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Year 6 Cross Section > Emergency Care > Flashcards

Emergency Care Flashcards

1
Q

causes of normal anion gap metabolic acidosis

A

diarrhoea
RTA
Addisons

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2
Q

causes of shock due to low CO

A

CO = HR x SV
1. Hypovolaemia
2. Pump failure

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3
Q

causes of shock due to low SVR

A

MAP = CO x SVR
1. Sepsis
2. Anaphylaxis
3. Neurogenic
4. Endocrine failure

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4
Q

classes of shock

A
  1. <15% circulating volume (<750ml) = compensated
  2. 15-30% CV (750-1500ml) = tachycardic
  3. 30-40% CV (1500-2000) = hypotensive
  4. > 40% CV (>2000) = unconscious
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5
Q

when can you discharge in anaphylaxis?

A

don’t discharge for 6-12 hours
biphasic response

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6
Q

Canadian C-spine rules vs NEXUS rules

A

Canadian: do they need immobilisation
Nexus: need to meet to clear a C spine

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7
Q

resus of a significant haemorrhage

A

1:1:1 (plasma, platelets, packed RBCs)

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8
Q

what is included in secondary survey?

A

AMPLE
exam
other test
= minimise risk of missed injuries

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9
Q

what is tertiary survey?

A

24 hours later
detects changes

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10
Q

causes of coma

A

Metabolic: drugs, hypoxia, hypothermia, sepsis, hypoglycaemia, myxoedema
Neurological: trauma, infection, tumour, vascular, epilepsy

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11
Q

pupils:
normal direct and consensual reflexes

A

intact midbrain

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12
Q

pupils:
midposition (3-5mm), non reactive and irregular

A

midbrain lesion

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13
Q

pupils:
unilateral fixed and dilated

A

3rd nerve compression

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14
Q

pupils:
small and reactive

A

pontine

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15
Q

V1-V4 territory and supply

A

anteroseptal
LAD

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16
Q

II, III, aVF territory and supply

A

inferior
RC

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17
Q

V4-6, I, aVL territory and supply

A

anterolateral
LAD or LC

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18
Q

I, aVL, V5-V6 territory and supply

A

Lateral
LC

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19
Q

Tall R waves V1-V2 territory and supply

A

Posterior
LC or RC

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20
Q

treatment of heart block post-MI

A

Inferior = atropine
Anterior = pacemaker

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21
Q

differentials for acute rupture (3-5 days) post MI

A

papillary muscle or ventricular septal

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22
Q

differentials for rupture 5 days to 2 weeks post MI

A

LVFW rupture

23
Q

symptoms of LVFW aneurysm

A

SOB
persistent ST elevation
no chest pain
LVF

24
Q

management of LVFW aneurysm

A

anticoagulant

25
Q

when to avoid fondaprinoux and give what instead?

A

if PCI is possible (only used for fibrinolysis)
if PCI, give LMWH

26
Q

causes of cardiogenic shock

A

MI
arrythmias
tamponade
PE
myocarditis

27
Q

investigations in cardiogenic shock

A

ECG
ABG
CXR
Echo
U&Es
Trop
BNP
UO
Swans Gantz catheter

28
Q

management of cardiogenic shock

A

ensure fluid filled
dobutamine

29
Q

ALTS, when to give adrenaline and amiodarone?

A
  • adrenaline every 3-5 mins (10mL, 1 in 10,000 IV)
  • amiodarone after 3 shocks
30
Q

causes of bradycardia

A

physiological
cardiac: post MI, sick sinus
non-cardiac: vasovagal, hypothermia
drug-induced

31
Q

management of bradycardia

A

atropine
transcutaenous pacing

32
Q

COPD exacerbation immediate management

A

24% oxygen
nebs
steroids

33
Q

indications for NIV (BiPAP)

A
  • COPD with resp acidosis
  • T2RF secondary to chest wall deformity, NM disease, OSA
  • cardiogenic pulmonary oedema
  • weaning from tracheal intubation
34
Q

treatment of PE in someone who is hemodynamically unstable

A

thrombolysis (heparin and alteplase)

35
Q

what measurement is used to classify ARDS?

A

dec arterial PaO2/FiO2 ratio

36
Q

mild, moderate and severe ARDS

A

mild : 201-300mmHg
moderate: 101-200
severe: <100

37
Q

management of ARDS

A
  • central venous access = ionotropes
  • IV = broad spectrum Abx, diuretics
  • 60-100% oxygen
    non-shocked = sit upright
    shocked = colloid infusion
38
Q

variceal bleed management

A
  • terlipressin, Abx
  • gastric varices: endoscopic injection, TIPS
  • oesophageal varices: endoscopic band ligation, Sengstaken-Blakemore
39
Q

non-variceal bleed management

A

endoscopic
- mechanical clips and adrenaline
- thermal coagulation, adrenaline

40
Q

indications for immediate CT spine (<1 hour)

A

GCS < 13 on initial assessment
Patient intubated
Ruling out needed (e.g. for surgery)
Clinical suspicion and age >65yo, focal neuro deficit, high impact injury, paraesthesia in limbs

41
Q

spinal cord compression above L1

A

UMN signs and sensory level

42
Q

spinal cord compression below L1

A

LMN signs and peripheral numbness

43
Q

DKA complications

A

VTE prophylaxis
cerebral oedema
aspiration pneumonia

44
Q

measuring amount of burns

A

Lund and Browder rule

45
Q

causes of distributive shock

A

sepsis
anaphylaxis
neurogenic

46
Q

first drugs for STEMI

A

aspirin 300mg and Clopi 300mg
(DAPT continued for 1 year)

47
Q

NSTEMI important drug

A

add fondaprinux

48
Q

what drug to avoid in hypotension?

A

nitrates

49
Q

management of Raised ICP

A

neuroprotective ventilation
mannitol/hypertonic saline

50
Q

features of severe asthma

A

RR > 25
HR >110
can’t complete sentences

51
Q

how frequent is monitoring in severe attack?

A

monitor PEFR every 15-30 mins

52
Q

important formulas in Burns

A

Lund and Browder Charts to assess amount of burn
Parkland formula to guide replacement (4 x wt x %burn = mL of Hartman’s in 24 hrs)

53
Q

how frequently do you give adrenaline and amiodarone in VF/pulseless VT?

A

adrenaline and amiodarone after 3rd shock
repeat adrenaline every cycle

54
Q

how often to give adrenaline in PEA/asystole?

A

adrenaline 1mg as soon as IV access obtained
repeat adrenaline every other cycle

Year 6 Cross Section (23 decks)

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