Emergencies Flashcards
1
Q
hyperkalaemia management
A
10mL 10% calcium gluconate
50mL 50% insulin + 10U actrapid
2
Q
10mL 10% calcium gluconate
50mL 50% insulin + 10U actrapid
A
hyperkalaemia management
3
Q
potassium normal range
A
3.5-5
4
Q
3.5-5 is the normal range for
A
potassium
5
Q
paracetamol OD
A
NAC - N-acetyl cysteine, ABG, serum paracetamol >4h post-ingestion, LFT, U+E, PT, INR
6
Q
NAC - N-acetyl cysteine, ABG, serum paracetamol >4h post-ingestion, LFT, U+E, PT, INR
A
paracetamol OD
7
Q
sepsis 6: give IV fluids if low BP or lactate…
A
> 2mmol
8
Q
sepsis 6: lactate >2mmol
A
give IV fluids
9
Q
sepsis 6: do serial lactates
A
corroborate ABG + VBG lactate values, if >4mmol call critical care team
10
Q
sepsis 6: corroborate ABG + VBG values, if >4mmol call critical care team
A
lactate
11
Q
sepsis 6: fluid challenge, don’t exceed
A
30mL/kg
12
Q
sepsis 6: don’t exceed 30mL/kg
A
fluid challenge
13
Q
ABG PaO2 NR
A
11-13
14
Q
ABG pH NR
A
7.35-7.45
15
Q
ABG PaCO2 NR
A
4.6-6
16
Q
ABG HCO3- NR
A
22-26
17
Q
ABG 11-13
A
PaO2
18
Q
ABG 7.35-7.45
A
pH
19
Q
ABG 4.6-6
A
PaCO2
20
Q
ABG 22-26
A
HCO3-
21
Q
CSF bacterial meningitis
A
cloudy/turbid, elevated opening P, elevated WCC (polymorphs), low glucose, high protein
22
Q
cloudy/turbid, elevated opening P, elevated WCC (polymorphs), low glucose, high protein
A
CSF bacterial meningitis
23
Q
bacterial meningitis organisms in newborns
A
Listeria monocytogenes, E. coli, GBS
24
Q
Listeria monocytogenes, E. coli, GBS
A
bacterial meningitis organisms in newborns
25
bacterial meningitis organisms in older children
Neisseria meningitidis, Haemophilus influenzae type B, Strep pneuoniae
26
Neisseria meningitidis, Haemophilus influenzae type B, Strep pneuoniae
bacterial meningitis organisms in older children
27
bacterial meningitis organisms in adults
Neisseria meningitidis, Strep pneuoniae, Listeria monocytogenes
28
Neisseria meningitidis, Strep pneuoniae, Listeria monocytogenes
bacterial meningitis organisms in adults
29
organophosphate poisoning antedote
pralidoxime
30
pralidoxime is used in
organophosphate poisoning
31
anticholinergic intoxication symptoms
flushed, aggitated, HTN, dilated pupils, tachycardia
32
flushed, aggitated, HTN, dilated pupils, tachycardia symptoms of what toxicity?
