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Emergency Flashcards

1
Q

Measured serum osmolality estimate formula

A

2[Na+]+[glucose]/18+[BUN]/2.8

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2
Q

Anticholinergic toxidrome

A

Mad as a hatter, dry as a bone, red as a beet, hot as a hare, blind as a bat (tachycardia, urinary retention, ileus)

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3
Q

Cholinergic-muscarinic toxidrome

A 
DUMBELLS
Diarrhoea, urination, miosis.
Brady/bronchoconstrict
Emesis
Lacrimation
Lethargy
Salivation
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4
Q

Cholinergic-nicotinic toxidrome

A 
Days of week 
Miosis
Tachycardia 
Weakness 
Tremors 
Fasiculations
Seizures
Somulence
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5
Q

Anion gap

A

[Na+]-([Cl-]+[HCO3-])

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6
Q

Resist adrenaline dose

A

10mcg/kg

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7
Q

Toxins which constrict and dilate pupils

A

Constrict: organophosphates, cholinergics (tears everywhere - salivation, lacrimation, sweat, incontinent )
Dilated: anticholinergics including TCA(mad as a hatter, red as a beet, dry as a bone, Lind as s bat, hot as hell)

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8
Q

Serotonin syndrome clinically

A 
Agitated, delirium
Tachycardia 
Fever
Sweating
Dilated pupils
Nausea and vomiting
Increased tone and reflexes and myoclonic jerks
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9
Q

Pupils in ecstasy

A

Dilated

Cyprhepidate if antidote critical

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10
Q

Carbon monoxide most important toxic mechanism

A

Reverse binding to cytochrome A3

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11
Q

Iron chelation agent in overdose

A

Desferoxamine

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12
Q

Snake bite most common manifestation

A

Coagulopathy

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13
Q

Lead poisoning on X-ray

A

Dense white metsphysesl bands

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14
Q

Mnemonic for wormian bones

A

PORK CHOPs

Pyknodysostosis
Osteogenesis imperfection
Rickets
Kinky hair
Cleidocranial dysostosis
Hypothyroid hypophosphataemia 
Idiopathic
Progeria
Syndromes
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15
Q

Do retinal haemorrhages occur in pertussis

A

No

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16
Q

NAI fracture types

A

Spiral fracture and fracture of distal metaphasis (bucket handle and corner fracture)

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17
Q

Myocarditis causes

A

Coxsackie, adeno, echo
Drugs
Immune mediated

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18
Q

Chest wall rigidity SE of..

A

Fentanyl

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19
Q

Hangmans frscture

A

C2 pedicels

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20
Q

Jefferson frscture

A

Burst C1

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21
Q

Sclerotic bone lesion

A

Think osteosarcoma

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22
Q

Monteggia and galeazzi #

A

GRUesome MURder
Galeazzi radius fracture ulnur dislocation
Monteggia ulnar fracture radial head dislocation

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23
Q

If VF or pulseless VT witness in monitor then..

A

Defibrillate straight away

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24
Q

Adrenaline dose IM and IV

A

IM 0.01ml/kg 1:1000

IV 0.1ml/kg of 1:10000

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25
Q

What is commotio cordis

A

Sudden death Vf in blunt trauma to anterior chest

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26
Q

Risk with supracondylar fracture

A

Median nerve and brachial artery

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27
Q

How much percent pseudosubluxation. Ervicso spine 2-3 in <8 y

A

40%

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28
Q

Acute vestibular neuritis any hearing loss

A

No

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29
Q

Retinitis pigmentosa assoc with

A

Bardot-Bielefeld (finger and limb abnormalities)

Usher (SNHL)

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30
Q

How common eczema in NZ kids

A

15-20%

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31
Q

FLG gene for filaggrin important in

A

Skin barrier

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32
Q

Fingertip unit steroid =

A

0.5g covers size of two palms of hand

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33
Q

Thumb and steeple sign on neck X-ray indicate

A

Thumb - epiglottitis

Steeple - croup

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34
Q

Snake bite management

A

Apply a pressure immobilisation bandage - immobilise joints either side of bite (use a splint), lay the patient down. The aim is to prevent lymphatic spread of venom, not to stop blood supply
Antivenom

35
Q

The classic findings of a what are unilateral, purulent, malodorous, sometimes bloody discharge.

36
Q

VF and pulseless VT give amiodarone when

A

After 3rd shock

37
Q

Shock straight away

A

When witness change to a shockable rhythm on ECG

38
Q

Beta blocker and calcium blocker antidote
Isoniazid antidote
Benzodiazepines antidote
Sulphonurea antidote

A

Glucagon (and calcium glauconate)
Pyridoxine
Flumazanil
Octreotide

39
Q

Meckles investigation

A

• 99m Technetium pertechnetate scan for ectopic gastric mucosa
Sensitivity improved by ranitidine
Laparoscopy

40
Q

What changes on X-ray suspicious for supracondylar fracture

A

Posterior fat pad (anterior can be normal)

41
Q

Ossification centres elbow

A

Ossification centres
• Appear in a predictable order
• Mnemonic: CRITOE
• Ages of appearance are approximately
• capitellum (age 1)
• radial head (age 3)
• internal epicondyle (age 5)
• trochlea (age 7)
• olecranon (age 9)
• external epicondyle (age 11)

42
Q

Salter Harris two and three

A

ME

2: metaphasis
3: epiphysis

43
Q

Spinal shock HR and BP

44
Q

RF arthritis treatment

45
Q

Penicillin prophylaxis until what age with severe

46
Q

Cardiac Surgery within 6m need IE prophylaxis?

