Brainscape's Knowledge GenomeTM

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


See full index

DPD 2019 > Emergency medicine/surgery > Flashcards

Emergency medicine/surgery Flashcards

1
Q

What do you hear on auscultation/percussion with effusion

A

Auscultation- absent breath sounds

Percussion- stony dullness

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

Acute severe asthma vs life threatening asthma

A 
Acute severe: 
33-55% of best PEF 
Can't complete sentences 
Resp >25/min 
Pulse>110 beats/min
Life threatening asthma:
PEF <33% of best 
SpO2 <92% 
Silent chest, cyanosis, or feeble respiratory effort
Arrhythmia/hypotension
Exhaustion, altered consciousness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is an important piece of info about an asthmatic in a&e

A

if they’ve ever been intubated… this means they were at the point of dying before so it is a big risk factor and you don’t want to send them home

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

Info to ask for asthma attack

A

Previous ITU
Other medical conditions
Allergies
Any infective symptoms

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

Pathophsiology of asthma

A

Reversible airway disease
Hyper reactivity
Airflow limitation

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

Clinical presentation of asthma

A

Wheeze?
-Other things which also cause wheeze. Not specific for asthma

Breathless?

Tachycardic?

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

Treatments for asthma

A 
Nebulised salbutamol
IV salbutamol
Nebulised adrenaline
Nebulised magnesium
Oral steroids
IV steroids
 (IV magnesium if they are terrible)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What would you give if he is an acute asthmatic

A

Give them whatever is in the nebuliser IV (if they’re not breathing properly it probably won’t go in)

Call for specialist help

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the difference between severe vs life threatening asthma

A

Decompensation

Unable to maintain adequate PO2 and PCO2

Drowsy due to rising PCO2, hypotension or exhaustion (note co2 should be low in asthma!)

Need intubation

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

What should CO2 be in an acute asthmatic

A

LOW (because they blow it off)

If co2 is normal you worry,

if it’s high then this is very bad

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

What is included in asthma review

A

How pathology creates the clinical signs
How physiology is explained- compensation vs decompensation
Treatment
Started to understand how history, examination and treatment might fit together in one package

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is special about meningitis rash

A

It is a vasculitic rash…. it is nonblanching

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

What will happen if you press on an uritcarial rash

A

It will go away (i.e. blanching)

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

Pathophsyiology of anaphylaxis

A

IgE mediated activation of mast cells leading to mediator release and airway airway obstruction

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

What is the treatment for anaphylaxis

A

Adrenaline
500mcg
0.5ml 1;1000 (IM not IV as it can predispose to arrythmia)

Lie flat and put legs in the air

Piriton

Hydrocortisone

Fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does adrenaline help you in anaphylaxis

A

α1 – vasoconstriction and relaxation of GI tract

α2 – platelet aggregation and reduction in noradrenaline release from nerve terminals

β1 – inotropic and chronotropic cardiac effects and relaxation of GI tract

β2 – bronchodilatation, increase in noradrenaline release from nerve terminals, increase in intracellular cyclic adenosine monophosphate (cAMP) production in mast cells and basophils, reduction in the release of cellular mediators

17
Q

Priorities for MI

A
  1. Call for help
  2. Open his airway and start rescue breaths
  3. Get IV access
  4. Get a 12 lead ECG

You need to check for a pulse first (because an ECG could be normal despite no pulse and thus death)

18
Q

What pulse should you check

A

Carotid pulse (close to the heart)

19
Q

2 algoriths in CPR

A

Shockable or non-shockable rhythm

20
Q

Which rhythms are shockable

A

VF or pulseless VT (check this)

21
Q

What rhythms are non-shockable

A

PEA and asystole

22
Q

Reversible causes of cardiac arrest

A 
Hs:
Hypoxia
Hypovolaemia
Hyper/hypokalamemia (&amp; other electrolyte disturbance)
Hypothermia
Ts:
Tension pneumothorax
Cardiac tamponade
Toxins
Thromboembolic
23
Q

Learn to recognise cardiac tamponade on echo!

A

……

24
Q

What do you do for a cardiac tamponade

A

An emergency pericardiocentesis (ultrasound guided)

25
Q

What is the correct dose of adrenaline in anaphylaxis

A

0.5 1 in 1000

26
Q

Primary survey for trauma

A 
Catastrophic Haemorrhage?
Airway with c spine control
Breathing
Circulation
Disability
Exposure
‘C-ABC’
27
Q

When do you get a dilated pupil

What should you do

A

It means the brainstem is being pushed through the foramen magnum which compresses crainial nerves affecting pupils.

Usually 1 eye first and then the second

Before survery give mannitol

28
Q

How to differentiate between subural and extradural

A

Subdural looks like banana

Extradural is convex

29
Q

ED management of extradural haemorrhage

A 
Optimise oxygenation
-A, B, C
Keep CO2 normal
-A,B
Maintain cerebral perfusion
-(CPP= MAP-ICP)
Make sure nothing more life threatening takes priority
-Primary survey
Neurosurgical input &amp; theatre
30
Q

Primary survey

A

Systematic approach
C- ABC
Treat life threatening problems as you find them
Trauma team – lead by a senior doctor
Simultaneous action
But we teach it in order so you remember the priorities

31
Q

What is the strongest predictor of injury

A

Mechanism of injury is the strongest predictor of injury
Applies to all trauma- minor and major
Create a mental picture of events in your head

32
Q

What do you want to know about airway

A

Are they breathing?

Is it normal or noisy?

  • Noisy = obstructed
  • Obstructed = do something!

Do they need a ‘definitive airway’

33
Q

Palpate for surgical emphysema

A

You have an airway leak going into the surrounding tissue

34
Q

Assessment of circulation

A

Pulse, BP, capillary refill time

General appearance

35
Q

Source of haemorrhage

A

‘On the floor and 4 more’:

Abdomen (spleen and liver)
Into leg (femur can bleed lots)
Chest
Pelvis

36
Q

What fluid should you give to hypertensive patients

A

Transfusion

red cells+platelets+FFP

37
Q

Circulation with haemorrhage control

A 
Turn off the tap
Fluids (blood)
Warfarin
Coagulopathy to correct
TXA (within 1hr)

Damage control surgery

38
Q

Assessment of disability

A

GCS- Glasgow Coma Score
level of consciousness

Pupils
Blood sugar
Limb movements

39
Q

Potential injuries for burns

A 
Direct Burns
Inhalation Injury
Smoke Inhalation
Carbon Monoxide Poisoning
Cyanide Poisoning
Trauma

DPD 2019 (30 decks)

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