Emergency

Question 1

Why does haemodilution occur?

Answer 1

Intracellular shift into organs

Question 2

What are some types of wounds

Answer 2

Abrasion- frictional type of wound
Haematoma- brusising contained in one area
Contusions- bruise
Burns
Puncture wound- deep. Narrow entry point
Laceration- wound that is longer on the surface than it is deep. Blunt force injury
Incision- surgical wound. Sharp blade.
De gloving

Question 3

Features of a laceration?

Answer 3

Blunt force
Ragged edge
Full thickness
Bruised edge
Tissue bridge

Question 4

Features of an incision

Answer 4

Sharp instrument
Straight edges
No tissue bridges
More on skin rather than deep

Question 5

Features of a puncture wound

Answer 5

Depth more than wide
Stab wound
Puncture impleis blunt wound
Bites

Question 6

Puncture vs perforation

Answer 6

Perforation has an entry and an exit wound

Question 7

What is repair?

Answer 7

Putting a scar In the area

Question 8

What is regeneration?

Answer 8

Wound fixing itself
Favoured over repair

Question 9

What is primary intention healing? Vs secondary

Answer 9

Primary is bring wound together. More likely to be regelation over repair

Question 10

Why is a monofilament suture good?

Answer 10

Wider surface area. Better for cosmetic results

Question 11

Which one of burns is drier?

Answer 11

Deeper the burn the dryer

Question 12

Rule of 9s

Answer 12

Arms
Head
2 on legs
1 chest
1 abdomen
2 on back

Question 13

Primary vs secondary brain injury

Answer 13

Primary- Pathology sustained at the time of injury. Can’t reverse
Secondary- Later and potentially treatable

Question 14

What is cerebral perfusion pressure equation?

Answer 14

CPP=MAP-ICP

Question 15

What are osmotic diuretics?

Answer 15

Things that you give people intravenously to suck fluid out of brain by osmosis

Question 16

What is important when doing a GCS?

Answer 16

Is it decreasing or increasing

Question 17

Motor parts of GCS?

Answer 17

6- Obeys command
5- Localises to supraorbital pain
4- Withdraws from nailbed pain
3- Abnormal flexion to pain
2- Extension to pain
1- No response

Question 18

Who needs an emergency CT scan within 1 hour

Answer 18

Decreased GCS
Clinical evidence of base of skull fracture or suspicion of open/depressed skull fracture
Focal neurological signs
Seizure
More than 1 episode of vomiting

Question 19

Who needs a CT scan within 8 hours?

Answer 19

Anticoagulation (Warfarin/DOAC)
Coagulopathy and LOC/amnesia
Age more than 65 and LOC/Amnesia
Dangerois mechanism and LOC/Amnesia
More than 30 minutes retrograde amnesia

Question 20

What kind of blood is an extradural haemorrhage normally?

Answer 20

Arterial

Question 21

Signs of base of skull fracture?

Answer 21

Panda eyes
CSF leak from eyes and ears
Battle sign

Question 22

What is subdural haemorrhage caused by?

Answer 22

Traumatic tear to the bridging veins

Question 23

Treatment of a subdural haematoma?

Answer 23

Reverse anticoagulation
Observe- Interval CT
If large need neurosurgical intervention

Question 24

Paediatric GCS

Answer 24

Question 25

What is a toxidrome?

Answer 25

Collection of symptoms that indicate a certain overdose has been taken

Question 26

What to do in an opiate overdose?

Answer 26

Bag ventilation or BIPAP Naloxone

Question 27

Exmaples of stimulant drugs?

Answer 27

Ampehtamine Cocaine Drugs that stimulate sympathetic pathway

Question 28

A in general manageemnt principles in poisoning

Answer 28

Suction Turn onto side Intubation

Question 29

B in general management principles in poisoning

Answer 29

Hypo or hyperventilation is an issue Bag mask them, BIPAP and give them oxygen

Question 30

C in general management principles in posioning

Answer 30

Worry about VF and VT

Question 31

What is giving in posioning to counteract acidosis?

Answer 31

Bicarbonate

Question 32

What does activated charcol?

Answer 32

Binds drugs in Gii TRACT Only works if drugs is still in stomach

Question 33

In severe posioning what can you do to get rid of the drugs?

Answer 33

Dialysis

Question 34

What is used in paracetemol overdose?

Answer 34

N-acetylcystine

Question 35

Why is paracetemol toxic?

Answer 35

Small amount turned into NAPQI which is a toxic substance. Always a small amount goes to NAPQI but in high levels of paracetemol more goes to NAPQI as more drug and causes hepatotoxicity

Question 36

What to do if over treatment line in paracetemol oD?

Answer 36

Start on treatment

Question 37

When to do blood levels in paracetemol OD?

Answer 37

4 hours

Question 38

When to start treatment of paracetemol OD?

Answer 38

8 hours

Question 39

What to do if present over 8 hours with paracetemol OD?

Answer 39

Take level and start on treatment in the meantime

Question 40

What to do with a staggered OD?

Answer 40

Give treatment based on total dose and do blood tests

Question 41

What to look at in LFTs in paracetemol OD?

Answer 41

LFTs and clotting factors

Question 42

Treatment of serotnin syndrome?

Answer 42

Cooling Benzodiazopines

Question 43

Treatment for TCA OD?

Answer 43

Sodium bicarbonate

Question 44

Treatment of CCB OD?

Answer 44

Calcium gluconate Atropine (pacing) Vasopressors and inotropes Glucagon

Question 45

What is lipid emulsion rescue therapy used for?

Answer 45

LA toxicity

Question 46

Benzodiazepine OD in a hospital context manegemnt?

Answer 46

Flumaxil