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ACC > Enhanced learning conditions > Flashcards

Enhanced learning conditions Flashcards

1
Q

how does aortic dissection present

A

severe ripping / tearing pain
intrascapular pain
syncope

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2
Q

what is the management principles for aortic dissection

A

oxygen
ALS
haemodynamic support

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3
Q

what investigations are diagnostic

A

CT
MRI
TOE

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4
Q

how is aortic dissection managed

A 
1. ascending aorta
urgent surgical repair
2. descending aorta 
beta blockade / medical management
life long surveillance with regular imaging
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5
Q

what investigations are useful for management

A 
ECG
CxR
cardiac enzymes
CTPA
U+E / LFT
lactate
FBC
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6
Q

what is medical management for aortic dissection

A

beta blockade
opioid analgesia
vasodilators

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7
Q

what are the symptoms of pericarditis

A

severe retrosternal chest pain

worse with inspiration + supine position

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8
Q

examination findings in pericarditis

A

pericardial friction rub

low grade fever

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9
Q

what are diagnostic signs for pericarditis

A

diffuse ST elevations

small pericardial effusions on echo

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10
Q

what is the treatment for pericarditis

A

treat underlying systemtic disorder
NSAIDs + colchicine
pericardiocentesis

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11
Q

what investigations for pericarditis

A

ECG
troponin
pericardial fluid culture

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12
Q

symptoms of pneumothorax

A

dyspnoea

chest pain

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13
Q

symptoms of tension pneumothorax

A

rapid laboured respirations
cyanosis
profuse diaphoresis
tachycardia

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14
Q

what is first line treatment for pneumothorax

A

observation with supplemental oxygen therapy

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15
Q

what is the next step in treatment for pneumothorax

A

percutaneous aspiration
chest drain
suction

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16
Q

examination findings in pneumothorax

A

hyperexpand ipsilateral hemithorax
hyper-reasonant
absent / diminsihed breath sounds

17
Q

investigations for pneumothorax

A

CxR

18
Q

what is the management for tension pneumothorax

A

immediate needle decompression
- 14G IV cathether mid calvicular line 2/3rd intercostal space
oxygen therapy
tube thoracostomy

19
Q

what are 3 key symptoms + signs of opiate overdose

A

respiratory depression
miosis
apnoea

20
Q

what is initial treatment for opiate overdose

A

adequate ventilation
naxloxone
monitor for re-sedation and repear antidote dose

21
Q

investigations for opioid overdose

A

trial of naloxone - reverse of symptoms
ECG
opioid urine screen

22
Q

what are markers for suspected TCA overdose

A

hx of sucidide
sudden deterioration in mental status + vital signs
hypotension
tachycardia

23
Q

how is TCA overdose diagnosis made

A

clinical history

ECG changes - sinus tachy moving to wide complex tachycardia

24
Q

what are the symptoms of TCA overdose

A 
tachycardia
hypotension
mydriasis
warm + flsuhed 
urinary retention
decreased bowel sounds
25
Q

what invesitgations for TCA overdose

A

ECG
sodium bicarbonate trial- narrows QRS
ABG-metabolic acidosis

26
Q

what is the management for TCA overdose

A

supporttive care
GI decontamination
sodium bicarbonate bolus

27
Q

signs + symptoms of TIA

A

focal neurological deficit
sudden onset + brief symptoms
resolve < 48hrs

28
Q

risk factors for TIA/stroke

A

AF / valvular disease / carotid stenosis / CHF / HTN

29
Q

what are the investigations for TIA

A 
Blood glucose
FBC
prothrombin time / INR / PTT
ECG
brain MRI with diffussion 
CT head
30
Q

what is the management for TIA

A

antiplatelet therapy
statin
life style modifications
carotid endarterectomy

31
Q

what the the class 4 symptoms of stroke

A

visual field deficit
weakness
aphasia
impaired co-ordination

32
Q

what are the main investigations for stroke

A 
CT head
glucose
electrolytes
U+E
cardiac enzymes
ECG
FBC
33
Q

what is treatment of stroke <4.5 hours of onset

A 
altephase
aspirin 
endovascular intervention
supportive care
swallowing asssessment 
VTE prophylaxis + ealry mobilisation
34
Q

what is the management of stroke > 4.5 hrs

A

aspirin 300mg
supportive care
swallowing asssessment
VTE prophylaxis

35
Q

what are the features of moderate acute asthma

A

increasing symptoms
PEF - 50-75% best
no features of acute severe

36
Q

what are features of acute severe asthma

A

PEF 33-50%
RR > 25
HR > 110
inability to complete sentences in one breath

37
Q

what are features of life-threatening asthma

A 
PEF < 33
Sp02 < 92
Pa02 < 8kPa
normal PaC02
silient chest
cyanosis
poor resp effort
arrhythmia
exhaustion
hypotension
38
Q

what is the management of an acute asthma attack

A 
Oxygen 
- keep sats 94-98
nebulised B2 agonist driven by oxygen
add ipratropium bromide  
Steroids
-continue pred 40 for atleast 5 days after
nebulised magnesium sulphate
refferal to ITU
39
Q

when should patients be referred to intensive care

A

require ventilatory support
deteriorating PEF
worsening hypoxia
hypercapnia

ACC (5 decks)

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