Management

Question 1

Acute Asthma (7)

Answer 1

• Oxygen
• Salbutamol
• Ipatropium bromide (antimuscuranic)
• All via nebulser with oxygen driven
• Predinsolone orally/ injected hydrocortisone - soluble pred
• No improvement: continued nebulisation rather than single dose
• No improvement: IV magnesium sulfate (bronchodilator)
• IV ketamne (analgeisc) and suxamethonium (relaxant) before ET tube for airway
• IPPV (Invasive positive pressure ventilation)
• Xray: puennothorax/lobar collapse mucus plugging/ET tube check

Question 2

Rehydration for diarrhoea and why?

Answer 2

• Water (increase blood vol, decrease bad mechanisms)
• Na+ (replaces loss + optimises water reabsorption)
• Glucose (energy+facilitates Na+ absorption)
• Citrate (instead of bicarb, buffer for H+ ions to bind to to treat metabolic acidosis)
• Potassium: replaces K+ ions lost due to foecal loss and lack of K+ secretion compensatory mechanism for metabolic acidosis)
• Same osmolarity

Question 3

Drugs given pre ET tube (2)

Answer 3

• IV ketamine

- IV suxamehoium

Question 4

Reasons for X ray in acute asthma (2)

Answer 4

• Check punemothorax/lobar collapse mucus plugging

- ET tube position

Question 5

Paracetomal overdose

Answer 5

N-acetyl cystine

Question 6

Rhadomyolosis

Answer 6

• Hyperkalamia
• Salbutomal
• IV calcium glutamate

Question 7

Puenmonia CURB

Answer 7

CURB 65

• Confused
• Urea
• Resp rate
• Blood pressure (below 90)

Question 8

Anaphylaxis

Answer 8

1:1000 IM adrenaline

Adults=1/2 a vial