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Medicine Year 1 > ICM > Flashcards

ICM Flashcards

1
Q

What is the intracellular fluid composed of?

A

High Potassium

Low Sodium

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2
Q

How is the intracellular gradient maintained?

A

Sodium-Potassium pump

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3
Q

What is interstitial fluid composed of?

A

High Sodium
Low Potassium
(Identical to blood but with lower levels of protein, and no red blood cells)

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4
Q

What is intravascular fluid composed of?

A

High Sodium
Low Potassium
(Identical to interstitial fluid but with higher protein and red blood cells)

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5
Q

What are the 2 fluid compartments of the body?

A

Intracellular

Extracellular

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6
Q

Which of the 2 major fluid compartments contain the most fluid?

A

Intracellular

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7
Q

What is extracellular fluid divided into?

A

Interstitial and Intravenous

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8
Q

Which is the smallest fluid compartment?

A

Intravenous (part of the extracellular compartment)

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9
Q

What are the basic daily requirements of sodium, potassium and fluid?

A

Sodium- 2mmols/kg/day
Potassium- 1mmol/kg/day
Fluid- 1-1.5mls/kg/hour (for adults, roughly 1.5l- 2.5l per day)

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10
Q

How much urine is lost on average per day?

A

1ml/kg/hr (adults, roughly 1.5l- 2.5l per day)

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11
Q

What are the 2 types of fluid?

A

Crystalloid and Colloid

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12
Q

Describe a crystalloid fluid

give examples of crystalloid fluids

A

Crystalloid fluids have low mollecular weight salts or sugars, that can pass freely between the intravascular and interstitial compartments. (Stays in the extracellular compartment)

Hartman’s
Dextrose
Normal Saline

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13
Q

Describe colloid fluids

give examples of colloid fluids

A

Colloid fluids are larger molecules and may take longer to diffuse out of the intravascular space.

Gelatins
Albumin
Plasma proteins

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14
Q

What is the purple blood bottle used for?

What does it contain?

A

Full blood count
Erythrocyte sedimentation rate
Blood film
Red cell folate

it contains EDTA, a strong anti-clotting factor

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15
Q

What is the pink blood bottle used for?

What does it contain?

A

Group and save
Crossmatch
Coomb’s test

it contains EDTA, a strong anti-coagulant

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16
Q

What is the blue blood bottle used for?

What does it contain?

A

Coagulation screen
INR
D-dimer

it contains sodium citrate, a reversible anticoagulant

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17
Q

What is the yellow blood bottle used for?

What does it contain?

A 
Urea and Electrolytes (Us+Es)
C-reactive protein (CRP)
Liver function tests (LFTs)
Amylase
Troponins
Creatine Kinase (CK)
Lipid profile

it contains silica particles and a serum separating gel

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18
Q

What does the grey blood bottle test for?

What does it contain?

A

Glucose
Lactate

It contains sodium fluoride as an antiglycolytic agent and potassium oxalate as an anticoagulant

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19
Q

What is the red blood bottle used for?

What does it contain?

A 
Hormones
Toxicology
Drug levels
Bacterial and viral serology
Antibodies

It contains silica particles, acting as a clot activator

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20
Q

What is the dark green blood bottle used for?

What does it contain?

A

Ammonia
Insulin
Renin and aldosterone

It contains sodium heparin which acts as an anticoagulant

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21
Q

What is the light green blood bottle used for?

What does it contain?

A

Routine biochemistry (although the yellow bottle tends to be preferred)

it contains lithium heparin as an anticoagulant and plasma separator gel

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22
Q

What is the blue lidded blood culture bottle used for?

A

Aerobic organisms

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23
Q

What is the purple liddd blood culture bottle used for?

A

Anaerobic organisms

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24
Q

What order do you take bloods in?

A
  1. Blood cultures
  2. Blue bottles
  3. Red bottles
  4. Yellow bottles
  5. Black bottles
  6. Green bottles
  7. Navy bottles
  8. Purple bottles
  9. Grey bottles
  10. Pink bottles
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25
Q

Why is there a specific order for collecting blood?

A

To avoid contaminating samples with the products that the bottles contain, anticoagulants etc.

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26
Q

How many times should you invert the blood bottles?

A

5-8 times

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27
Q

Which blood bottle label should you write by hand at the bedside?