anticholinergic
33
agent used to reverse anticholinegic effects
physostigmine
34
physostigmine is used in
anticholinergic intoxication
35
ABG interpretation: resp acidosis
pH low
| PaCO2 high
36
ABG interpretation: resp alkalosis
pH high
| PaCO2 low
37
ABG BE NR
-2-+2
38
ABG -2-+2
BE
39
ABG interpretation: high flow 02
expect high PaO2
40
ABG interpretation: expect high PaO2
when PT on high flow O2
41
ABG interpretation: N PaCO2 in hypoxic asthmatic
sign they're tiring, require ITU support
42
ABG interpretation: sign asthmatic required ITU support
hypoxic + N PaCO2
43
ABG interpretation: PaO2 on O2
10kPa < FiO2 e.g. PaO2 on 40% O2 = 30kPa
44
ABG interpretation: PaO2 <10
hypoxic
45
ABG interpretation: PaO2 <8
severely hypoxic = respiratory failure
46
ABG interpretation: hypoxia
PaO2 <10
47
ABG interpretation: severe hypoxia
PaO2 <8 aka respiratory failure
48
ABG interpretation: T1RF
PaO2 <8 + PaCO2 4.6-6
49
PaO2 <8 + N PaCO2
T1RF
50
ABG interpretation: T2RF
PaO2 <8 + PaCO2 >6
51
PaO2 <8 + PaCO2 >6
T2RF
52
ABG interpretation: resp acidosis with metabolic compensation
pH low/N
PaCO2 high
HCO3- high
53
ABG interpretation: resp alkalosis with metabolic compensation
pH high/N
PaCO2 low
HCO3- low
54
ABG interpretation: metabolic acidosis
pH low
| HCO3- low
55
ABG interpretation: metabolic alkalosis
pH high
| HCO3- high
56
ABG interpretation: metabolic acidosis with resp compensation
pH low/N
HCO3- low
paCO2 low
57
ABG interpretation: metabolic alkalosis with resp compensation
pH high/N
HCO3- high
PaCO2 high
58
pH low
| PaCO2 high
resp acidosis
59
pH high
| PaCO2 low
resp alkalosis
60
pH low/N
PaCO2 high
HCO3- high
resp acidosis with metaboic compensation
61
pH high/N
PaCO2 low
HCO3- low
resp acidosis with metabolic compensation
62
pH low
| HCO3- low
metabolic acidosis
63
pH high
| HCO3- high
metabolic alkalosis
64
pH low/N
HCO3- low
PaCO2 low
metabolic acidosis with respiratory compensation
65
pH high/N
HCO3- high
PaCO2 high
metabolic alkalosis with respiratory compensation
66
ABG interpretation: BE
high BE = suggestive of metabolic component 1' or compensatory
67
syncope triggers
emotion, pain, exercise
68
emotion, pain, exercise can be triggers for
syncope
69
syncope duration
seconds
70
syncope may be preeceeded by
nausea, pallor, sweating
71
nausea, pallor, sweating may present pre-
syncope
72
seizure triggers
light, stress, EtOH
73
light, stress, EtOH may be triggers for
seizure
74
causes of resp acidosis
resp depression (opiates), GBS (inability to adequately ventialte), asthma, COPD
75
opiates, GBS, asthma, COPD may be causes of
resp acidosis
76
causes of resp alkalosis
anxiety (panic attack), pain, hypoxia, PE, pneumothorax
77
panic attack, pain, hypoxia, PE, pneumothorax may be causes of
resp alkalosis
78
causes of metabolic acidosis
use the anion gap to calculate: +ve ions - -ve ions
| increased acid producion/ingestion (raised anion gap) vs decreased acid secretion/HCO3- losses (low)
79
NR anion gap
4-12
80
high anioin gap indicates
increased acid production/ingestion: DKA, lactic acidosis, aspirin OD
81
DKA, lactic acidosis, aspirin OD may be causes of
metabolic acidosis, raised anion gap
82
low anion gap indicates
reuced acid secretion/renal/GI HCO3- losses: diarrhoea, ileostomy, proximal colostomy, renal tubular acidosis, Addison's DZ
83
diarrhoea, ileostomy, proximal colostomy, renal tubular acidosis, Addison's DZ may be causes of
metabolic acidosis with a reduced anion gap
84
causes of metabolic alkalosis
diarrhoea, vomiting, loop + thiazide diuretics, HF, nephrotic S, cirrhosis, Conn's
85
diarrhoea, vomiting, loop + thiazide diuretics, HF, nephrotic S, cirrhosis, Conn's may be causes of
metabolic alkalosis
86
causes of T2RF
COPD, pneumo, rib #, obesity, MND, GBS, opiates
87
COPD, pneumo, rib #, obesity, MND, GBS, opiates are all causes of
T2RF
88
T1RF causes
pulmonary oedema, bronchoconstriction (asthma), PE
89
pulmonary oedema, bronchoconstriction (asthma), PE are causes of
T1RF
90
Cullen's sign
periumbiical oedema + bruising suggestive of retroperitoneal bleeding
91
periumbiical oedema + bruising
Cullen's sign, suggestive of retroperitoneal bleeding
92
Grey-Turner sign
