June 15-2, 2021 Flashcards
unconscious man in GP car park, unconscious on the ground, lying face down not moving. 7 immediate steps
- look for surrounding dangers
- assess for response by shouting, shaking
- send for help, call ambulance 000 urgently
- turn him on his back
- move bystanders away
- bring resus trolley
- assess airway
- look for emergency bracelet
unconscious man in GP car park, unconscious on the ground, lying face down not moving, O2 82%, improves on jaw thrust, bilateral mitosis, HR 60, script for oxycontin in pocket, 2 mx steps
- insert guedel airway
- high flow oxygen by facemask
- IV naloxone
38F 2/12 post partum, vaginal birth, nil perinatal complications, home with husband, bottle fed, wakes twice overnight, increasing anxiety, episodes of palpitations, shaky, 3 possible causes?
- post partum thyroiditis
- -post natal depression
- Grave’s disease
- post natal anxiety
38F 2/12 post partum, vaginal birth, nil perinatal complications, home with husband, bottle fed, wakes twice overnight, increasing anxiety, episodes of palpitations, shaky,, low TSH, normal T4, hight antithyroglobulin abs, neg tSH receptor antibody
-postpartum thyroiditis
38F 2/12 post partum, vaginal birth, nil perinatal complications, home with husband, bottle fed, wakes twice overnight, increasing anxiety, episodes of palpitations, shaky, treated. now 3/12 later, baby is 3/12, unsettled and crying, ?colic, 6 hx questions
- number of wet and soiled nappies?
- fever?
- settled after feeds?
- any decreased growth velocity?
- diarrhoea?
- vomiting?
- onset of crying, sudden?
- timing: in evenings?
38F 2/12 post partum, vaginal birth, nil perinatal complications, home with husband, bottle fed, wakes twice overnight, increasing anxiety, episodes of palpitations, shaky, 3/12 baby sudden onset crying 4/7 ago, 4 ddx?
- urinary tract infection
- raised ICP
- corneal abrasion
- hair tourniquet
- intussusception
- trauma/ NAI
38F 2/12 post partum, vaginal birth, nil perinatal complications, home with husband, bottle fed, wakes twice overnight, increasing anxiety, episodes of palpitations, shaky, 3/12 baby sudden onset crying 4/7 ago, ok between episodes, then sudden distress, single dx?
intussusception
58F feeling ‘giddy’, 2 similar episodes past year, vertigo, woke up fine, then mid morning, unwell, no meds, no pmhx. 6 hx
- how long each episode lasts?
- any high sodium meal?
- hearing loss?
- associated with head movements?
- recent URTI
- associated palpitations?
58F feeling ‘giddy’, 2 similar episodes past year, vertigo, woke up fine, then mid morning, unwell, no meds, no pmhx. unidirectional nystagmus, no cerebellar signs, positive head impulse, negative test of skew, 5ddx
- BPPV
- vestibular neuronitis
- meniere’s disease
- labarynthitis
- acoustic neuroma
58F feeling ‘giddy’, 2 similar episodes past year, vertigo, woke up fine, then mid morning, unwell, no meds, no pmhx. unidirectional nystagmus, no cerebellar signs, positive head impulse, negative test of skew, likely meniere’s 2 exam findings with tuning fork
weber’s lateralises to left
-rinne’s positive both sides
58F feeling ‘giddy’, 2 similar episodes past year, vertigo, woke up fine, then mid morning, unwell, no meds, no pmhx. unidirectional nystagmus, no cerebellar signs, positive head impulse, negative test of skew, likely meniere’s, 3 long term mx
- low sodium diet <2-3G per day
- commence hydrochlorothiazide
- avoid caffeine
- referral to ENT
- audiologist for hearing aids
58F feeling ‘giddy’, 2 similar episodes past year, vertigo, woke up fine, then mid morning, unwell, no meds, no pmhx. unidirectional nystagmus, no cerebellar signs, positive head impulse, negative test of skew, has now vitiligo, 4 mx
- cosmetic camouflage
- no treatment needed
- phototherapy
- topical corticosteroid daily, mometasone furoate 0.1%
