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1. Jim > Emergency/Meds/Other > Flashcards

Emergency/Meds/Other Flashcards

1
Q

Tamiflu indications - ie who to give to (7)

A

> 65
pregnancy
BMI >30
ATSI
Child <5
Homeless
resident of aged care facility

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2
Q

Treatment of impetigo in endemic settings

A

Single IMdose of benzathine benzylpenicillin
Other option - oral bactrim

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3
Q

Pt with cellulitis, states previous prophylaxis to penicillin

A

Oral bactrim for 5/7

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4
Q

Pt with anaphylaxis, Rx steps + doses (6)

A
  1. Remove trigger
  2. Position flat or sitting
  3. Adrenaline
    - Adults: 0.5mg (0.5ml of 1:1000)
    - Paeds: 10mck/kg (0.01ml/kg of 1:1000)
  4. Rpt adrenaline 5mins if needed
    Shock
    • IV access
    • Fluid bolus
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5
Q

KFP: Mx Steps in ITP (5)

A
  1. Avoid anti-platelets or NSAIDs
  2. Advise retricting contact sports
  3. Advise present to ED if significant bleeding or severe headache
  4. Advise rpt FBE in 1wk
  5. Provide written information
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6
Q

Timing of malaria chemoprophylaxis (3)

A

Doxycycine
- 1-2days prior, 4wks after leaving area
Malarone
- 1-2 days prior, 7 days after
Mefloquine
- 2-3wks prior, 4wks after

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7
Q

DDx for UGI bleed/haematemesis (6)

A
  1. Bleeding peptic ulcer
  2. Ruptured oesophageal varice
  3. Erosive oesophagitis
  4. Mallory-Weis tear
  5. Gastric or oesoph cancer
  6. Angiodysplasia
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8
Q

When to stop DOAC prior to surgery

A

Any high risk/major op = Withhold for 48hrs (ie last dose 3 days prior to surgery)
- Recommence 48-72hrs post op

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9
Q

Snake bite in rural ED. Pt in shock. Immediate management (6)

A
  1. Seek urgent advice from poisons information or toxicologist
  2. Apply pressure bandage over entire limb
  3. Immobilise the patient
  4. Obtain 2x large bore cannula in cub fossa
  5. Administer fluids
  6. Appropriate analgesia
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10
Q

KFP: Non-pharma management options for IBS? (6)

A
  1. Use food diary to indentify triggers to avoid
  2. Refer to dietician for low FODMAP diet plan
  3. Refer to pyschologist for CBT
  4. Advise meal portion control
  5. > 30g fibre intake (if constipated)
  6. Refer to hypnotherapist for gut base hypnotherpay for refractory symptoms
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11
Q

44yoM presents 2/7 after dentist extracted infected mandibular 2nd molar
Presents with difficulty swallowing, neck pain, fever and chills
Smoker, poorly controlled T2DM, HTN, Hyperlipidaemia
HR 112, BP 120/75, RR26, Sat 93% T 38.3
Tender around his neck + throat, but able to swallow saliva, albeit with pain
Oral exam reveals an elevated tongue with marked submandibular and sublingual swelling
What is most important DDx

A

Ludwig angina
- gangrenous bilateral cellulitis of sub mandibular space
- can cause life threatening airway compromise

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12
Q

What drug mistake to AVOID in anaphylaxis

A

Do not give anti-histamine
Can drop BP

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13
Q

38M with T21 brought in by carer. Been aggressive recently. DDx (7)

A
  1. Mental illness - depression
  2. Environmental - abuse
  3. GI disturbance - constipation
  4. infection - UTI
  5. Geri - early onset dementia
  6. Unrecognized pain
  7. Sleep disturbance
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14
Q

KFP Emergency situation - common marks (4+4)

A
  1. Call ED/relevant specialist for advice
  2. Insert 2x large bore cannulas
  3. Give 1L NS bolus immediately
  4. Give relevant medication to case

Other common
- oxygen
- group+hold
- NBM
- Analgesia

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15
Q

Pharmacological options for smoking cessation (4)

A
  1. NRT - LA
  2. Varenicline (champix) - grade up to BD over 1wk, for 12wks
  3. Bupropion oral daily
  4. Oral nortriptyline
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16
Q

KFP: Hx to assist with further treatment of chronic wound? depends on what info has already been given (6)

A
  1. Smoking status
  2. Tetanus immunisation status
  3. ?Reduced sensation
  4. Claudication
  5. Any discharge?
  6. What has been tried so far
17
Q

Features of venous ulcer (4)

A
  1. Varicosisty or venous eczema/flare
  2. Lipodermatosclerosis - hard skin, inverted wine bottle
  3. Haemosiderin staining
  4. Oedema
18
Q

Patient non compliant with treatment, options to improve their involvement (not relevant to all patients) (6)

A
  1. Educate about poor outcomes of poor compliance
  2. Arrange a Webster pack
  3. Organise a HMR
  4. Arrange home visits (GP or nursing)
  5. Involve family with patients permission
  6. Involve aboriginal health worker

1. Jim (20 decks)

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