Brainscape's Knowledge GenomeTM

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


See full index

Oishi's Final year flashcards > Emergency Med > Flashcards

Emergency Med Flashcards

1
Q

What GCS or below do we worry about airway compromise?

A

8 or below

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

What is the toxic dose of paracetamol?

A

75mg/kg

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

What bloods should be done at 4 hours post ingestion in paracetamol OD?

A 
VBG
INR
U&Es
LFTs
FBC
Paracetamol level
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How long is the standard course of NAC?

A

21 hours

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

What 3 criteria do the bloods need to meet post NAC?

A

INR is 1.3 or less AND
ALT is less than two times the upper limit of normal AND
ALT is not more than double the admission measurement

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

What to do if a pt on warfarin is actively bleeding?

A

Stop warfarin
Give 5mg IV Vit K
IV prothrombin complex concentrate (octaplex)

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

What does Geriatric Admission Profile (GAPS) include?

A

U&E, FBC, LFT, glucose, CRP, calcium, B12 & folate, ferritin, iron and transferrin, TFT, vitamin D

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

Bamford stroke classification for TACS?

A 
Unilateral weakness (and/or sensory deficit) of the face, arm and leg
Homonymous hemianopia
Higher cerebral dysfunction (dysphasia, visuospatial disorder)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Bamford stroke classification for PACS?

A

2 of 3 symptoms:
Unilateral weakness (and/or sensory deficit) of the face, arm and leg
Homonymous hemianopia
Higher cerebral dysfunction (dysphasia, visuospatial disorder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a lacunar stroke?

A

Purely motor or sensory?

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

Mx of HTN in in the acute management of ischaemic stroke?

A 
Avoid tx unless any of the following:
hypertensive encephalopathy
hypertensive nephropathy
hypertensive cardiac failure/myocardial infarction
aortic dissection
pre-eclampsia/eclampsia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of VF arrests?

A

Electrolyte abnormalities (hyperkalaemia, hypokalaemia, hypocalcaemia)
Toxins (particularly TCA od)
Hypothermia
Less commonly the other causes of cardiac arrest

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

What rhythm is seen in cardiac arrest?

A

PEA

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

What should be administered in cardiac arrest with non-shockable rhythm?

A

IV adrenaline

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

5Ds of Charcot’s foot?

A 
Density change (areas of lucency and sclerosis)
Destruction
Debris (loose bodies and bone fragments)
Distension (joint effusion)
Dislocation (e.g. metacarpophalangeal joints)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Gas gangrene abx?

A

Tazocin + clindamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tx for orthostatic hypotension?

A

Fludrocortisone

Midodrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What temp increase should we aim for in hypothermia?

A

1 degree rise per hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What formula should be used for burns victims fluid requirement in first 24 hrs?

A

Parkland Formula
Fluid required in 1st 24 hr = 4ml x patients weight in kg x % burn
Half should be given in first 8 hours and remainder over 16 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When to catheterise burns patient?

A

Patients with burns >20% TBSA or intubated

Patients with perineal burns or 15-19% TBSA catheterisation should be considered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When to refer to burns unit?

A

Burns > 10 % TBSA in an Adult
Burns > 5 % TBSA in a Child
Full thickness burns > 5% TBSA
Burns of face, hands, feet, perineum, genitalia, and major joints
Circumferential burns
Chemical or electrical burns
Burns in the presence of major trauma or significant co-morbidity
Burns in the very young patient, or the elderly patient
Burns in a pregnant patient
Suspicion of Non-Accidental Injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

First aid for minor burns?

A

Hold under cool running water for 20mins

Wrap in cling film

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What layers do superficial, partial and full thickness burns affect?

A

Superficial - epidermis
Partial thickness - dermis
Full thickness - underlying subcutaneous tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What should you do with blistered areas of a burn?

A

De-roof, dress with non-adherent dressing and review in 48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which types of anaesthesia can cause malignant hyperthermia?

A

Volatile anaesthetic agents

Suxamethonium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

CIs to lidocaine Tx?

A

SAN disease and all forms of AV block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How long does lidocaine take to work and wear off?

A

Few mins

Lasts 1-2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

MOA of lidocaine?

A

Local anaesthetics act on the smaller C fibres, which transmit pain and temperature sensation, before the larger A fibres, which transmit touch and power

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Causes of prolonged QTc? (TIMMES)

A

Toxins: drugs including anti-arrhythmics, anti-psychotics, TCAs, macrolides
Inherited: congenital long QT syndromes such as Romano-Ward and Jervell and Lange-Nielson syndromes.
Ischaemia
Myocarditis
Mitral valve prolapse
Electrolyte abnormalities, such as hypokalaemia and hypocalcaemia
Subarachnoid Haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Mx of DKA in hour 1 in adults?

