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Emergencies Flashcards

1
Q

hyperkalaemia management

A

10mL 10% calcium gluconate

50mL 50% insulin + 10U actrapid

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2
Q

10mL 10% calcium gluconate

50mL 50% insulin + 10U actrapid

A

hyperkalaemia management

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3
Q

potassium normal range

A

3.5-5

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4
Q

3.5-5 is the normal range for

A

potassium

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5
Q

paracetamol OD

A

NAC - N-acetyl cysteine, ABG, serum paracetamol >4h post-ingestion, LFT, U+E, PT, INR

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6
Q

NAC - N-acetyl cysteine, ABG, serum paracetamol >4h post-ingestion, LFT, U+E, PT, INR

A

paracetamol OD

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7
Q

sepsis 6: give IV fluids if low BP or lactate…

A

> 2mmol

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8
Q

sepsis 6: lactate >2mmol

A

give IV fluids

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9
Q

sepsis 6: do serial lactates

A

corroborate ABG + VBG lactate values, if >4mmol call critical care team

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10
Q

sepsis 6: corroborate ABG + VBG values, if >4mmol call critical care team

A

lactate

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11
Q

sepsis 6: fluid challenge, don’t exceed

A

30mL/kg

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12
Q

sepsis 6: don’t exceed 30mL/kg

A

fluid challenge

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13
Q

ABG PaO2 NR

A

11-13

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14
Q

ABG pH NR

A

7.35-7.45

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15
Q

ABG PaCO2 NR

A

4.6-6

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16
Q

ABG HCO3- NR

A

22-26

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17
Q

ABG 11-13

A

PaO2

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18
Q

ABG 7.35-7.45

A

pH

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19
Q

ABG 4.6-6

A

PaCO2

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20
Q

ABG 22-26

A

HCO3-

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21
Q

CSF bacterial meningitis

A

cloudy/turbid, elevated opening P, elevated WCC (polymorphs), low glucose, high protein

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22
Q

cloudy/turbid, elevated opening P, elevated WCC (polymorphs), low glucose, high protein

A

CSF bacterial meningitis

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23
Q

bacterial meningitis organisms in newborns

A

Listeria monocytogenes, E. coli, GBS

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24
Q

Listeria monocytogenes, E. coli, GBS

A

bacterial meningitis organisms in newborns

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25
Q

bacterial meningitis organisms in older children

A

Neisseria meningitidis, Haemophilus influenzae type B, Strep pneuoniae

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26
Q

Neisseria meningitidis, Haemophilus influenzae type B, Strep pneuoniae

A

bacterial meningitis organisms in older children

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27
Q

bacterial meningitis organisms in adults

A

Neisseria meningitidis, Strep pneuoniae, Listeria monocytogenes

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28
Q

Neisseria meningitidis, Strep pneuoniae, Listeria monocytogenes

A

bacterial meningitis organisms in adults

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29
Q

organophosphate poisoning antedote

A

pralidoxime

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30
Q

pralidoxime is used in

A

organophosphate poisoning

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31
Q

anticholinergic intoxication symptoms

A

flushed, aggitated, HTN, dilated pupils, tachycardia

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32
Q

flushed, aggitated, HTN, dilated pupils, tachycardia symptoms of what toxicity?

