Emergency Medicine Flashcards
classification system for ankle fractures?
Ottowa rules
classification system for scaphoid fractures?
Herbert classification:
Grade A: acute/ stable
Grade B: acute/ unstable
Grade C: Delayed union
Grade D: Established non-union
Herbert classification of scaphoid fractures?
Grade A: acute/ stable
- A1: Tubercle
- A2: non displaced waist crack
Grade B: acute/ unstable
- B1: Oblique/distal third
- B2: Displaced waist
- B3: Proximal pole
- B4: Fracture dislocation
- B5: Comminuted fracture
Grade C: Delayed union
Grade D: Established non-union
- D1: Fibrous
- D2: Sclerotic
Classification system for fractures involving the growth plate (epiphyseal fractures)?
Salter- Harris classification
Salter-Harris classification of epiphyseal fractures?
I: Straight across the growth plate
II: Above. through growth plate + above (metaphysis)
III: Below. through growth plate + below (epiphysis)
IV: Through (metaphysis + growth plate + epiphysis)
V: Crush injury involving growth plate
Classification of supracondylar fractures in children?
Gartland classification
Salicylate poisoning - effect on Respiratory rate?
Salicylates e.g. aspirin increase RR -> hyperventilation and respiratory alkalosis
ECG changes in hyperkalaemia?
tall-tented T waves, small P waves, widened QRS leading to a sinusoidal pattern and asystole
Does acidosis or alkalosis lead to hyperK?
Acidosis.
H+ and K+ ions compete with each other for exchange with sodium ions across cell membranes and in the distal tubule.
Causes of hyperuricaemia due to increased synthesis of uric acid?
increased cell turnover/ increased production of uric acid:
- Lesch-Nyhan disease
- myeloproliferative disorders
- diet rich in purines
- exercise
- psoriasis
- cytotoxics
Causes of hyperuricaemia due to decreased renal excretion of uric acid?
- drugs: low-dose aspirin, diuretics, pyrazinamide
- pre-eclampsia
- alcohol
- renal failure
- lead
- acidosis (eg, diabetic ketoacidosis, ethanol or salicylate intoxication, starvation ketosis) The organic acids that accumulate in these conditions compete with urate for tubular secretion.
Drugs that cause hyperuricaemia due to reduced excretion of uric acid?
CANT LEAP
C iclosporin
A lcohol
N icotinic acid
T hiazides
L oop diuretics
E thambutol
A spirin
P yrazinamide
Purpose of BHCG rise in first trimester of pregnancy?
to maintain the corpus luteum and thereby progesterone production
What proteins are the alpha-subunit of HCG identical to?
It is a protein dimer. Its alpha subunit is identical to LH, FSH, TSH
most dangerous location for ectopic pregnancy?
isthmus of Fallopian tube
Borders of the femoral triangle?
Superiorly: Inguinal ligament
Laterally: Sartorius
Medially: Adductor longus
Contents of the femoral triangle?
- Femoral vein (medial to lateral)
- Femoral artery-pulse palpated at the mid inguinal point
- Femoral nerve
- Deep and superficial inguinal lymph nodes
- Lateral cutaneous nerve
- Great saphenous vein
- Femoral branch of the genitofemoral nerve
Causes for high anion gap metabolic acidosis (>11 mEq/L)?
MUDPILES:
Methanol Uraemia DKA Paraldehyde Infection Lactic acidosis Ethylene glycol/ethanol Salicylates
Causes for normal anion gap metabolic acidosis (3-11 mEq/L)?
Diarrhoea
Type I, III, & IV renal tubular acidosis
Alcohol
Addison’s disease
Causes of low anion gap metabolic acidosis?
Haemorrhage
Nephrotic syndrome
Intestinal obstruction
Wallace’s rules of nine for assessing extent of burns in children >16?
head + neck = 9% each arm = 9% each anterior part of leg = 9% each posterior part of leg = 9% anterior chest = 9% posterior chest = 9% anterior abdomen = 9% posterior abdomen = 9%
palmar surface 1%
most accurate method for assessing extent of burn?
Lund and Browder chart
Which burns should be referred to secondary care?
- all deep dermal and full-thickness burns.
- superficial dermal burns of more than 2% TBSA in children
- superficial dermal burns involving the face, hands, feet, perineum, genitalia, or any flexure, or circumferential burns of the limbs, torso, or neck
- any inhalation injury
- any electrical or chemical burn injury
- suspicion of non-accidental injury
indications for escharotomies in burns?
- Indicated in circumferential full thickness burns to the torso or limbs.
- Careful division of the encasing band of burn tissue will potentially improve ventilation (if the burn involves the torso)/ relieve compartment syndrome and oedema (where a limb is involved)
