Intro lectures Flashcards
glucose in urine leading to polyuria
osmotic diuresis
problem list for diabetic foot ulcer
- dehydration and low bp
- pain
- septic ulcer
- high blood glucose
prescription for fluid challenge
500ml 0.9% saline over 30 mins
prescription for maintenance fluids
1 litre 0.9% saline with 20mmol of potassium over 8 hours
step 1 pain management
paracetamol, NSAIDS
step 2 pain management
Codeine
Step 3 pain management
morphine
When to avoid metformin
eGFR less than 30 (risk of lactic acidosis)
Variable rate insulin infusion lowest rate (50units actrapid in 50ml of 0.9%saline)
T1DM 0.5/hour
T2DM 0/hour
When should TED stockings be avoided
peripheral vascular disease
A of ABCDE
Is the airway patent
no stridor
B
- Respiratory rate
– Using accessory muscles?
– O2 saturations; inspired O2
– Chest examination – crackles, wheeze
C
CIRCULATION – Capillary refill time (press nail bed, hand above the heart, for 5 secs) ‐ should be <2 secs – Pulse – Blood pressure – Urine output – Cardiovascular examination
D
DISABILITY (DON’T FORGET THE GLUCOSE) – GCS E4 V5 M6
– Capillary blood glucose (BM)
E
Exposure
Family history of renal stones
consider cystinuria (rare)
Most common constituent of renal stones
Calcium oxalate. Also CaP, Uric acid, cysteine, indinavir; Infec7on MAP/Struvite
Investigations that give a diagnosis of renal colic
Usually dipstick haematuria
Must confirm with CT/KUB
Renal Colic management
Analgesia - NSAID’s & opiates Admit if: Single kidney Pyrexia Continuing pain Renal impairment Pregnancy Large stone/severe obstruction on CT Otherwise can be discharged with stone clinic OPA
Tx of renal stones
Conservative/Medical - tamsulosin
ESWL
Ureteroscopy
PCNL
General advice for stone formers
High fluid intake –2.5-3L per day • Do not cut out dairy products • Less salt • Less animal proteins especially red meat Attend / return to A&E if • Pain not controlled by analgesia • PYREXIA