A

anticholinergic

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33
Q

agent used to reverse anticholinegic effects

A

physostigmine

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34
Q

physostigmine is used in

A

anticholinergic intoxication

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35
Q

ABG interpretation: resp acidosis

A

pH low

PaCO2 high

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36
Q

ABG interpretation: resp alkalosis

A

pH high

PaCO2 low

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37
Q

ABG BE NR

A

-2-+2

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38
Q

ABG -2-+2

A

BE

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39
Q

ABG interpretation: high flow 02

A

expect high PaO2

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40
Q

ABG interpretation: expect high PaO2

A

when PT on high flow O2

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41
Q

ABG interpretation: N PaCO2 in hypoxic asthmatic

A

sign they’re tiring, require ITU support

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42
Q

ABG interpretation: sign asthmatic required ITU support

A

hypoxic + N PaCO2

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43
Q

ABG interpretation: PaO2 on O2

A

10kPa < FiO2 e.g. PaO2 on 40% O2 = 30kPa

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44
Q

ABG interpretation: PaO2 <10

A

hypoxic

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45
Q

ABG interpretation: PaO2 <8

A

severely hypoxic = respiratory failure

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46
Q

ABG interpretation: hypoxia

A

PaO2 <10

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47
Q

ABG interpretation: severe hypoxia

A

PaO2 <8 aka respiratory failure

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48
Q

ABG interpretation: T1RF

A

PaO2 <8 + PaCO2 4.6-6

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49
Q

PaO2 <8 + N PaCO2

A

T1RF

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50
Q

ABG interpretation: T2RF

A

PaO2 <8 + PaCO2 >6

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51
Q

PaO2 <8 + PaCO2 >6

A

T2RF

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52
Q

ABG interpretation: resp acidosis with metabolic compensation

A

pH low/N
PaCO2 high
HCO3- high

53
Q

ABG interpretation: resp alkalosis with metabolic compensation

A

pH high/N
PaCO2 low
HCO3- low

54
Q

ABG interpretation: metabolic acidosis

A

pH low

HCO3- low

55
Q

ABG interpretation: metabolic alkalosis

A

pH high

HCO3- high

56
Q

ABG interpretation: metabolic acidosis with resp compensation

A

pH low/N
HCO3- low
paCO2 low

57
Q

ABG interpretation: metabolic alkalosis with resp compensation

A

pH high/N
HCO3- high
PaCO2 high

58
Q

pH low

PaCO2 high

A

resp acidosis

59
Q

pH high

PaCO2 low

A

resp alkalosis

60
Q

pH low/N
PaCO2 high
HCO3- high

A

resp acidosis with metaboic compensation

61
Q

pH high/N
PaCO2 low
HCO3- low

A

resp acidosis with metabolic compensation

62
Q

pH low

HCO3- low

A

metabolic acidosis

63
Q

pH high

HCO3- high

A

metabolic alkalosis

64
Q

pH low/N
HCO3- low
PaCO2 low

A

metabolic acidosis with respiratory compensation

65
Q

pH high/N
HCO3- high
PaCO2 high

A

metabolic alkalosis with respiratory compensation

66
Q

ABG interpretation: BE

A

high BE = suggestive of metabolic component 1’ or compensatory

67
Q

syncope triggers

A

emotion, pain, exercise

68
Q

emotion, pain, exercise can be triggers for

69
Q

syncope duration

70
Q

syncope may be preeceeded by

A

nausea, pallor, sweating

71
Q

nausea, pallor, sweating may present pre-

72
Q

seizure triggers

A

light, stress, EtOH

73
Q

light, stress, EtOH may be triggers for

74
Q

causes of resp acidosis

A

resp depression (opiates), GBS (inability to adequately ventialte), asthma, COPD

75
Q

opiates, GBS, asthma, COPD may be causes of

A

resp acidosis

76
Q

causes of resp alkalosis

A

anxiety (panic attack), pain, hypoxia, PE, pneumothorax

77
Q

panic attack, pain, hypoxia, PE, pneumothorax may be causes of

A

resp alkalosis

78
Q

causes of metabolic acidosis

A

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
Q

NR anion gap

80
Q

high anioin gap indicates

A

increased acid production/ingestion: DKA, lactic acidosis, aspirin OD

81
Q

DKA, lactic acidosis, aspirin OD may be causes of

A

metabolic acidosis, raised anion gap

82
Q

low anion gap indicates

A

reuced acid secretion/renal/GI HCO3- losses: diarrhoea, ileostomy, proximal colostomy, renal tubular acidosis, Addison’s DZ

83
Q

diarrhoea, ileostomy, proximal colostomy, renal tubular acidosis, Addison’s DZ may be causes of

A

metabolic acidosis with a reduced anion gap

84
Q

causes of metabolic alkalosis

A

diarrhoea, vomiting, loop + thiazide diuretics, HF, nephrotic S, cirrhosis, Conn’s

85
Q

diarrhoea, vomiting, loop + thiazide diuretics, HF, nephrotic S, cirrhosis, Conn’s may be causes of

