Emergency Flashcards

1
Q

When can activated charcoal be given?

A

Those who present within 1hour, fully conscious and protected airway

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

In potential trauma - initial steps

A

1) Airway
2) Cervical spine immobilisation

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

What is an appropriate Ix for cervical spine fracture?

A

CT scan of neck

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

In pt who is hypotensive + tachycardic, but adequately (overloaded even, e.g., pulmonary oedema) what is the most appropriate next treatment?

A

IV noradrenaline

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

Mx for TCA overdose

A

IV sodium bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mx beta blocker OD

A

glucagon

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

Ix to confirm anaphylaxis

A

elevated mast cell tryptase

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

Initial mx anaphylaxis

A

0.5mg of IM 1 in 1000 adrenaline
+ remove source of reaction
+ monitor >6h due to risk biphasic reaction

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

What is pathophysiology behind anaphylaxis

A
  1. Sensitisation phase
    - Immune system encounters allergen & produces allergen specific IgE
    - asyx
  2. Reaction phase
    - Re-exposure to allergen -> cross links w IgE on surface of mast cells
    - Degranulation of mast cells -> histamine release
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Fever + rash + lymphadenopathy + deranged LFTs + eosinophilia

A

Drug reaction w eosinophilia and systemic syx (DRESS)
- basc a v severe drug reaction

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

Hypersensitivity types

A

Type 1 - Anaphylaxis: Ig E; e.g., allergy
Type 2 - antiBody: IgG; e.g., goodpastures
Type 3 - immune Complx: IgG/IgM; e.g., SLE
Type 4 - Delayed: T-cell; e.g., contact derm
Type 5 - autoimmunE: IgG/IgM; e.g., Graves, MG

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

Sepsis 6

A

3 in
- high flow O2
- Fluid challenge
- IV abx

3 out
- Bloods incl lactate
- Blood culture
- Urine output

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

Primary care mx if suspected meningococcal disease

A

IM benxylpenicillin 1.2g

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

Mx if contact w pt who has meningococcal meningitis

A

Ciprofloxacin 500mg STAT

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

Encapsulated yeast on india ink staining of CSF

A

cryptococcal meningitis (seen in HIV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Neutropenic sepsis abx mx

A

Tazocin

17
Q

Meningitis mx

A

Cefotaxime
(+ampicillin if risk listeria)

18
Q

Flushed + dry + tachy + dilated pupils

A

Anticholinergic syndrome

19
Q

Reduced GCS, pupillary changes + cardioresp depression

A

Sedative - opioid, benzo

20
Q

dilated pupils, tachycardia, hypertension, hypertonia

A

serotonin syndrome/toxicity

21
Q

Opiate OD mx

A

Naloxone

22
Q

Benzos OD mx

A

Flumazenil

23
Q

Iron OD mx

A

Desferrioxamine

24
Q

Signs of basal skull #

A
  • haemotympanum
  • peri-orb bruising
  • battle’s sign - bruising behind ears
  • CSF leakage from ears/nose
25
Q

Factors for CT head <1h, <8h

A
  1. <1h
    - GCS <13
    - GCS <15 at 2hr post injury
    - Open/depressed skull #
    - Signs of basal skull #
    - >1 vomit
  2. <8h
    - None of above
    - on anticoag
    - >65
    - dangerous mode of injury

!! if deterioration -> immediate assess ± repeat imaging

26
Q

Facial N palsy following head injury

A

Basal skull #

27
Q

Unilateral ptosis (drooping lid) + down and out eye + fixed dilated pupil

A

Surgical/traumatic 6th N palsy

28
Q

Cocaine OD mx

A

Benzodiazepine

29
Q

Low GCS + dilated pupils + tachy + brady + prolonged QRS!!

A

TCA overdose