Emergency Medicine

Question 1

Risk factors for AKI

Answer 1

Age
Race (black)
CKD
Mechanical ventilation
Surgical patient
Emergency surgery

Question 2

Causes of AKI

Answer 2

Pre renal: hypotension, sepsis, renovascular
Renal: nephrotoxins, glomerular disease, rhabdomyolysis
Post renal: obstruction, Abdo compartment syndrome

Question 3

Oxygen delivery
Nasal cannula
Venturi
Simple face mask
Non rebreathe mask

Answer 3

Nasal cannula 24-40% 1-5L/min
Venturi - variable
Simple face mask - 40-60% 5-10L/min
Non rebreathe mask - 90% 15L

Question 4

Venturi colours

Answer 4

Blue 24%/2L
White 28%/4L
Orange 31%/6L
Yellow 35%/8L
Red 40%/10L
Green 60%/15L

Question 5

Causes of metabolic acidosis (normal anion gap)

Answer 5

USED CARP
Ureteric diversion
Small bowel fistula
Extra chloride
DKA
Carbonic anhydrase inhibitors
Addisons
Renal tubular acidosis
Pancreatic fistula

Question 6

Causes of metabolic acidosis (raised anion gap)

Answer 6

MUDPILES
Methanol
Ureaemia
DKA (also alcoholic/starvation KA)
Paraldehyde
Iron
Lactic acidosis
Ethanol
Salicylates

Question 7

Causes of respiratory alkalosis

Answer 7

Induced by increased respiratory drive:
   CNS
   Hypermetabolic
   Environmental (hyperthermia)
   Drugs (aspirin)
   Liver failure
   Mechanical ventilation

Induced by hypoxaemia:
   Pneumonia, PE, asthma
   CHD
   Chronic altitude compensation
   Early altitude aclimatisation

Question 8

Cuases of respiratory acidosis

Answer 8

Induced by reduced respiratory drive:
CNS - CVA, tumour, infection
Drugs - narcotics, sedatives

Induced by decreased chest wall movement:
Neuro - neuromuscular, MG, tetanus
Toxicity - muscle relaxants
Respiratory - trauma, deformity, obstruction

Question 9

Syncope - who to admit?

Answer 9

San Francisco Syncope Rule (CHESS)
Congestive heart failure Hx
Haematocrit 
ECG abnormal
SOB
Systolic BP

Question 10

Contraindications to organ donation

Answer 10

Known/suspected CJD
HIV
Untreated systemic infection
Visceral/haematological neoplasm

Question 11

Acute management of ACS

Answer 11

Morphine
Oxygen
Nitrates
Aspirin

Question 12

GCS

Answer 12

E 1-4 
   1 won't open
   2 to pain
   3 to voice 
   4 spontaneous

V 1-5 
   1 no sounds
   2 incomprehensible
   3 inappropriate words
   4 confused, disoriented
   5 normal, oriented

M 1-6
   1 no movements
   2 extension  to pain (decerebrate)
   3 abnormal flexion to pain (decorticate)
   4 flexion/withdrawal to pain
   5 localises to pain
   6 obeys commands