Med/Surg

Question 1

S+S of CHF

Answer 1

dyspnoea, fatigue, swollen legs, tachycardia

Question 2

cause and S+S of MS

Answer 2

autoimmune disorder affecting myelin (nerve covering)

vision loss, pain, fatigue, ataxia

Question 3

Important Ax for PACU

Answer 3

AVPU, vital signs, wound site - haemorrhage risk, pain, lines in - lines out

Question 4

S+S of ^ICP

Answer 4

reduced pupil response (early sign), headache, nausea, HTN, confusion (altered MS), decreased alertness (altered AVPU/GCS), slow & irregular RR

Question 5

Causes of ^ICP

Answer 5

Head trauma/injury, aneurysm, stroke, tumor, brain infection, HTN

Question 6

Difference between thrombus and embolus (relates to ischaemic stroke)

Answer 6

Thrombus is a blood clot formed at the site of blockage

Embolus is a travelling clot, causing a blockage at a different site to formation

Question 7

Function of amylase and cause of increased level

Answer 7

Enzyme in saliva used to break down starch into sugars, increased levels indicate pancreatitis

Question 8

Complications pancreatitis

Answer 8

Frequent GI bleed -> hypovolemic shock
Hypoglycaemia, hyperglycaemia, diabetes, DKA
Necrosis->infection->sepsis

Question 9

S+S of hypoglycaemia

Answer 9

Blurred vision, light-headedness, confusion, unconsciousness, palpitations, tremors

Question 10

S+S of hyperglycaemia

Answer 10

Polyuria, polydipsia, polyphagia, tachycardia, vision problems, vomiting

Question 11

S+S of DKA

Answer 11

Polydipsia, polyuria, nausea, abdominal pain, fruity-scented breath, weakness and confusion

Question 12

Cause of DKA

Answer 12

Not enough insulin -> BSL high -> excess ketones produced -> pH more acidic

Question 13

S+S of hypoxia

Answer 13

Confusion, restlessness, SOB -> Headache, tachycardia, cough, wheeze, cyanosis, tachypnoea

Question 14

S+S of anaphylaxis

Answer 14

Tachycardia, hypotension (think shock), dyspnoea, exanthema (rash), erythema (redness), oedema

Question 15

What are antigens and antibodies?

Answer 15

Antigen = allergen

Antibodies destroy antigens i.e. if you have antibodies, you have immunity

Question 16

main side effect of salbutamol?

Answer 16

headache

Question 17

long term/chronic complication of asthma?

Answer 17

pulmonary fibrosis (scarring)

Question 18

pathophysiological response in asthma

Answer 18

bronchoconstriction, bronchospasm, excessive mucus, histamine release, IGE antibodies released/produced

Question 19

Best body positioning for asthma attack

Answer 19

Semi fowlers (45 degree sitting)

Question 20

IV bronchodilators

Answer 20

theophylline & aminophylline

Question 21

Serum creatinine levels

Answer 21

60-110 uml/L for men (micromols)
45-90 uml/L for women
High levels indicate poor kidney function

Question 22

Urine clearance creatinine levels

Answer 22

950-3000mg/24h for men
600-1700mg/24h for women
Low levels indicate poor kidney function
High levels can indicate carbon monoxide poisoning or pregnancy

Question 23

S+S of angina

Answer 23

Non-radiating pain, SOB, nausea, fatigue

Question 24

Side effects of GTN

Answer 24

Headache, dizziness, weak feeling, fatigue, nausea

Question 25

GTN spray administration regime

Answer 25

1st dose, wait 5 mins
PRN 2nd dose, wait 5 mins
PRN call ambulance

Question 26

Generally the ____ muscles are stronger than the _____ muscles

Answer 26

Flexor are stronger than the extensor

Question 27

What is malignant hyperthermia?

Answer 27

a severe reaction to anaesthetic drugs

S+S include sudden hyperthermia, tachycardia, muscle rigidity

Question 28

How is cerebral palsy caused?

Answer 28

Birth injury (lack of oxygen) - non progressive

Question 29

What is glucagon?

Answer 29

Hormone secreted by the alpha cells of the pancreas (insulin is secreted by the beta cells) that converts stored sugar into glucose that cells can use i.e. increasing BSL

Question 30

What is cachexia?

Answer 30

wasting away of muscles

Question 31

what is cor pulmonale?

Answer 31

R) heart failure

Question 32

MoA for ACE inhibitors

Answer 32

vasodilator (angiotensin II constricts vessels)

Question 33

MoA for beta blockers

Answer 33

stop adrenalines affect on the heart -> HR drops

Question 34

MoA for loop diuretics

Answer 34

inhibit Na/K/Cl transporter in ascending loop of Henle i.e. kidneys pass out more fluid

Question 35

what is pitting oedema and how is it treated

Answer 35

oedema that shows indentation when pressed, treat with elevation, diuretics, and ted stockings

Question 36

what is haemophilia?

Answer 36

disorder in which there is a lack of clotting function
type A: deficiency in factor 8 (around 80% of haemophilia)
type B: deficiency in factor 9

Question 37

Respiratory alkalosis and acidosis ABG results

Answer 37

Respiratory alkalosis = high pH and low pCO2
Respiratory acidosis = low pH and high pCO2
normal pH = 7.35-7.45
normal pCO2 = 35-45 mmHg

Question 38

Metabolic alkalosis and acidosis ABG results

Answer 38

Metabolic alkalosis = high pH and high HCO3- (bicarb)
Metabolic acidosis = low pH and low HCO3- (bicarb)
Normal pH= 7.35-7.45
normal bicarb = 22-28 mEq/L

Question 39

Key sign of hyperkalaemia

Answer 39

muscle weakness

Question 40

Key sign of hypocalcaemia

Answer 40

MS change and confusion

Question 41

Key sign of hypermagnesaemia

Answer 41

depression of deep tissue reflexes

Question 42

S+S of fat embolism

Answer 42

present 24-72 hours after the trauma/injury = SOB, confusion, petechial rash, decreased LOC, fever, low urine output

Question 43

Interventions for raised ICP

Answer 43

Position bed 15-30 degrees to optimise venous drainage from brain
craniotomy
drain CSF
hypertonic osmotherapy (IV fluids)

Question 44

treatment of MS

Answer 44

can’t be cured

immunosuppressants, anti-inflammatories, steroids, chemotherapy, PT, acupuncture