A

metabolic alkalosis

86
Q

causes of T2RF

A

COPD, pneumo, rib #, obesity, MND, GBS, opiates

87
Q

COPD, pneumo, rib #, obesity, MND, GBS, opiates are all causes of

88
Q

T1RF causes

A

pulmonary oedema, bronchoconstriction (asthma), PE

89
Q

pulmonary oedema, bronchoconstriction (asthma), PE are causes of

90
Q

Cullen’s sign

A

periumbiical oedema + bruising suggestive of retroperitoneal bleeding

91
Q

periumbiical oedema + bruising

A

Cullen’s sign, suggestive of retroperitoneal bleeding

92
Q

Grey-Turner sign

A

bruising on the flanks bx, suggestive of retroperitoneal bleeding

93
Q

bruising on the flanks bx

A

Grey-Turner sign, suggestive of retroperitoneal bleeding

94
Q

McBurney’s sign

A

deep tenderness over McBurney’s point (1/3 -/- ASIS to umbilicus), suggestive of acute appendicitis

95
Q

deep tenderness over the point 1/3 -/- ASIS to umbilicus)

A

McBurney’s sign, suggestive of acute appendicitis

96
Q

Rovsing’s sign

A

palpation of the LLQ causes pain in RLQ, suggestive of acute appendicitis

97
Q

palpation of the LLQ causes pain in RLQ

A

Rovsing’s sign, suggestive of acute appendicitis

98
Q

needlestick injury immediate managment

A

correct disposal of sharps, squeeze wound, wash under tap, don’t scrub

99
Q

needlestick injury risk assessment of transmitted blood

A

safe sex, IVDU, country of origin, tattoos/piercings abroad, previous STIs, blood transfusions abroad

100
Q

if a high risk needlestick start PEP within

101
Q

risk of HIV transmission /1000 needlestick injuries

102
Q

duration of PEP

103
Q

tests after needlestick injury

A

3/12 later = HIV, Heb A + C

104
Q

PEP SE

A

N, V, diarrhoea, headaches, dizziness

105
Q

post-needlestick precautions

A

document in notes, incident form, occupational health, no exposure prone proceedures, protected sex, no blood donations

106
Q

ecstasy clinical features

A

aggitation, anxiety, confusion, ataxia, tachycardia, HTN, hyponatraemia, hyperthermia, rhabdomyolysis

107
Q

management of ecstacy

A

supportive, dantrolene (for hyperthermia)

108
Q

aggitation, anxiety, confusion, ataxia, tachycardia, HTN, hyponatraemia, hyperthermia, rhabdomyolysis describe the clinical features of

109
Q

features of opioid misuse

A

rhinorrhoea, needle tract marks, pinpoint pupils, drowsiness, watering eyes, yawning

110
Q

complications of opioid misuse

A

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
Q

management of opioid OD

A

IV naloxone

112
Q

rhinorrhoea, needle tract marks, pinpoint pupils, drowsiness, watering eyes, yawning are features of

A

opioid misuse

113
Q

neonatal resuscitation at birth

A

dry baby, remove wet towels, start the clock

114
Q

neonatla resuscitation w/i 30”

A

assess tone, RR, HR

115
Q

neonatal resuscitation w/i 60”

A

if gasping/not breathing open airway + give 5 rescue breaths

116
Q

paediatric basic life support: unresponsive start with

A

5 rescue breaths

117
Q

paediatric life support: compressions ratio

A

15:2 (if >2 rescuers, if not 30:2)

118
Q

CI to thrombolysis

A

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
Q

thrombolysis examples

A

altepase, tenecteplase, streptokinase

120
Q

SE of thrombolysis

A

haemorhage, hypotension

121
Q

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

A

thrombolysis

122
Q

altepase, tenecteplase, streptokinase are examples of

A

thrombolytic agents

123
Q

sinister headache (2+ symptoms do a CT head)

A

V >1 w/o cause, new neuro deficit, reduced GCS, coughing/sneezing/positional headaches, progressive headache with fever

124
Q

classification of croup

A 
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
Q

croup management

A

ABCDE, 0.15mg/kg PO dexamethasone, high flow O2, nebulised adrenaline

126
Q

choking management

A

“are you choking?”, A: encourage cough (if mild), 5 back blows, 5 abdo thrusts, repeat, BCDE

127
Q

NR for anion gap

128
Q

N anion gap in metabolic acidosis

A

GI HCO3- loss (D, ureterosigmoidostomy, fistula), RTA, acetazolamide, NH4Cl injeciton, Addison’s
[ABCD = Addison’s, Bicarb loss, Cl, Drugs]

129
Q

raised anion gap in metabolic acidosis

A

lactate (shock, hypoxia, burns, metformin), ketones (DKA, EtOH), urate (renal failure), acid poisoning (salicylates, MeOH)

Medicine (30 decks)

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