A

Pink bottle- to avoid cross match errors

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28
Q

What are the 5 sites for intra-muscular injections?

A 
Deltoid
Dorsogluteal
Rectus femoris
Vastus Lateralis
Ventrogluteal
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29
Q

How long should intra-muscular needles be?

A

Long enough to penetrate the muscle and still leave 1/4 of the needle to remain external.

Commonly 21-23 G

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30
Q

Why should you use the smallest needle size possible?

A

Reduce the risk of thromboli; blood can still flow around it.

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31
Q

How tight should the tourniquet be?

A

Tight enough to occlude venous flow but not arterial flow; you should be able to fit 2 fingers under the torniquet

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32
Q

When would you not want to cannulate in the veins of the forearm?

A

If the patient has any fistulas, i.e. if they are on or due to have dialysis treatment

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33
Q

Give the size of cannula going from smallest to largest

A 
Yellow
Blue
Pink
Green
Black
Grey
Brown
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34
Q

What questionnaire can you use to assess anxiety?

A

The GAD-7 questionnaire

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35
Q

What questionnaire can you use to assess depression?

A

The PHQ-9 questionnaire

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36
Q

List the scores and severity for anxiety when using the GAD-7 questionnaire

A 
Mild= 0-5
Moderate= 6-10
Moderate-Severe= 11-15
Severe= 16-21
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37
Q

List the severity scores for depression when using the PHQ-9 questionnaire

A 
Mild= 0-5
Moderate= 6-10
Moderate-Severe= 11-15
Severe= 16-20
38
Q

What is clubbing a sign of?

A

Malabsorption
Crohn’s disease
Cirrhosis

39
Q

What is leuconychia a sign of?

Describe it, what is it associated with?

A

White marks on the nails
Hypoalbuminaemia
Associated with renal failure, fungal infection and lymphoma

40
Q

What is koilonychia?

What causes it?

A

Spoon shaped nail

Iron deficiency anaemia

41
Q

What is dupuytrens contracture?

What is it associated with?

A

This is the thickening of connective tissue in the palm.

It is associated with numerous things including diabetes, alcohol and epilepsy

42
Q

What is palmar erythema and what is it associated with?

A

Red palms

Alcohol related liver disease, diabetes and Wilson’s diseas

43
Q

What is asterixis?

What is it associated with?

A

‘Liver flap’

Encephalitis

44
Q

What are Kayser-Fleischer Rings?

What are they associated with?

A

Brownish-yellow rings around the eye.

Copper deposits and Wilson’s disease

45
Q

What is the Kocher’s surgical scar typically from?

A

Cholecystectomy

46
Q

What is the Pfannensteil scar typically from?

A

C-section

Prostatectomy

47
Q

What is the Lanz incision typically from?

A

Apendectomy

48
Q

What is ascities?
What causes it?
How can you test for it?

A

Accumulation of fluid in the peritoneal cavity
Cirrhosis, cancer, heart failure
Percuss for shifting dullness

49
Q

What are spider Naevi?

What cause them?

A

Red dot on abdomen with ‘spider-leg’ like projections around it
High oestrogen levels, pregnancy or liver disease

50
Q

What is Caput Medusa?

What causes it?

A

Distended and engorged superficial veins

Severe portal hypotension
Inferior vena cava obstruction

51
Q

What is gynaecomastia?

What causes it?

A

Man boobs
Liver disease
May also be drug induced

52
Q

Where would you find Virchow’s node?

What is it a sign of?

A

Left supra-clavicular lymph node

Strong association with abdominal cancer

53
Q

From foetal to puberty, what percent of growth is done when?

A

Foetal- 30%
Infantile- 15%
Childhood- 40%
Puberty- 15%

54
Q

How should you measure height from birth to 2 years?

Then from 2 years and old?

A

Horizontally

Vertically

55
Q

Where should you place the chest ECG leads?

A

V1- Right sternal edge, 4th intercostal space
V2- Left sternal edge, 4th intercostal space
V3- Mid way between V2 and V4
V4- 5th intercostal space, mid clavicular line
V5- Mid way between V4 and V6
V6- Left axillary line, at the same level as V4

56
Q

Where do you place the ECG limb leads?

