important things to remeber

Question 1

Itis means inflammation not necessarily infection but when it comes to the abdomen we always GIVE ANTIBITOCS
appendicits, pancreatitis

Question 2

bacterial usuallay CRP AND WBC RISE TOGETHER IN VIRAL CRP CAN COME FIRST AND WBC CAN LAG

Question 3

AMTS

Answer 3

10 POINTS used for delerium and demenia

6 or less suggests either both

Question 4

When thinking about anion gap what are talking about

Answer 4

The causes of metabolic acidosis and trying to figure out whether it’s normal anion gap or high anion gap

Question 5

Mud piles is specific for

Answer 5

High anion gap acidosis

Question 6

Normal anion gap acidosis

Answer 6

Also known as hyperchloremic acidosis because almost always you are losing bicarb and so the body tries to compensate by increasing cl so that’s why you have a normal anion gap because it low key balances out

Question 7

How to calculate anion gap

Answer 7

Positives ~ negatives

Positive usually only Na (but some labs incl K)
Negatives include bicarb and chlorine

Question 8

How to calculate anion gap and why do we need it

Answer 8

Normally the blood should be in a neural state as positives and negatives should be equal and if not the body will try to compensate. We cannot measure all the charged ions in body so we use the dominate ones that contribute the most.
Positives ~ negatives

Positive usually only Na (but some labs incl K)
Negatives include bicarb and chlorine

Question 9

The 2 pneumonic for metabolic acidosis

Answer 9

Mud piles
Hard ups

Question 10

Explanation of high anion gap

Answer 10

The body is overproducing acid to compensate for the loss of bicarb?

Question 11

Ways in which the body looses bicarb

Answer 11

Diarrhoea (Gi loss)
Fistulas (Gi loss )
Kidneys which regulate bicarb
Acetazolamide ( remember first bicarb is secreted then reabsorbed, this medication works by inhibiting it’s reabsorption
Addisons ( don’t know why bicarb is low)

Question 12

WITH DOCUMENTATION ALWASY JUSTIFY WHY E.G WHY ORDER A D -DIMER (because they are expensive k suggested asking a reg so long as you can justify with a wells score calm)

Question 13

someone comes in with a history of vomitting and lethargy what bedside test you want to do

Answer 13

Capillary glucsoe

Question 14

whats a nomral post void amount

Answer 14

<50 considered normal
50-100- mild
>100 - concerining

Question 15

sp02 vs pa02 vs sa02

Answer 15

sp02 measured with a pulse oximeter this is the amount of o2 bound to hemoglobin

pa02- the amount of dissolved oxgen- this is what the ABG looks at

sa02- similar to pulse but in ABG but specific and gives you a more specific reading

Question 16

nomral oxygen sats

Answer 16

> 94

Question 17

any pt coming in with bleeding what do you do

Answer 17

GROUP AND SAVE

so you send it to the lab so they know the blood group just incase a massive bleed comes . You send 2 20 mins apart.

hematemeis
hemorroids

Question 18

what is group and save

Answer 18

you want to prepare just incase

group: blood group and RH

save: if they need a transfusion the donor blood is mixed with theirs to look for a reaction. called a cross march

Question 19

alcoholic vs intoxcated

Answer 19

there’s a difference

an alcoholic has built up tolerance so usually does not appear drunk just uneasy

whereas someone drunk has passed their limit

Question 20

which medications are essential meds that you must prescribe to patients in the ED

Answer 20

parkinsons
insulin
antiocagulants
steroids
strong opiods used for pain
abx for infectiion
antiepipleptics

PIE ASAO

Question 21

with pain whats always important to ask

Answer 21

1. what were you doing when it came on
2. the COURSE of the pain how has it changed since then e.g might have tsrated of coliky then became constant

Question 22

cholinergic crisis

Answer 22

too much ACH

wet wet wet

droolin
lacrimation
diarrhea
pin point

Question 23

anticholenrgic crisis

Answer 23

dry dry

dry as a bone
mad as a hat
hot as a hare
myadriasis

Question 24

what did khadijah say about orthosatic drop

Answer 24

esp in the elderly more than 20 systolic drop cant send them home as if they go home could happen again

have to admit them for ‘significant postural drop, its a valid enough reason’

Question 25

what did k say about neutropenic sepsi

Answer 25

you don’t wait for the bloods, as oon as you see cancer pt, you give pip taz, even if its not sepsis you won’t kill them.

Question 26

end tidal co2 everything

Answer 26

measures the amount of co2 in exhaled breath

If higher than usual could mean that decreased resp effort like res failure of hypoventilation

if low then hyperventilation like anxiety or PE

1.to check proper placement of ET tube and make sure its not in the esophagus

2. used in cardiac arrest as if it suddenly increases could mean ROSC

3.

Question 27

so in a bacterial infection whats the timeline in terms of bloods

Answer 27

Neutrophils are released first in response rather than WBC so its possible to have a normal WBC but high neutrophils and high CRP

Even before CRP it rises first

so neutrophils then CRP then wbc

Question 28

if you. have nomral WBC but high neutrophils and raised CRP

Answer 28

1. Could mean early infection before WBC have risen uo