A

A to E
1L 0.9% saline over 1 hour (if SBP <90 add STAT bolus 500ml in 15 mins)
Fixed rate insulin infusion (0.1 units/kg/hr) AFTER commencing fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What needs to be checked hourly in DKA?

A

Blood/capillary glucose
Blood/capillary ketones
Observations including GCS
AND continuous ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Fluid resuscitation in DKA in hours 2-12?

A

If K+ <5.5mmol/L add KCl

1L 0.9% saline + 40mmol KCl over 2 hours then
1L 0.9% saline + 40mmol KCl over 2 hours again then
1L 0.9% saline + 40mmol KCl over 4 hours then
1L 0.9% saline + 40mmol KCl over 4 hours again then
1L 0.9% saline + 40mmol KCl over 6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Until when do you continue fixed rate insulin in DKA?

A

Blood ketones <0.3mmol/L AND
pH >7.3 AND
Bicarbonate >18mmol/L

34
Q

Mx of DKA in hours 12-24?

A

Aim to have normal biochemical parameters
If patient unable to eat and drink then start sliding scale insulin
If able to eat and drink then restart subcutaneous insulin regimen - this will need some crossover with IV insulin.

35
Q

Mx of HHS?

A

Fluid resuscitation
Insulin at 0.05 units/kg/hour
VTE prophylaxis

36
Q

Fluid resuscitation in HHS?

A 
Fluid of choice is 0.9% saline:
1L over 1-2 hours
1L (+KCl) over 2-4 hours
1L (+KCl) over 4-6 hours
1L (+KCl) over 6-8 hours
1L (+KCl) over 8-10 hours
37
Q

What score is used prior to endoscopy in patients with an upper GI bleed?

A

Glasgow-Blatchford score

Any score >0 suggests medical intervention needed

38
Q

What score is used after endoscopy in patients with an upper GI bleed?
What is it used to estimate?

A

Rockall score

Used to estimate the risk of re-bleeding and the risk of mortality

39
Q

Define AKI

A

increase in serum creatinine of 26 μmol/L within 48 hours
increase in serum creatinine ≥1.5 times above baseline value within 1 week
urine output of <0.5 ml/kg/hr for > 6 consecutive hours

40
Q

antidote for anti-freeze?

A

Fomepizole

41
Q

Damage to which vessels causes extradural haemorrhage?

A

Middle meningeal vessels

42
Q

Damage to which vessels causes subdural haemorrhage?

A

Bridging veins

43
Q

drug-induced pancreatitis causes? FATSHEEP

A 
Furosemide
Azathioprine/Asparaginase
Thiazides/Tetracycline
Statins/Sulfonamides/Sodium Valproate
Hydrochlorothiazide
Estrogens
Ethanol
Protease inhibitors and NRTIs
44
Q

Contraindications to thrombolysis in MI? AGAINST

A 
Aortic Dissection
GI bleed
Allergic reaction
Iatrogenic: recent surgery
Neurological disease: recent stroke (within 3 months), malignancy
Severe HTN (>200/120)
Trauma, including recent CPR
45
Q

What common SE can doxycycline cause?

A

Oesophagitis

46
Q

4 adverse signs of tachycardia?

A

Shock
Sycope
Heart failure
Myocardial ischaemia

47
Q

When can you immediately safely cardiovert in AF?

A

No adverse signs

Onset <48 hours

48
Q

How long do patients need anticoagulation before and after cardioversion in AF?

A

3 weeks before

4 weeks after

49
Q

Which meds are CI in WPW?

A

Digoxin

Verapamil

50
Q

What carboxyhaemoglobin concentration is diagnostic of carbon monoxide poisoning?

A

> 20%

51
Q

Beck’s triad of cardiac tamponade?

A

Raised JVP
Hypotension
Muffled heart sounds

52
Q

What is Kussmaul’s sign?

A

Rise in JVP with inspiration

53
Q

What is pulsus paradoxus?

A

Drop in SBP of about 15mmHg with inspiration

54
Q

Aspirin od blood gas findings?