47
Q

Wormian bones differential

A

PORK CHOPS
Pyknodysostosis
• Osteogenesis imperfecta
• Rickets (healing phase)
• Kinky hair (Menkes disease)
• Cleidocranial dysostosis
• Hypothyroidism/Hypophosphatasia
• IdiOpathic
• Pachydermoperiostosis/Primary acro-
osteolysis/Progeria
• S

48
Q

Cocaine antidote

A

Sodium bicarbonate

49
Q

Snake bite (brown, tiger and red bellied black effects)

A

Brown - consumptive coagulopathy can collapse and have cardiac arrest
Tiger - consumptive coagulopathy and systemic symptoms common
Red bellied black - anticoagulant and common to have systemic symptoms

50
Q

Dance sign RLQretracted in

A

Intussusception

51
Q

Wrist drop from

A

Radial nerve

52
Q

Mx bleeding oesophageal varices

A

Gastroscopy and balloon tamponade
Octreotide
Fix clotting
Beta blocker and PPI

53
Q

Most common bacterial infection and causes

A 
OM
viral (25%)
Streptococcus pneumoniae (35%)
non-typable strains of Haemophilus influenzae (25%)
Moraxella catarrhalis (15%).
(Second is UTI)
54
Q

Burns resuscitation fluid if what percent or more body surface burnt

55
Q

Recent trip to Asia

Fever + 2 of myalgia, retro-orbital pain, arthralgia, headache, leucopoenia, haemorrhagic manifestations

A

Dengue fever

56
Q

India travel

Constipation, abdominal pain. Diarrhoea a late sign. Rose spots rare in childhood

57
Q

Respiratory
GI neuro fever
Trip overseas

A

Think malaria

58
Q

Ramsay Hunt syndrome can cause

A

painful shingles rash, facial paralysis and hearing loss in the affected ear.

59
Q 
Presents with muscle weakness
Tingling, numbness, and/or burning in the feet, hands, arms, and legs 
Confusion or forgetfulness
Paranoia
Macrocytic anaemia
Homocysteinuria and MMA in urine
Cause?
A

12 deficiency

60
Q

Lacy rash after red cheeks illness cause

A

Parvovirus B19

61
Q

When will surgeons correct undesc testes

62
Q

Age to operate hydrofoils and umbilical hernia

63
Q 
In children with reading disability (developmental dyslexia) the underlying neurocognitive deficit most 
commonly occurs in: 
A. attention. 
B. auditory processing. 
C. phonemic awareness. 
D. saccadic visual tracking. 
E. sensorimotor perception
64
Q

Horners and brachial plexus injury at what level

65
Q

4/5th digits sensation

A

Ulnar nerve

Rest fingers by median nerve (affected in carpal tunnel)

66
Q

What is the most common cause of persistent hypoglycaemia under 2 years? The presence of ketonuria and/or ketonaemia makes this diagnosis very unlikely.

A

Hyperinsulinism

DDx no ketones and fatty acids in blood and Carnitine / acylcarnitine in blood is fatty acid disorder

67
Q

Reducing substances in urine with hypoglycaemia indicate either

A

Galactosaemia

Fructosaemia

68
Q

Urinary amino acids and organic acids indicate

A

Urea cycle defect

69
Q

Reversal agent if collapse from local anaesthetic

A

IV lipid emulsion

70
Q

BP drop more 10mmHg in systolic BP with inspiration

Two other pulmonary causes

A

PE and tension pneumothorax

Tamponade

71
Q

Infant presents like MAS with ferritin >10,000 caused by?

A

HLH
(Neonatal haemochromatosis presents earlier)
Can be induced by EBV

72
Q

Hearing affected with vestibular neuritis or labyrinthitis?

A

Labyrinthitis

73
Q

Chorea treatment

A

Carbamazepine

74
Q

Klumpke and Rebs roots?

A

C5-7 Rebs

C8/T1 klumpke

75
Q

Enzyme immunoassay used to detect

76
Q

Antidote to antifreeze (ethylene glycol or methanol)

A

Ethanol

Fomepizole

77
Q

10 year old with ataxia worsening, hypertrophic cardiomyopathy, diabetes and scoliosis
Diagnosis?

A

Friedreichs ataxia

78
Q

Arnold chiari malformation associated with?

A

CT disorders

79
Q

Three triples repeats and one that doesn’t exhibit anticipation

A

You hunt animals and put them in the cage: Huntington Disease CAG
You SEE a Gross Guy: Fragile X Syndrome CGG
You SEE Tonic Gestures: Myotonic dystrophy CTG

GAA with FXN friedreichs ataxia

80
Q

Heinz bodies and bite cells on film indicate?

81
Q

Collage affected in osteogenesis imperfect

A

Collagen 1

COL1A1 and 1A2

82
Q

Egg anaphylaxis can you give MMR?

83
Q

Three causes of eisenmenger syndrome

Clubbing, cyanotic, RVH, increased P2 from plum HTN

A

PDA
VSD
AVSD

84
Q

Diagnostic changes in sexual abuse found in what percent

good paeds (19 decks)

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