Brainscape's Knowledge GenomeTM

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


See full index

Year 5 notes > Emergencies and substance abuse > Flashcards

Emergencies and substance abuse Flashcards

1
Q

mechanism of action of adrenaline

A

alpha-receptor agonist (reverses peripheral vasodilation and oedema)

also has beta-receptor activity (dilates bronchial airways, increases force of myocardial contraction and suppresses histamine and leukotriene release)

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

dosage of adrenaline to use for anaphylaxis at different ages

A
  • adult >12 = 500mcg
  • child 6-12 = 300mcg
  • child <6 years = 150mcg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

first choice vasopressor in septic shock

A

noradrenaline

dobutamine can be added if myocardial dysfunction

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

leading cause of death in acute MI

A

cariogenic shock

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

stages I-IV of haemorrhagic shock

A 
I = <15% blood loss
II = 15-30%
III = 30-40%
IV = >40%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

examples of non-haemorrhagic hypovolaemic shock

A
  • dehydration, D&V, burns, polyuria

- 3rd space loss - pancreatitis, ascites

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

why not to push BP >100 if in haemorrhagic shock

A

might dislodge clot trying to form

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

when to consider major haemorrhage protocol and what does it entail

A
  • actively bleeding, HR >110, BP <90

- 4 units blood, 4 units FFP every 20 mins

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

causes of T2RF

A
  • COPD
  • near fatal asthma
  • drug overdose/poisoning
  • myasthenia gravis
  • polyneuropathy
  • muscle disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

usual cause of cardiogenic pulmonary oedema

A

complication of MI/IHD

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

usual cause of non-cardiogenic pulmonary oedema

A

IV fluid overload

could also be caused by decreased plasma oncotic pressure e.g. hypoalbuminaemia

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

ABG result in pulmonary oedema

A

acidotic - not perfusing tissues

hypoxic and hypercapnia - impaired gas exchange

lactate likely elevated - tissues hypo perfused

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

dose of furosemide to give in pulmonary oedema/acute heart failure

A

20-40mg if diuretic naive

otherwise 40mg

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

antiemetic to give in pulmonary oedema

A

ondansetron 4-8mg

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

signs of obstructive shock

A

fluid overload:

  • pulmonary oedema
  • cardiomegaly
  • raised JVP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

causes of obstructive shock

A
  • PE
  • tension pneumothorax
  • cardiac tamponade

basically blocking outflow of blood from heart

17
Q

brain complication of paracetamol overdose

A

hepatic encephalopathy

18
Q

LFT results in paracetamol overdose indicating hepatotoxicity

A

ALT >1000

19
Q

blood glucose level in paracetamol overdose

A

hypoglycaemic

20
Q

amount of paracetamol ingested suggesting severe liver damage

A

> 150mg/kg

more than 24 tablets (12g) is potentially fatal

21
Q

what drugs increase paracetamol toxicity

A

p450 INDUCERS: P CARBS

P - phenytoin
C - carbamazepine
A - alcohol (chronic) 
R - rifampicin
B - barbiturates 
S- sulfonylureas
22
Q

when can pabrinex (NAC) be stopped after paracetamol overdose

A

once INR <1.3 and ALT <2x upper limit of normal/hasn’t doubled

23
Q

when to consider liver transplant for paracetamol overdose

A

if pH <7.3 24 hours after ingestion OR

  • PTT >100 seconds AND
  • creatinine >300 ANDF
  • grade III or IV encephalopathy
24
Q

how much naloxone to give in opiate overdose

A

0.4-2mg

may require infusion/multiple doses (IV/IM)

25
Q

ECG findings in TCA overdose

A
  • sinus tachycardia
  • widening PR or QRS complexes - QRS >100ms associated with increased risk of seizures
  • QTc heart block
  • ventricular dysrhythmias
26
Q

drugs to give in TCA overdose

A
  • IV bicarbonate

- IV lipid emulsion (binds free drug and reduces toxicity)

27
Q

doses of salicylates likely to cause toxicity (e.g. aspirin)

A

> 250mg/kg - moderate

> 500mg/kg - severe/fatal

28
Q

how to take plasma salicylate concentration

A
  • taken 2 hours (symptomatic) or 4 hours (asymptomatic) after ingestion
  • repeat after a further 2 hours
  • intoxication usually associated with concentrations >350mg/L
  • check potassium every 3 hours
29
Q

when is hospital admission not required for aspirin overdose

A

ingested <125mg/kg and no symptoms

30
Q

when to consider activated charcoal/gastric lavage for aspirin overdose

A
  • charcoal if >125mg/kg less than 1 hour ago

- gastric lavage if >500mg/kg less than 1 hour ago

31
Q

when to do haemodialysis in aspirin overdose

A
  • serum concentration >700mg/L
  • metabolic acidosis resistant to treatment
  • acute renal failure
  • pulmonary oedema
  • seizures
  • coma
32
Q

antidote to iron overdose

A

desferrioxamine mesylate IV

33
Q

mechanism of action of ketamine

A

NMDA antagonist

34
Q

mechanism of action of cocaine

A

monoamine reuptake inhibitor

potentiates dopaminergic, serotinergic and noradrenalinergic transmission

35
Q

what can be used for heroin detox

A
  • symptom relief = lofexidine (alpha agonist)
  • loperamide
  • metoclopramide
  • ibuprofen
  • methadone or buprenorphine or dihydrocodeine
36
Q

mechanism of action of benzodiazepines and GHB

A

GABA agonist

37
Q

how long to give chlordiazepoxide for alcohol withdrawal

A

over 5-7 days with reducing dose

38
Q

management of delirium tremens

A

parenteral thiamine (Pabrinex):

  • no WK syndrome = 250mg/day for 3-5 days
  • WK syndorme = 500mg/day for 3-5 days

prophylactic carbamazepine (if previous hx of seizures)

chlordiazepoxide

39
Q

what counts as binge drinking

A

twice the recommended daily unit limit in one session - 6 units

Year 5 notes (10 decks)

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