General Flashcards
Acute asthma life threatening
33 92 CHEST
PEFR <33% of normal O2 sats <92% Cyanosis/confusion Hypotensive Exhaustion Silent chest Tachycardia
Thyroid eye disease treatment
Conservative: Artificial tears, sleeping upright
Medical: Prednisolone or biologic therapy
Radiological: Orbital radiotherapy
Surgical: Orbital decompression surgery, eyelid or eye muscle surgery
Metabolic syndrome?
can result from anti-psychotic use
- hypertension
- dyslipidaemia
- raised blood glucose
- central obesity
Rheumatoid arthritis signs on hand Xray?
- periarticular erosions
- bony destruction at the MCP joints
- ulnar deviation
- displaced thumb joint
- joint space narrowing
- soft tissue swelling
- juxtaarticular osteoporosis
Upper GI bleed association with urea and creatinine?
Urea and creatinine are raised in an Upper GI bleed not due to AKI but due to digested blood
Complications of Pre-eclampsia
AKI HELLP syndrome DIC Eclampsia Liver failure Cerebral haemorrhage Placental Abruption
Causes of postpartum haemorrhage
Retained products Genital tract trauma Uterine atony Abnormal placental placement (praevia or accreta) Coagulopathy Infection
Management of acute heart failure
PODMAN
Position patient upright Oxygen Diuretics Morphine for venodilation Anti-emetics Nitrates
When doing an acute heart failure station - questions to ask
Have you gained any weight recently?
Are you breathless at night?
Have you noticed any swelling in your ankles?
Are you experiencing any palpitations?
Do you get any chest pain?
Do you have a cough at night at all?
Do you have any history of problems with your heart?
Heart failure on CXR
ABCDEF
Alveolar shadowing Kerley B lines Cardiomeghaly (>50% in the PA view) Diversion of the upper lobe Edema signs (bat's wings) Fluid in the fissures (pleural effusions)
Investigations for Acute Heart failure
Bloods - FBC, U&Es, LFTs, Lipid profile, BNP, Troponin T, CRP, Coag screen CXR ECG (compare with previous ones) ECHO - gold standard for diagnosis Serial weighing
Investigations for Stroke
CT head
Bloods - FBC, INR, U&Es, LFTs, Lipid profile, lactate, coag screen
ECG (looking for AF)
Carotid Doppler USS
Blood glucose (to check for hypoglycaemia as a mimic)
Bilateral LMN causes
ABCDE
Alcohol excess
B12/thiamine deficiency
Charcot-Marie-Tooth (NB: champagne bottle) or carcinomas
Diabetes or Drugs (amiodarone, nitrofurantoin, metronidazole)
Everything vasculitis
Missed pill guidance for COCP
- If one missed then just take next one as soon as remembered even if two on one day and you are fine
- If two or more msised then take one as soon as you remember even if you need two on one day and don’t take the earlier pills. Then use additional contraception for the next 7 days and get emergency contraception if you had sex in the pill free window.
Pre-eclampsia treatment
BP control with Labetolol (nifedipine if asthmatic)
If BP >160/100 give PO nifedipine or IV Labetolol (if not working then give IV hydralazine)
If still unable to control and concerned about eclampsia give Magnesium Sulphate within 24hours of delivery. Deliver ASAP.