bruising on the flanks bx, suggestive of retroperitoneal bleeding
93
bruising on the flanks bx
Grey-Turner sign, suggestive of retroperitoneal bleeding
94
McBurney's sign
deep tenderness over McBurney's point (1/3 -/- ASIS to umbilicus), suggestive of acute appendicitis
95
deep tenderness over the point 1/3 -/- ASIS to umbilicus)
McBurney's sign, suggestive of acute appendicitis
96
Rovsing's sign
palpation of the LLQ causes pain in RLQ, suggestive of acute appendicitis
97
palpation of the LLQ causes pain in RLQ
Rovsing's sign, suggestive of acute appendicitis
98
needlestick injury immediate managment
correct disposal of sharps, squeeze wound, wash under tap, don't scrub
99
needlestick injury risk assessment of transmitted blood
safe sex, IVDU, country of origin, tattoos/piercings abroad, previous STIs, blood transfusions abroad
100
if a high risk needlestick start PEP within
1h
101
risk of HIV transmission /1000 needlestick injuries
3
102
duration of PEP
28/7
103
tests after needlestick injury
3/12 later = HIV, Heb A + C
104
PEP SE
N, V, diarrhoea, headaches, dizziness
105
post-needlestick precautions
document in notes, incident form, occupational health, no exposure prone proceedures, protected sex, no blood donations
106
ecstasy clinical features
aggitation, anxiety, confusion, ataxia, tachycardia, HTN, hyponatraemia, hyperthermia, rhabdomyolysis
107
management of ecstacy
supportive, dantrolene (for hyperthermia)
108
aggitation, anxiety, confusion, ataxia, tachycardia, HTN, hyponatraemia, hyperthermia, rhabdomyolysis describe the clinical features of
ecstacy
109
features of opioid misuse
rhinorrhoea, needle tract marks, pinpoint pupils, drowsiness, watering eyes, yawning
110
complications of opioid misuse
viral infection (HIV, hep B, C) 2' to sharing needles, bacterial infection (IE, septic arthritis, septicaemia, necrotising fasciitis) 2' to injecting, VTE, respiratory depression, cravings, crime, prostitution, homelessness
111
management of opioid OD
IV naloxone
112
rhinorrhoea, needle tract marks, pinpoint pupils, drowsiness, watering eyes, yawning are features of
opioid misuse
113
neonatal resuscitation at birth
dry baby, remove wet towels, start the clock
114
neonatla resuscitation w/i 30"
assess tone, RR, HR
115
neonatal resuscitation w/i 60"
if gasping/not breathing open airway + give 5 rescue breaths
116
paediatric basic life support: unresponsive start with
5 rescue breaths
117
paediatric life support: compressions ratio
15:2 (if >2 rescuers, if not 30:2)
118
CI to thrombolysis
active internal bleeding, recent haemorrhage/trauma/Sxs, coagulation/bleeding disorders, intracranial neoplasm, stroke <3/12 ago, aortic dissection, recent head injury, pregnancy, severe HTN
119
thrombolysis examples
altepase, tenecteplase, streptokinase
120
SE of thrombolysis
haemorhage, hypotension
121
active internal bleeding, recent haemorrhage/trauma/Sxs, coagulation/bleeding disorders, intracranial neoplasm, stroke <3/12 ago, aortic dissection, recent head injury, pregnancy, severe HTN are CI of
thrombolysis
122
altepase, tenecteplase, streptokinase are examples of
thrombolytic agents
123
sinister headache (2+ symptoms do a CT head)
V >1 w/o cause, new neuro deficit, reduced GCS, coughing/sneezing/positional headaches, progressive headache with fever
124
classification of croup
```
mild = occasional cough, no stridor, mild effort of breathing, well child
moderate = frequent cough, stridor at rest, recession, mildly stressed child
severe = frequent cough, prominant stridor, marked recession, significant distress, tachycardia, hypoxia
```
125
croup management
ABCDE, 0.15mg/kg PO dexamethasone, high flow O2, nebulised adrenaline
126
choking management
"are you choking?", A: encourage cough (if mild), 5 back blows, 5 abdo thrusts, repeat, BCDE
127
NR for anion gap
10-18
128
N anion gap in metabolic acidosis
GI HCO3- loss (D, ureterosigmoidostomy, fistula), RTA, acetazolamide, NH4Cl injeciton, Addison's
[ABCD = Addison's, Bicarb loss, Cl, Drugs]
129
raised anion gap in metabolic acidosis
lactate (shock, hypoxia, burns, metformin), ketones (DKA, EtOH), urate (renal failure), acid poisoning (salicylates, MeOH)
