
  2. Environmental - abuse
  3. GI disturbance - constipation
  4. infection - UTI
  5. Geri - early onset dementia
  6. Unrecognized pain
  7. Sleep disturbance
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11
Q

KFP Emergency situation - common marks (4+4)

A
  1. Call ED/relevant specialist for advice
  2. Insert 2x large bore cannulas
  3. Give 1L NS bolus immediately
  4. Give relevant medication to case

Other common
- oxygen
- group+hold
- NBM
- Analgesia

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12
Q

Pharmacological options for smoking cessation (4)

A
  1. NRT - LA
  2. Varenicline (champix) - grade up to BD over 1wk, for 12wks
  3. Bupropion oral daily
  4. Oral nortriptyline
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13
Q

KFP: Hx to assist with further treatment of chronic wound? depends on what info has already been given (6)

A
  1. Smoking status
  2. Tetanus immunisation status
  3. ?Reduced sensation
  4. Claudication
  5. Any discharge?
  6. What has been tried so far
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14
Q

Features of venous ulcer (4)

A
  1. Varicosisty or venous eczema/flare
  2. Lipodermatosclerosis - hard skin, inverted wine bottle
  3. Haemosiderin staining
  4. Oedema
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15
Q

Patient non compliant with treatment, options to improve their involvement (not relevant to all patients) (6)

A
  1. Educate about poor outcomes of poor compliance
  2. Arrange a Webster pack
  3. Organise a HMR
  4. Arrange home visits (GP or nursing)
  5. Involve family with patients permission
  6. Involve aboriginal health worker
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16
Q

Factors in evidence based medicine

A

Overlap of
- Best available evidence
- Doctors judgement
- Patients value

17
Q

Reviewing medical lit/evidence
- what makes the study strong (VALID) (4)

A
  • does it have an appropaite PICO (is the patient applicable, is the intervention what we want, do we care about this outcome)
  • is it blinded (and to what extent)
  • is it randomised (and did this work - are the patient groups similar)
  • p<0.05 = statistically significant. comment on both statistical significance and then if also clinically significant
18
Q

Delivering bad news/results (6)

A
  1. Setting - need anyone else, organise long appt
  2. Perception - what do they know OR expecting
  3. Deliver Knowledge - simple and short
  4. Empathy - acknowledge
  5. Summarise - simple plan, summarize, written info
  6. Follow-up - within 1 wk
19
Q

Four concerns that would trigger mandatory report to AHPRA for colleague

A
  • impairment
  • intoxication whilst practicing
  • sexual misconduct
  • significant departure from accepted standards
20
Q

TH appt, personal attended funeral, asking for sick cert for sick leave for last 10 days
Steps? (5)

A
  1. Offer condolences
  2. Explain medical certificate only for medical illness
  3. Explain might be eligble for personal leave
  4. Offer letter of support
  5. Offer F2F follow-up to assess further
21
Q

KFP: Patient with high risk hx+ex for eg. cancer. You send for investigations but they dont attend follow-up.
What actions may you take to follow this up? (5)

A
  1. Contact patient urgently because of possible serious underlying pathology
  2. Sen registered letter to request urgent contact as serious consequences of delay
  3. Contact NOK and request that patient contact me
  4. Check with local hospital if pt admitted
  5. Check with emergency services to see if they have attended her
22
Q

Conta-indications for bupropion (3)

A
  1. Hx of Seizures
    + during abrupt withdrawal from ETOH + BZD
  2. Eating disorders
  3. Irreversible MAO-inhibitors
23
Q

19yo with CP + ID, some communication difficulties. What methods could you employ to support pt with communication (6)

A
  1. Speak directly to pt
  2. Avoid medical jargon
  3. Use visual aids
  4. Ask simple yes/no questions
  5. Involve family member if relevant
  6. Check regularly that they have understood
24
Q

Pt requesting permanent disability paperwork for short term injury - alternative supports you can offer (4)

A
  1. Medical cert for time off
  2. Centrelink certificate for alt income
  3. Letter support to income protection if have any
  4. Work cover cert if appropiate

CCE (18 decks)

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