MACS Flashcards

1
Q

immediate drug management for anaphylaxis

A

give 500 micrograms IM adrenaline 1:1000

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2
Q

indications for long term oxygen therapy

A

chronic hypoxaemia:
- COPD
- interstitial lung disease
- CF
- bronchiectasis
- pulmonary arterial disease
- pulmonary HTN
- severe HF

–> when PaO2 is consistently at/below 7.3 kPa

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3
Q

use of nasal cannulae O2

A

mild hypoxia, usually non-acute
prongs positioned in nose

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4
Q

flow rate of nasal cannula O2

A

24-30% O2 –> max 4L/min

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5
Q

issues with nasal cannula O2

A

high flows will dry and irritate nasal passages
do not allow close control of FiO2

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6
Q

flow rate of non-rebreather mask

A

~70% when used with 15L O2 flow rate

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7
Q

who are venturi masks used on

A

those with COPD due to risk of T2 resp failure

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8
Q

what are the colours of venturi mask and their flow rates?

A

blue venturi
2-4 L/min, 24%
white venturi
4-6L/min, 28%
yellow venturi
8-10L/min, 35%
red venturi
10-12L/min, 40%
green venturi
12-15L/min, 60%

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9
Q

how do you interpret the bradens score?

A

out of 24, low score =high risk
some risk=15+

moderate risk=13-14

high risk=10-12

very high risk=9 or below

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10
Q

what factors does the Bradens score take into account

A

sensory perception
moisture
activity
mobility
nutrition
friction/shear

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11
Q

components of MUST tool

A

BMI score
weight loss score
acute disease effect score
–> added together calculate overall malnutrition risk

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12
Q

scoring in MUST tool

A

0 = low risk
1 = medium risk
2 + = high risk

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13
Q

normal urine output in health individual

A

between 0.5-1.5ml/kg/hr
should urinate at least every 6 hours

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14
Q

oliguria definition

A

production of inadequate urine volumes
<500ml/day in adults

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15
Q

composition of NaCl 0.9%

A

isotonic
154 mmol/L of Na+
154 mmol/L of Cl-

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16
Q

composition of Hartmann’s

A

isotonic
131 mmol/L of Na+
5 mmol/L of K+
111 mmol/L of Cl-
29 mmol/L of HCO3-

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17
Q

composition of NaCl 0.18% + glucose 4%

A

hypotonic
30 mmol/L of Na+
30 mmol/L of Cl-
40 g/L of glucose

18
Q

composition of 5% dextrose fluid

A

hypotonic
50g/L of glucose

19
Q

what are the daily maintenance fluid requirement

A
  • 25-30ml/kg/day of water
  • ~ 1mmol/kg/day of K, Na, Cl
  • ~ 50-100g/day of glucose to limit starvation ketosis
20
Q

what is obstructive shock?

A

Shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the body’s tissues.

21
Q

what is distributive shock?

A

Shock due to a shift of fluid from blood to tissues

22
Q

when would there not be an increase in HR in shock

A

if on beta blockers

23
Q

clinical conditions associated with obstructive shock

A
  • cardiac tamponade
  • tension pneumo
  • PE
  • coarctation of aorta
  • air embolus
  • aortocaval compression
24
Q

what is malar flush associated with

A

mitral stenosis

25
Q

what is a narrow pulse pressure

A

<25mmHg between

26
Q

what is a wide pulse pressure

A

more than 100mmHg between

27
Q

what is the difference between a central line and an arterial line?

A

arterial-into artery
central-into large vein eg internal jugular, subclavian going into the vena cava.

28
Q

examples of medications which need central line

A

amiodarone
inotropes
high conc electrolytes

29
Q

what is the surgical site bundle

A
  • antibiotic prophylaxis within last 60 mins
  • patient warning
  • hair removal
  • glycaemic control
30
Q

types of adrenaline

A

1/1000 = anaphylaxis
1/10000 = cardiac arrest

31
Q

atropine use

A

symptomatic bradycardia
bradydysrhythmias

32
Q

what is the treatment for asymptomatic inguinal hernia?

A

routine referral for surgical repair-because most become symptomatic and have surgery anyway but obvs is not urgent

33
Q

what are the 3 types of distributive shock?

A

septic
anaphylactic
neurogenic
(due to redistribution of body fluids)

34
Q

what is a contraindication of bipap?

A

current smoking

35
Q

what is a common cause of fever a few days after surgery?

A

pneumonia -especially in those who have undergone thoracic/abdominal procedures

36
Q

what are the causes of post-op fever in the timeline of after the operation?

A

5Ws: wind, water, walking, wound, wonder about drugs
1-2 days: lungs -aspiration, pneumonia, atelectasis, PE
3-5 days: UTI, CAUTI (catheter associated UTI)
4-6 days: DVT/PE, immobility
7+ days: wonder about drugs -doesn’t fit the picture

37
Q

what are used for reporting suspected adverse drug reactions to medicines, medical device incidents, and suspected fake or defective medicines?

A

yellow cards

38
Q

what investigations imaging wise do you do for bowel obstruction?

A

CT abdo pelvis -gold standard for diagnosis. go straight to this if you’re pretty sure it’s bowel obstruction.
AXR -to rule it out

39
Q

what substances do you use to clean wounds post op?

A

sterile saline -up to 48 hours after
past 48 hours -can shower
tap water past 48 hours if wound has seperated /has been surgically opened to drain pus

40
Q

what is oliguria?

A

production of inadequate volumes of urine (<500ml/day in adults, <1ml/kg/hour in infants)

41
Q

what are the types of post op bleeding?

A

primary =within intraoperative period
reactive =within 24h of operation
secondary =7-10 days post op

42
Q

what is staging tool for pressure ulcers and the different stages?

A

NPUAP/EPUAP pressure ulcer classification system
stage 1-non blanchable erythema
stage 2-partial thickness skin loss
stage 3-full thickness skin loss
stage 4 -full thickness tissue loss