A

Red- Right wrist
Yellow- Left wrist
Green- Left foot
Black- Right foot

57
Q

What is the normal paper speed for an ECG?

A

25mm/sec

58
Q

How long does 1 small square on an ECG represent?
1 large square?
5 large squares?

A

.04 seconds
.2 seconds
1 second

59
Q

What is the formula for working out heart rate on an ECG?

A

No. of large squares between R peaks x .2,

60 divided by ans.

60
Q

How many squares should the P-R interval be?

A

3-5 small squares

61
Q

How many squares should the QRS complex be?

What does a widened QRS complex mean?

A

2-3 small squares

Ventricular conduction problems

62
Q

What does elevation or depression of the ST segment mean?

A

Elevation- Infarction

Depression- Ischemia

63
Q

What does inversion of the T wave mean?
What does a large peaked T wave mean?
What does a flattened T wave mean?

A

Inversion- could be due to infarction
Large peaked- Hyperkalaemia
Flattened- Hypokalaemia

64
Q

Describe ventricular rhythm on an ECG

A

No P wave

Wider QRS complexes

65
Q

Name the shockable cardiac arrest rhythms

A

Ventricular fibrilation

Pulseless ventricular tachycardia

66
Q

Name the non shockable cardiac arrest rhythms

A

Pulseless electical activity

Asystole

67
Q

What is foetal lie?

A

Relationship of longitudinal axis of foetus to the mothers spine

68
Q

When is a foetus engaged?

A

When there are 2 or fewer fifths of the head palpable per abdomen

69
Q

When can you hear the baby’s heartbeat with a dopler?

A

12 weeks of gestation onwards

70
Q

When can you hear the baby’s heartbeat with a Pinard?

A

24 weeks of gestation onwards

71
Q

From when does the PSH match the number of weeks gestation?

A

20 weeks

72
Q

What is the pterodactyl like speculum called?

A

Cusco speculum

73
Q

What is an antalgic gait?

A

Avoidance of pain

74
Q

What are the signs of Parkinson’s in terms of gait?

A 
Bradykinesia
Hypokinetic
Rigidity
Shuffling
En bloc turning
75
Q

What is ataxic gait?

A

‘drunk walking’
Wide stance
Poor coordination

76
Q

What make a good X-ray?

A

Good Inspiration
Good Penetration
No rotation
Good coverage of area

77
Q

On an abdominal x-ray, what are haustra a sign of?

A

Colon or large bowel,

lines that do not go all the way accross

78
Q

On abdo X-ray, how large should the small bowel and large bowel (or colon) be?

A

3cm across for small bowel

6cm across for large bowel

79
Q

What, on an abdo x-ray, indicates small bowel?

A 
Valvulae Conniventes (lines all the way across)
No faeces
80
Q

What can cause small bowel obstruction?

A

Scarring from previous operations (adhesions)
Herneas
Peritoneal cancers

81
Q

What is Rigler’s sign?

A

Being able to see the inside and outside of the bowel. It is a sign of free gas (pneumoperitoneum)

82
Q

What are the signs of pneumoperitonium?

A

Triangular patches of gas

Rigler’s sign

83
Q

What are the causes of large bowel obstructions?

A

Cancers

Strictures fro things like diverticulitis

84
Q

What is a decubitus film?

A

Images of a baby side on- show pneumoperitoneum.

85
Q

What is the best test for pneumoperitonium?

A

Erect chest X-ray

86
Q

Name the 10 peripheral pulses

A 
Carotid
Subclavian
Axillary
Brachial
Radial
Ulnar
Femoral
Popliteal
Posterior Tibial
Dorsalis Pedis
87
Q

Name the oxygen masks in order from low flow rate to highest flow rate

A

Nasal cannula
Venturi mask
Medium concentration mask (Hudson)
Non-rebreathe mask

88
Q

What does ‘clean’ mean?

A

Free from dirt

89
Q

What does asepsis mean?

A

Free from pathogenic organisms

90
Q

What does sterile mean?

A

Free from live bacteria and other microorganisms

91
Q

What are the 2 types of ANTT?

A

Standard ANTT

Surgical ANTT

92
Q

How do you distinguish between the 2 types of ANTT?

A

Can you do the procedure without touching the key parts?
yes- Standard
no- Surgical

Medicine Year 1 (2 decks)

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