Management

Question 1

What is the management of stroke?

Answer 1

1. Aspirin 300mg PO/PR ASAP if haemorrhagic stroke excluded
2. AF - no anticoagulants until haemorrhagic stroke excluded + 14 days from onset of ischaemic stroke
3. Thrombolysis with alteplase - 4-5hrs of onset of stroke symptoms and haemorrhage excluded

Question 2

What is the management of a STEMI?

Answer 2

• A-E, O2 if required
• Aspirin 300mg PO
• Morphine 5-10mg V w/ cyclizine 50mg IV
• GTN spray/tablet
• Primary PCI or thrombolysis

Question 3

What is the management of an NSTEMI?

Answer 3

• A-E, O2 if required
• Aspirin 300mg PO
• Morphine 5-10mg V w/ cyclizine 50mg IV
• GTN spray/tablet
• Clopidogrel 300mg PO and either LMWH e.g. tinzaparin or fondaparinux 2.5mg OD SC

Question 4

What is the management of acute LV heart failure?

Answer 4

• A-E, O2 if required
• Sit patient up
• Morphine 5-10mg IV with cyclizine 50mg IV
• GTN spray/tablet
• Furosemide 40-80mg IV (repeat as required/tolerated)
• Inadequate response - isosorbide dinitrate infusion +/- CPAP

Question 5

What is the initial management of DKA?

Answer 5

0.9% Sodium Chloride 500ml over 10-15 mins, can repeat if BP remains <90mmHg.