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G.S > Med Year Exam > Flashcards

Med Year Exam Flashcards

1
Q

presence of microorganisms in a wound

A

Contamination

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2
Q

When organisms invade the tissue and produce ill effects (inflammation)

A

Infection

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3
Q

Non-suppurative invasive infection of the skin + subcutaneous tissues

A

Cellulitis

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4
Q

Acute spreading inflammation of the outer dermis + superficial lymphatics.

A

Erysipelas

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5
Q

is a localized suppurative inflammation.

A

Acute abscess

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6
Q

Rapidly progressive poly-microbial cellulitis, of the sublingual + submandibular space Involving floor of mouth + suprahyoid area (both sides of the neck)

A

Ludwig’s angina

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7
Q

Inadequate tissue perfusion with decreased oxygen delivery + impaired cellular metabolism

A

Shock

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8
Q

End diastolic ventricular volume (represented by: end diastolic pressure)

A

Preload

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9
Q

Vascular resistance (represented by: mean arterial blood pressure MAP)

A

Afterload

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10
Q

Diminished blood volume

A

Hypovolemic shock:

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11
Q

Due to pump failure. Alteration of the heart failure + inability maintain adequate cardiac output OR restriction of cardiac work.

A

Cardiogenic shock:

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12
Q

Mal-distribution of blood flow leads to inadequate tissue perfusion in spite of NORMAL BLOOD VOLUME + normal cardiac function.

A

Distributive shock:

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13
Q

Allergic reaction IgE antibodies against certain antigens (drugs, insect bite, foods)

A

Anaphylactic shock:

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14
Q

Persisting hypotension despite adequate volume resuscitation, occurring in a patient with SEPSIS.

A

Septic shock:

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15
Q

presence of bacteria in the blood stream

A

Bacteremia

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16
Q

presence of toxins in blood stream

A

Toxemia

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17
Q

presence of both bacteria + toxins

A

Septicemia

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18
Q

Aqueous solution of low molecular weight ions (salt) with or without glucose (dextrose)

A

Crystalloids

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19
Q

Solution containing high molecular weight substances such as proteins or large glucose polymers

A

Colloids

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20
Q

Mere presence of microorganisms in a wound.

A

Contamination

21
Q

When organisms invade the tissues and produce ill effects (inflammation)

A

Infection

22
Q

Q1- What are Components of wound healing?

A
  1. Wound contraction
  2. Granulation tissue formation
  3. Epithelialization
23
Q

Q2- what are Stages of wound healing?

A

1- Haemostasis and inflammation phase, 72 hours
2- Proliferation phase
3- Maturation and remodeling phase

24
Q

Q3- what are Types of wound healing?

A

1- Healing by primary intention
2- Healing by secondary intention
3- Healing by tertiary intention

25
Q

Q4- what are general Factors affecting wound healing?

A

1- Age
2- Nutritional state
3- Debilitating diseases
4- Drug intake Steroids

26
Q

Q5- what are local Factors affecting wound healing?

A

1- Vascularity
2- Irradiation
3- Tension
4- Infection delays healing
5- Foreign bodies

27
Q

Q6- what are Classification of surgical wound?

A

1- Clean wound
2- Clean contaminated wound
3-Contaminated wound
4-Dirty infected wound

28
Q

Q1- What are the definition of shock?

A

is a state of inadequate tissue perfusion with decreased oxygen delivery & impaired cellular metabolism.

29
Q

Q2- what are Types of shock?

A

1-Cardiogenic shock
2-Hypovolaemic shock

30
Q

Q3- Types of Cardiogenic shock?

A

Cardiomyopathy
Myocardial infarction
CHF - ventricular anuerysm
Depressed myocardium
Arrythmias - Pulmonary hypertension, drugs

31
Q

Q4- Types of Hypovolaemic shock?

A

1 - Constrictive
2 - Distributive

32
Q

Q4- Types of constrictive Hypovolaemic shock?

A

Tension pneumothorax
Pulmonary embolism
constrictive pericarditis
pericardial tamponade

33
Q

Q4- Types of Distributive Hypovolaemic shock?

A

Anaphylactic
Septic
Neurogenic
Endocrine
Hypo and hyperthyroidism
Adrenal insufficiency

34
Q

Q5- what are Effect of shock on organs?

