Guided Studies Flashcards
What does the ACE-III test?
Examines cognitive functions
Memory, attention, language, perception and problem solving
What are the 2 forms of cognitive impairment?
Degenerative (worse over time)
and
Static (remains constant)
What are some possible causes of cognitive impairment?
Medications
Alcohol and Drugs
Pain and Discomfort
Head injury
Learning disability
Psychiatric problems
What are some progressive illnesses that affect cognition?
Alzheimer’s disease
Vascular dementia
Dementia w/ lewy body
Fronto temporal dementia
What are the 5 subscales of the ACE-III exam?
Attention
Language
Fluency
Memory
Visuospatial
How many points are there in an ACE-III and a mini ACE?
100
and
30
When should the ACE-III be used?
Individuals over 50 y/o with suspected cognitive impairment
What are the cut-off scores for the ACE-III exam and Mini ACE?
88-82 out of 100
and
25-21 out of 30
What 6 physiological parameters form the basis for the NEWS2 scoring system?
Respiratory rate
Pulse rate
O2 Saturation
Systolic BP
Level of consciousness
Temperature
What should you be thinking about when a patient has a NEWS2 score of 5 or above?
Consider Sepsis
When would it be inappropriate to use NEWS2?
Pregnant women
Children
Spinal injury (tetraplegia)
What is Microtia / Anotia?
Malformation of Pinna
Small or absent ear
Treatment for Perichondritis?
Incision and drainage of pus
Antibiotics
What are some symptoms of Perichondritis?
Red, swollen, tender ear
Pus + discharge
Fever
What is a Pinna Haematoma?
Result of direct trauma
If left untreated may cause cauliflower ear due to fibrotic tissue
Treatment for Pinna Haematoma?
Drained via incision and compression dressing
What is Otitis Externa?
Bacterial infection of External Auditory Canal
May be swollen, exquisitely tender and filled with debris
Treatment for Otitis Externa?
Steroids
and
Antibiotics
What is Cerumen Impaction?
Build up and compacting of ear wax
What does Otitis Media often proceed?
Upper respiratory tract infection
What may be a severe symptom of Suppurative Otitis Media?
Perforation of tympanic membrane
What 3 structures would need to be anaesthetised durring shoulder surgery?
Articular Capsule
Articular Surface
Skin
What dermatomes would need to be anaesthetised for shoulder surgery?
C4 & 5
What is Hilton’s Law?
The nerves that supply the muscles of a joint, also supply that joint itself
What nerves would you aim to anaesthetise in order to perform shoulder surgery?
The C5 and C6 roots
or
Superior Trunk of brachial plexus
What is an Interscalene block, and why would it be performed?
Anaesthetising the sup. roots and sup. trunk of the brachial plexus as they pass between ant. and mid. scalene
Anesthetises the shoulder for surgery
What nerve functions would you want to check to make sure that an Interscalene block has been effective?
What structures may be damaged during an Interscalene block?
Sympathetic chain
Phrenic nerve
Apex of lung
What are the 2 main ligaments that hold the malleus, incus and stapes in place?
Ant. Malleal lig.
and
Post. Incudal lig.
What is the purpose of the round window in the labyrinth?
Membranous structure that can deform to allow movement of perilymph in the labyrinth.
Without this the perilymph couldn’t move and we couldn’t hear
Located at the very end of the Cochlea
What membrane seperates Scala Vestibuli from Scala Media?
Reissner’s membrane
What membrane seperates Scala Tympani from Scala Media?
Basilar membrane
What specific structure are the hair cells within?
Organ of Corti
(within basilar membrane)
Lower frequencies vibrate the basilar membrane closer to the apex of the cochlear, whereas higher frequencies produce vibrations closer to the base. What is this known as?
Tonotopic organisation
Name some first line opioids
- Codeine
- Morphine
- Diamorphine
Name some second line opioids
- Oxycodone
- Fentanyl
Name some third and fourth line opioids
- Methadone
- Buccal / SL fentanyl
What is the standard dose of a strong opioid for breakthrough pain?
one-sixth to one-tenth of the regular 24h dose
Repeated every 2 - 4 hours as required