A

Initially respiratory alkalosis

Later metabolic acidosis

55
Q

Features of unstable angina

A

Chest pain at rest or minimal exertion lasting >15 minutes
ECG changes (new ST-depression or T wave inversion)
NO rise in troponin: no myocardial necrosis

56
Q

Features of NSTEMI

A

Chest pain at rest or minimal exertion lasting >15 minutes
ECG changes (new ST-depression of T wave inversion)
Rise in troponin: myocardial necrosis

57
Q

Features of STEMI

A

Chest pain at rest or minimal exertion, lasting >15 minutes
ECG changes (new ST-elevation or left bundle branch block)
Rise in troponin: myocardial necrosis

58
Q

Tx of bradycardia with HISS?

A 
Atropine 500mcg IV
Can repeat up to max of 3mg
Isoprenaline 5mcg/min IV
Adrenaline 2-10mcg/min IV
or transcutaneous pacing
59
Q

RFs for acute closed angle glaucoma?

A

Female
Asian
Use of antimuscarinics

60
Q

Tx of acute closed angle glaucoma?

A

IV Acetazolamide and a topical beta-blocker such as Timolol

61
Q

Causes of VT?

A

Electrolyte abnormalities such as hypokalaemia and hypomagnesaemia
Structural heart disease including Myocardial infarction and HOCM
Drugs that cause QT prolongation e.g. clarithromycin, erythromycin
Inherited channelopathies e.g. Romano-Ward syndrome, Brugada syndrome

62
Q

Occlusion of the LAD puts you at increased risk of what?

A

Rupture of interventricular septum

63
Q

What times should mast cell tryptase be measured?

A

Initially
4hrs
12hrs

64
Q

What would you expect to find with an optic neuritis?

A

RAPD

A relatively dilated pupil on the affected side when a torch light is swung towards it

65
Q

Clinical features of central retinal vein occlusion?

A

sudden painless loss of vision

stormy sunset on fundoscopy

66
Q

Clinical features of central retinal artery occlusion?

A

sudden painless loss of vision over a few seconds

pale retina and cherry red spot at macula on fundoscopy

67
Q

Clinical features of Ischaemic optic neuropathy?

A

sudden onset monocular vision loss and colour blindness
RAPD o/e
fundoscopy - optic disc swelling in the acute phase or a pale optic disc in the chronic phase that suggests optic atrophy

68
Q

Clinical features of Retinal detachment?

A

floaters and flashes followed by a ‘curtain falling over’ their vision
pale-grey area of retina ballooning forward on fundoscopy

69
Q

Clinical features of Vitreous haemorrhage?

A

If minor, patients complain of floaters, if severe, patients complain of painless loss of vision
Common in diabetics
Retina hard to view on fundoscopy

70
Q

Clinical features of optic neuritis?

A

Painful loss of vision over hours to days
Pain on moving eyes
‘red desaturation’
Common in MS

71
Q

What to do if a pt has an anaphylactoid reaction to NAC?

A

Stop infusion

Give 10mg IV Chlorphenamine

72
Q

universal donor of fresh frozen plasma?

A

AB RhD negative blood

73
Q

When to discharge in anaphylaxis after symptom resolution?

A

Minimum 2 hours:
1 dose of adrenaline

Minimum 6 hours:
2 doses adrenaline
Previous biphasic response

Minimum 12 hours:
>2 doses adrenaline
severe asthma
ongoing reaction possible
patient presents late at night
when A&E access difficult
74
Q

What to give in potential tetanus exposure and unclear vaccine hx?

A

booster vaccine + immunoglobulin

75
Q

King’s College Hospital criteria for liver transplantation (paracetamol liver failure)?

A

Arterial pH < 7.3, 24 hours after ingestion

or all of the following:
prothrombin time > 100 seconds
creatinine > 300 µmol/l
grade III or IV encephalopathy

76
Q

Indications for thoracotomy in haemothorax?

A

> 1.5L blood initially or losses of >200ml per hour for >2 hours

77
Q

3 things usually given in acute variceal bleed?

A

Blood products
Terlipressin
Empirical abx: Ceftriaxone

78
Q

When to offer platelet transfusions?

A

platelet count of <30 x 10^9 with clinically significant bleeding
platelet count < 100 x 10^9 with severe bleeding or bleeding at critical sites, such as CNS

79
Q

Mx of epistaxis?

A
  1. Pinch the cartilaginous (soft) area of the nose firmly for 20mins
  2. Cautery if bleeding point visible
  3. Packing (rapid rhino)
  4. Sphenopalatine ligation in theatre
80
Q

Flail chest mx?

A

Analgesia

Respiratory support - consider PPV

Oishi's Final year flashcards (9 decks)

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