A

• Heart… / COP, hypotension, myocardial depression
- Lung…. V gas exchange , lung oedema tachypnea
- Renal … I GF, I urine out put
- GIT …. Mucosal ischemia, bleeding
…. Liver damage
- Blood …. Coagulation abnormalities , DIC
- Endocrine …. ^ADH - 1 water retention

• CNS
… V Perfusion, altered mental function

35
Q

Q6- What are Classification of hemorrhagic shock?

A

1-Class I hemorrhage (<15% or 750 cc blood loss)

2-Class Il hemorrhage (15% to 30% or 750 to 1500 cc blood loss)

3-Class IIl hemorrhage (30% to 40% or 1500 to 2000 cc blood loss)

4-Class IV hemorrhage (> 40% or >2000 cc blood loss)

36
Q

Q7- what are Symptoms and sign of hypovolaemic shock?

A

O Thirst, anxiety
O Fainting
O Sweating
O Coldness And shivering
O Systolic pressure may not drop till loss of 30% of blood volume
O Tachycardia in adults > 100 BPM

37
Q

Q8-what are Goals for emergency treatment?

A
    • Maximize oxygen delivery
    • Control further blood loss
    • Fluid resuscitation
38
Q

Q9- what is Management of hypovolaemic shock?

A

1-Apply A B C D E of resuscitation in injured patients
2-Give oxygen 100% , May need intubation

3-Secure venous access by two large bore short cannulas
4-Do ABG
5-Start fluid therapy , (Crystalloid - Ringer Lactate or Hartmann solution)

39
Q

010- How to get venous access ?

A

0 - Arm veins.
0 - Intra osseous route .
0 - Central lines.
0 - Cut down of long saphenous vein

40
Q

Q11- what is Endpoints of resuscitation?

A
    • Vital sign ..pulse<100,, BP>100
    • Urine output >=0.5ml /hr/1kg
    • CVP .. 5-10 cm H20
    • MAP 65-90
    • Central venous oxygen concentration > 70%
  • Improvement in mental state
41
Q

012- what are causes of Cardiogenic shock?

A

• Acute mvocardial infarction
• Aortic or mitral stenosis , Myocarditis
• Sepsis & myocardial depression
• Myocardial contusion, Cardiomyopathy, Arrhythmias.
• Massive pulmonary embolism.

42
Q

013- what are Clinical picture of the original cause:?

A

O Pulse decreased or increase.
O Dyspnea, Tachypnea.
O Blood pressure decreased, Hypotention
O Congested neck veins with high CVP.
O Cool mottled skin of extremities.
- SBP < 90 mmHg
- PCWP > 18 mmHg

43
Q

Q14- Management of Cardiogenic shock?

A

18 Oxygen therapy
28 continuous fluid therapy, ( according to pt. condition)
31 treat underlying cause
42 support myocardium
57 needs special management in ICU

44
Q

Q15- what are causes of Anaphylactic shock?

A
    • Drugs : contrast media, vaccines, local anesthetic drugs,
    • Insect bite
    • foods
45
Q

Q16- Management of anaphylactic shock?

A

B Oxygen therapy. 02 mask.
R Airway management, may need intubation, ICU care.

A Intravenous access , start IV fluids, needs large volume.
A Adrenaline 1:1000 0.2-0.5ml & 0.01 mg/kg in children S/C or IM
El Repeat the dose 2-3 times in 10-15min.
Antihistamines, provide dramatic relief of symptoms
B Use of nebulizers if wheezing or respiratory distress
- IV Aminophylline may be considered
A Use of steroids , Hydrocortisone IV

46
Q

Q17- Causes of septic shock?

A

> Most common is bacteria
- Gram negative in two thirds 2/3
- Gram positive in one third 1/3
Gram negative as eg.
- E. coli, klebsiella
- Entrobacteria, bacteriods
Gram positive as
- Streptococci, Staph, Pneumococci, Clostridia

47
Q

018- What are Clinical picture two stages?

A

1-Hyper dynamic (warm) septic shock i.e-early
stage, Fever.
2-Hypo-volaemic (cold) septic shock: - late stage.

48
Q

Q19- - Treatment ( principle of treatment)?

A

>

  • Needs I.C.U if no response to initial ED treatment
  • Oxygen
  • fluid therapy correct hypo perfusion
  • Antibiotics
49
Q

Q20- Treatment started with?

A

A) - Dealing with the infection by : -
• - Drainage of abscesses or peritonitis etc….
• -I.V. strong antibiotics
B) Anti-shock measure as : -
• Fluid replacement and may be fresh blood until
normal urine output and normal C.V.P.
• Drugs as inotropics and vasopressors.
• Oxygen support.

G.S (2 decks)

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