Ix + Mx Flashcards
PE:
Cardio/resp exam
Ix:
Basic obs/
Bedside/
- ECG: arrhythmias or heart strain
Bloods/
- FBC: anaemia
- CRP + cultures: infection
- U+E/LFTs: baseline and medications can affect function
- ABG: hypoxia or sepsis
Imaging:
- CXR: fluid + consolidation
- CTPA
Mx: Oxygen Analgesia Anticoagulation Prevention advice e.g. cessation of pill/smoking
ACS
Cardio/resp exam
Ix:
Basic obs/
Bedside/
ECG - guides management
Bloods/
FBC - anaemia (can cause chest pain)
U+E/LFTs - baseline and medications can affect function
Troponin
Imaging/
CXR - rule out lung pathology
Mx: Oxygen if hypoxic Analgesia Dual anti-platelet therapy PCI
Pericarditis
Cardio/resp exam
Ix:
Basic obs/
Bedside/
ECG - can rule out ACS and show changes of pericarditis
Bloods/
FBC - anaemia (can cause chest pain)
U+E/LFTs - baseline and medications can affect function + dehydration (may need admission for IV fluids)
Troponin - rule out MI
Imaging/
CXR
Echo - confirm
Mx:
Self limiting + pain relief
Safety net if pain gets worse/not improving
TB
Resp exam
Ix:
Basic obs/
Bedside/ Sputum sample (for AFB)
Bloods/
FBC - anaemia (can cause chest pain)
U+E/LFTs - dehydration (IV fluids), baseline and medications can affect function
CRP and cultures - infection
ABG if hypoxic
Imaging/
CXR
Mx:
Refer to respiratory team for antibiotic management for 8 months
CAP
Resp exam
Ix:
Basic obs/
Bedside/
Sputum sample
Bloods/
FBC - anaemia (can cause chest pain)
U+E/LFTs - baseline and medications can affect function. CURB 65.
CRP and cultures - infection
ABG if hypoxic
Imaging/
CXR
Mx:
Calculate CURB-65
Management in hosp or at home based on this.
Antibiotics
Lung cancer
Resp exam
Ix:
Basic obs/
Bedside/
Sputum sample
Bloods/
FBC - anaemia (can cause chest pain)
U+E/LFTs - baseline and medications can affect function. CURB 65.
CRP and cultures - infection
ABG if hypoxic
Imaging/
CXR
CT
Biopsy if necessary
Mx:
Refer to MDT including resp and onc
Heart failure
Cardio/resp exam
Ix:
Basic obs/
Bedside/
ECG - heart strain and arrhythmia
Bloods/
FBC - anaemia (can cause chest pain)
U+E/LFTs - baseline and medications can affect function
BNP
Troponin - rule out MI
Imaging/
CXR
Echo - confirm
Mx: Acute: Oxygen Analgesia Furosemide Monitor urine, fluid intake and weight
Chronic:
Monitor urine, fluid intake and weight
ACEi + B-blocker and symptomatic management
Bowel obstruction
Abdo + PR exam
Ix:
Basic obs/
Bloods/
FBC - anaemia due to blood loss
U+E/LFTs - baseline and medications can affect function + paralytic ileus
CRP
ABG - lactate (ischaemia)
G+S/X match
Imaging/
Erect CXR - perforation
AXR - obstruction
CT - identify the cause
Mx: NBM NG tube + fluids Analgesia Call surgeons
Variceal bleed
Abdo exam
Ix:
Basic obs/
Bloods/ FBC - anaemia due to blood loss Clotting U+E/LFTs - baseline and medications can affect function CRP
G+S/X match
Imaging/
Endoscopy
CXR - oesophageal perf
Mx: IV access Fluid/blood resus Terlipressin Call gastro for emergency endoscopy
Mallory Weiss
Abdo exam
Ix:
Basic obs/
Bloods/ FBC - anaemia due to blood loss Clotting U+E/LFTs - baseline and medications can affect function CRP
G+S
Imaging/
Erect CXR
Endoscopy
Mx:
Antiemetics + PPI
Call gastro for emergency endoscopy
Oesophageal cancer
Abdo exam
Ix:
Basic obs/
Bloods/ FBC - anaemia due to blood loss Clotting U+E/LFTs - baseline and medications can affect function CRP
Mx:
Either 2WW or referral to MDT with gastro + onc fo endoscopy + CT
Chemo/radiotherapy + surgery
Haemorrhoid
Abdo + PR exam
Ix:
Bloods/
FBC - anaemia due to blood loss
Clotting
U+E/LFTs - baseline and medications can affect function
Imaging/
Colonoscopy - rule out IBD + cancer
Mx:
Pain relief, lubricants + increasing fibre
Colorectal cancer
Abdo + PR exam
Ix:
Bedside/
Stool MC+S
Bloods/
FBC - anaemia due to blood loss
Clotting
U+E/LFTs - baseline and medications can affect function
CEA tumour marker
Imaging/
Colonoscopy
Mx:
2WW or MDT referral for colonoscopy
CT for spread and staging
Appendicitis
Abdo + PR exam
Ix:
Bedside/
Stool MC+S
Pregnancy test
Bloods/ FBC - anaemia due to blood loss Clotting U+E/LFTs - baseline and medications can affect function CRP
G+S for surgery
Mx:
Admit + NBM and fluids
Call surgeons
Biliary colic
Abdo exam
Ix:
Bloods/ FBC - anaemia due to blood loss Clotting LFTs - jaundice and ALP U+E - medications can affect CRP
G+S for surgery
Imaging/
USS or ERCP (cholangitis)
Mx:
Analgesia
Refer to general surgeons for gall bladder removal