ICM Flashcards
Device for measuring BP?
Sphygmomanometer
Korotkoff sound level 1?
As the cuff is deflated (no greater than 5mmHg per second) a sharp tapping sound is heard as the cuff pressure equals the systolic pressure. At systolic the pressure is enough to force open the artery walls for blood to spurt through. The level at which you hear consistent beats is recorded as the systolic pressure
Korotkoff sound level 2?
This phase is characterised as a swishing sound caused by the swirling currents on the blood as the flow through the artery increases. Sometimes if the cuff is deflated too slowly the sounds vanish temporarily. This happens when the blood vessels beneath the cuff become congested, and is often a sign of hypertension. The congestion eventually clears and sounds resume. This is known as the auscultatory gap.
Korotkoff sound level 3?
In this phase the sounds become louder and have a tapping quality similar to phase 1. At this stage the increased blood flow is pounding against the artery walls.
Korotkoff sound level 4?
At this point the tapping sounds of Phase 3 are abruptly replaced by a muffled sound.
Korotkoff sound level 5?
This is the point at which sounds cease to be heard all together. The blood flow has returned to the normal and is now laminar. This is the diastolic pressure. This phase is absent in some people in which case some medical practitioners choose to record Phase 4 as the diastolic pressure.
List all the pulses
Radial, Brachial, Axillary, Carotid, Subclavian, Femoral, Popliteal, Dorsalis Pedis, Posterior Tibial
ANTT: Define clean
Free from dirt, stain, or impurities; unsoiled
ANTT: Define asepsis
The state of being free of pathogenic microorganisms.
ANTT: Define sterile
Free from live bacteria or other microorganisms
Difference between situation where you so standard or surgical ANTT?
If you need to touch the key part- surgical
What are the 5 moments for hand washing?
before touching a patient, before clean/aseptic procedures, after body fluid exposure/risk, after touching a patient, and. after touching patient surroundings.
ANTT: What is a key site?
Open wounds, including insertion and puncture sites.
ANTT: What is a key part?
Critical parts of the procedure equipment that come into direct or indirect contact with active Key-Parts connected to the patient, any liquid infusion or Key-Site
Abdominal pain in neonate -3 months?
Intestinal obstruction (ie. volvulus, Hirshsprung,
pyloric stenosis)
Peritonitis (i.e. necrotising enterocolitis, GI
perforation)
Hernia
Gastroesophageal Reflux
Trauma (i.e. during birth)
Abdominal pain in infant under 2 years old?
Constipation Acute gastroenteritis Trauma Hernia Volvulus Intussusception Respiratory illness
Abdominal pain in children?
Acute gastroenteritis Urinary tract infection/ Pyelonephritis Constipation Ingestion Intestinal obstruction Trauma Testicular torsion Dawn Edwards November 2017, Week 108 Page 2 Henoch-Schonlein Purpura Respiratory illness, pneumonia Appendicitis Pancreatitis Cholecystitis Mesenteric adenitis DKA
Abdominal pain in teenagers?
Trauma Ingestion Food poisoning Dysmenorrhea Pregnancy (i.e. ectopic) Pelvic inflammatory disease Testicular torsion Ovarian torsion/cysts Gastroenteritis Constipation
Name for newborn blue hands and feet?
Acrocyanosis
What skin abnormalities in newborn exam?
Milia (White papules found on the nose and cheeks that resolve in the first few weeks of life and are benign)
Erythema toxicum (White papules 1-2 mm in size, Develop on 2nd – 3rd postnatal day, Benign)
Mongolian blue spots (Blue/grey/greenish blue macules with a definite border, benign)
Capillary haemangioma “stork bite” (Can be found in middle of forehead, nape of neck, upper eyelid )
Port wine stain (can be found anywhere- may not be a benign sign in a newborn)
What head abnormalities in newborn exam?
Caput succedaneum - Oedema over the presenting part of the head, Common at birth, Crosses suture lines, Resolves within a few days
Cephalohaematomas - Subperiosteal collections of blood, Occur in 1-2% of newborn babies, feel like a fluctuant mass that does not cross suture lines, May increase in size after birth, Take weeks to months
resolve
Subgaleal haemorrhages - Collections of blood between the aponeurosis covering the scalp and
the periosteum, Extend across suture lines, Feel firm and fluctuant, Can be associated with significant blood loss
Abnormalities in mouth in newborn exam?
Micrognathia
Cleft lip and palate
Macroglossia
Teeth (Usually occur in isolation but may be associated with syndrome)
Epstein’s pearls( Benign white cysts, Seen in most babies)
Mucous retention cyst
Tongue tie
Abnormalities in face in newborn exam?
Facial palsies
Asymmetric crying facies - Due to congenital absence or hypoplasia of the depressor anguli oris
muscle, Benign
Abnormalities in neck in newborn exam?
Excess skinfold (Turner’s syndrome) Masses Sterocleidomastoid tumour Cystic hygroma Branchial cyst Thyroglossal cyst Cervical lymph nodes Decreased movement (Torticollis)
Abnormalities in chest in newborn exam?
Size- (Small or malformed may suggest pulmonary hypoplasia)
Asymmetry (Pectus excavatum, Pectus carinatum)
Breast (Breast hypertrophy van be due to maternal hormones. Occasionally the breast can secrete a thin milky fluid known as “witch’s milk” and this can last for several days to weeks)
Widely spaced nipples (Turner’s syndrome)
Accessory nipple
Abnormalities in abdominal wall in newborn exam?
Omphalocoele
Gastroschisis
Umbilical hernia
Hip tests in newborn exam?
Ortolani and Barlow’s test
Milestones at 6 week newborn exam?
Baby looks at, recognises and smiles at mother
Baby able to feed properly
Milestones at 6 months old?
Baby able to hold up own head
Baby able to weight bear if held upright
Baby can grab block in palmer grasp and pass from one had to the other
Milestones at 9 months old?
Pincer grip
Wary of strangers
Sits independently
Milestones at 1 year?
Crawling
Recognise name
Ask for a drink
Wave goodbye
Milestones at 15 months old?
Able to toddle around
Is able to make 2 block tower
Drink out of a cup
Milestones at 18 moths old?
Nearly running
3 blocks tower
Eats with a spoon
Milestones at 2 years old?
Running
Temper tantrums
6 block tower
Milestones at 2.5 years old?
Can kick a ball
Potty trained
Can sit on tricycle and use legs to push
Milestone at 3 years old?
Jump off bottom step of stairs Use scissors Talks Ride tricycle 9 block tower Eat using fork
Order of draw for bloods? And what for?
Blood culture
Blue (Haem - clotting tests, INR)
Red (Biochem- Thyrogoubin &ab, Digoxin. Micro - serology and abs)
Gold (Biochem - Thyroid, all proteins, FSH, LH, prolactin etc, hGH, B12, tumour markers)
Green (Biochem- amino acids, carboxyhaemoglobin, chromosomes, insulin)
Lavender (Haem - FBC, ESR, PCR)
Pink (Blood transfusion, cross matching)
Grey (Biochem- glucose, alcohol, lactate)
