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Acute Care (Y4) > Emergency Medicine > Flashcards

Emergency Medicine Flashcards

1
Q

What is the treatment for acute asthma attack?

A 
OSHITMAN
Oxygen
Salbutamol
Hydrocortisone
Ipratropium
Theophylline
Magnesium
ANaesthetics
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2
Q

What blood glucose suggests hypoglycaemia?

A

< 4 mmol/L

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3
Q

What is the management for hypoglycaemia if the patient can swallow?

A

4-5 glucotabs or 150-200ml fruit juice

Then banana, bread, biscuit

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4
Q

What is the management for hypoglycaemia if the patient is drowsy/confused?

A

Squeeze 1.5-2 tubes of glucogel into their mouth

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5
Q

What is the management for hypoglycaemia if the patient is unconscious?

A

75ml 20% dextrose IV or 1mg Glucagon IM

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6
Q

What is the treatment for DKA?

A

IV insulin infusion until < 12mmol/L, then start saline & 5% dextrose IV too to prevent hypoglycaemia

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7
Q

What Potassium level would suggest Hyperkalaemia?

A

> 5.5 mmol/L

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8
Q

What is the treatment for Hyperkalaemia?

A

10mls 10% calcium gluconate
Insulin/dextrose IV
Consider nebulised salbutamol

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9
Q

Which medication is used to stabilise the myocardium in hyperkalaemia?

A

10mls 10% calcium gluconate

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10
Q

Which medication is used to drive Potassium intra-cellularly in hyperkalaemia?

A

Insulin

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11
Q

What is the treatment for opiate overdose?

A

naloxone 400 micrograms IM - repeat after 2-3 mins if necessary

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12
Q

What is involved in the ‘sepsis six’?

A

Take 3:

  • Blood culture
  • Urine output
  • Lactate

Give 3:

  • Fluids
  • Antibiotics
  • Oxygen
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13
Q

What is the initial treatment for MI?

A 
MONA + T
Morphine
Oxygen
Nitrates eg. GTN
Aspirin
Tricagelor (if not going for PCI)
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14
Q

What are the definitive treatment options for MI?

A

medical, PCI or thrombolysis

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15
Q

Which scoring system is used to assess risk of PE?

A

Wells’ score

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16
Q

If a PE is likely, which investigation should be performed?

A

CTPA

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17
Q

What is the treatment for PE?

A

LMWH eg. dalteparin

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18
Q

What is a toxidrome?

A

Collection of symptoms and signs caused by a toxin

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19
Q

Cholinergic syndrome is caused by…

A

Excess stimulation of ACh receptors

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20
Q

Give a possible cause of cholinergic syndrome.

A

Organophosphates

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21
Q

Give symptoms of cholinergic syndrome.

A

Pinpoint pupils, increased bowel sounds and urine output

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22
Q

Give symptoms of anticholinergic syndrome.

A

Tachycardia, Hypertension, Hyperthermia, dilated, dehydrated (urinary retention)

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23
Q

What is the mechanism of anticholinergic syndrome?

A

competitive antagonism of ACh receptors - reduces parasympathetic drive

24
Q

Give causative drugs of anticholinergic syndrome.

A

Anti-histamines, TCAs, anti-parkinson drugs

25
Give symptoms of sympathomimetic syndrome.
Tachycardia, Hypertension, dilated pupils, agitated
26
What is the mechanism of sympathomimetic syndrome?
Inhibition of NE and Dopamine re-uptake
27
Give causes of sympathomimetic syndrome.
Cocaine, Mephedrone, SSRIs
28
Give symptoms of sedative-hypnotic syndrome.
Bradycardia, hypotension, hypothermia
29
Give symptoms of sedative-hypnotic syndrome.
Bradycardia, hypotension, hypothermia
30
What is the mechanism of sedative-hypnotic syndrome?
Caused by CNS depression (usually through GABA stimulation)
31
Give causes of sedative-hypnotic syndrome.
BZDs, anti-histamines
32
TCA overdose is associated with which toxidrome?
Anticholinergic
33
Give ECG changes classic of TCA overdose.
Sinus tachycardia, RBBB, broad QRS
34
What is the reversal agent for Amitriptylline?
Sodium bicarbonate
35
How long after a paracetamol overdose should levels be measured?
4-6 hours
36
What is the reversal agent for paracetamol?
N-acetylcysteine
37
What is the reversal agent for Lidocaine?
Intralipid
38
What is the reversal agent for beta-blockers?
Glucagon
39
Give some symptoms of aspirin overdose.
Tinnitus, metabolic acidosis
40
What is the reversal agent for ethylene glycol?
ethanol or Fomepizole
41
The deadly nightshade mushroom causes which toxidrome?
Cholinergic
42
What is the reversal agent for cyanide?
Hydroxycobalamin
43
What is the reversal agent for iron salts?
Desferrioxamine
44
How is coronary vasospasm after cocaine ingestion treated?
GTN, BZDs, may need PCI if ongoing chest pain
45
Which ECG changes are consistent with hypokalaemia?
T wave inversion, ST depression, U waves
46
Which ECG changes are consistent with Hyperkalaemia?
Peaked T waves, PR prolongation, Wide QRS
47
Give a serious side effect of ACEIs.
Angio-oedema
48
Is profound resp acidosis with or without compensation more worrying in acute asthma?
Without comp more worrying - patient is tiring
49
What are the criteria for liver transplantation after paracetamol overdose?
pH < 7.3 24 hours after ingestion PT > 100 Creatinine > 300 Encephalopathic
50
Give a common side effect of N-acetylcysteine.
Anaphylactoid reaction
51
How should you manage a massive haemorrhage?
``` ABCDE Call 2222 stating 'massive haemorrhage' Alert senior Send urgent blood samples Will be sent 4 RBC and 4 FFP - transfuse as appropriate ```
52
Shock with increased RR, low HR and BP suggests...
Neurogenic shock
53
Give signs of progressive shock,
``` Hypotension Acidosis Oedema Cool & clammy skin Reduced LOC ```
54
Give causes of cardiogenic shock.
Valvular heart disease MI Cardiac arrhythmias Cardiomyopathy
55
Give causes of obstructive shock.
Cardiac tamponade PE Tension pneumothorax
56
Shock with bradycardia, warm/flushed peripheries suggests...
Neurogenic shock
57
What is the treatment for anaphylaxis?
500 micrograms adrenaline IM (0.5ml of 1:1000 solution)

Acute Care (Y4) (3 decks)

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