Medical & Trauma Flashcards
1
Q
True or False - Most common triggers for anaphylaxis are food, drugs and venom
A
True
2
Q
What is defined as a severe, life threatening, generalised or systemic hypersensitivity reaction?
A
rapidly developing life threatening airway and/or breathing and/or circulation problem, usually associated with skin + mucosal changes
3
Q
4 common ways to sustain an allergic reaction
A
Ingestion, absorption, injection, inhalation
4
Q
4 signs of anaphylaxis
A
tachycardia, palor, stridor, hypotension
5
Q
3 drugs given for anaphylaxis
A
oxygen, salbutamol and adrenaline
6
Q
5 types of shock
A
hypovalemic, distributive, cardiogenic, obstructive, dissociative
7
Q
Hypovolaemic shock can be caused by what 3 things?
A
internal/external haemorrhage, extensive burns, severe diarrhoea + vomiting
8
Q
Briefly explain what distributive shock is
A
Distributive shock is where there is mass dilation of peripheral vascular system causing the body to effectively become ‘larger’ leading to lower blood pressure. This also creates ‘leaky’ blood vessels where fluid is leaked into interstitial space
9
Q
3 causes of distributive shock are
A
anaphylaxis/allergic reaction, sepsis, nervous system trauma e.g spinal cord injury
10
Q
3 causes of cardiogenic shock are
A
arrhythmia, acute heart failure, myocardial infarction
11
Q
3 causes of obstructive shock are
A
pulmonary embolism, cardiac tamponade, Tension Pneumothorax
12
Q
Briefly explain what dissociative shock is
A
dissociative shock is where the oxygen carrying capability of the blood is reduced, for example my carbon monoxide poisoning or anemia meaning the cells do not receive enough oxygen.
13
Q
4 signs and symptoms of shock are
A
tachycardia, bradycardia, tachypnoea, pallor, unusual behaviour, dizzy/faint, delayed cap refill, sweating, dilated pupils
14
Q
4 management points of shock are
A
DR CACBCDE, high % oxygen administration, constant reassurance, lay flat with head raised
15
Q
What is an infection of the lungs and airways?
A
A chest infection
16
Q
What are the 2 main types of chest infection?
A
Bronchitis + pneumonia
17
Q
Most bronchitis causes are caused by …….., whereas most pneumonia causes are due to ……
A
Viruses & bacteria
18
Q
Name 4 high risk groups for respiratory infections
A
elderly, asthma sufferers, COPD suffers, diabetes, immuno compromised, cancer patients, pregnant, bariatric/overweight, smokers
19
Q
True or False - Most chest infections are not serious and will recover in a few days or weeks
A
True
20
Q
If the bodys lungs defences cannot overcome an infection a build up of flow and blood cells occurs. What is this process known as?
A
Consolidation
21
Q
Blood clots are most common in what area of the body?
A
Lungs
22
Q
A clot that breaks off will enter the heart at the …..?
A
right atrium
23
Q
What type of shock could be caused by a pulmonary embolism?
A
Obstructive shock
24
Q
What does COPD stand for?
A
Chronic Obstructive Pulmonary Disease
25
What are the 2 main types of COPD?
Emphysema, Bronchitis
26
………. is caused by viruses/bacteria and is usually short loved and common in the young and elderly. …….. results from long term infection and lung damage and is common in the elderly.
Acute bronchitis, Chronic bronchitis
27
Emphysema is characterised by ………. of the alveoli.
| Lung tissue loses its ……….
distension and destruction
| Elasticity
28
Patients can present with one of four presentations of asthma. Name them:
moderate, severe, life threatening, near fatal
29
True or False - Asthma is rare in the elderly
True
30
In asthma patients, airways almost continuously are sensitive and ……….., this increases excess ……….. Bronchial muscles become irritates and ………..
inflamed
mucus secretion
contract
31
Regarding a recent asthma review, patients who use an inhaler over ……. times a year is a red f lag.
12
32
Respiratory distress is also known as
hyperventilation
33
True or False - Sepsis is a non-life threatening condition that arises when the body’s response to an infection injures its own tissues and organs
False
34
True or False - Sepsis is a syndrome and not an illness
True
35
There are an estimated ……. sepsis cases annually
150,000
36
True or False - Mortality rate for sepsis is high
True
37
True or False - You are 3 times more likely to die from sepsis than ACS or stroke
FALSE - 6 x more likely
38
4 groups at risk of sepsis are:
elderly, immuno compromised, diabetes sufferers, cancer patients, recent surgery
39
Define poison:
exposure of a substance that may result in mortality or morbidity
40
4 ways poison can enter the body:
injection, inhalation, ingestion, absorption
41
5 common types of poison:
household products, alcohol, fungi, cleaning products, chemicals, cosmetics
42
3 main bullet points of poison treatment that management should be based on:
identification of poison, specific treatment for specific poisons, rapid access to hospital
43
4 underlying causes of diabetes mellitus generally fall into what 4 categories?
Age, weight genetics, ethnicity
44
Briefly explain the difference between type 1 and type 2 diabetes
type 1 you produce no insulin at all, type 2 the receptor sites have mutated and insulin can no longer enter cells to allow sufficient glucose absorption.
45
True or False - Type 2 diabetes is controlled by insulin only
False
46
……….. is the amount of glucose in the blood
Blood glucose level
47
List 4 autonomic hypoglycaemia sigs and symptoms:
sweat, shaking, hunger, palpitations
48
List 4 neurological hypoglycaemia signs and symptoms:
confusion, drowsiness, odd behaviour, speech difficulty, un-coordination, aggression, fitting, unconsciousness
49
………. is low levels of glucose and …….. is high levels of glucose
Hypoglycaemia, hyperglycaemia
50
True or False - There are 200 different types of cancer
True
51
True or False - 35% off people will get cancer in their lifetime
False
52
What are the 5 types of cancer?
Carcinomas, lymphomas, leukaemia, brain tumour, sarcomas
53
……….. is used to treat and kill cancer cells or stop them from spreading
Chemotherapy
54
This is a potentially fatal complication of cancer treatment
neutropenic sepsis
55
This type of therapy uses X-rays to damage the DNA of cells
radiotherapy
56
When cholesterol gets lodged in the tunica media and accumulates, white blood cells surround around ir and forms a fibrous cap. This build up is called?
atherosclerosis
57
Ischaemic chest pain from a reduction of the blood supply to the myocardium can cause?
angina pectoris
58
True or False - Angina pectoris causes no pain at rest but can cause pain during exertion
True
59
An abnormality of cardiac structure of function is called?
heart failure
60
Cardiac output is?
stroke volume x heart rate
61
……… is the volume of blood stretching the resting heart muscle at the end of diastole
Preload
62
……… of the forcefulness of the muscle contraction
Contractility
63
…….. is the pressure needed to inject blood from the left ventricle
Afterload
64
ACS stands for :
acute coronary syndrome
65
True or False - Unstable angina is a branch of a coronary artery that becomes blocked, causing reduced blood flow to the tissue leading to infarction
True
66
True or False - Atypical presentations of ACS are not uncommon
True
67
True or False - Sickle cell is a hereditary or non-hereditary condition affecting the haemoglobin within red blood cells
False
68
The life span of red blood cells is ………, the life span of sickle cell is ………
120 days
| 19 days
69
When sickle shaped RBCs clump together to occlude microvasculature causing schema and pain is also known as ………..
sickle cell crisis
70
Name 4 signs and symptoms of sickle cell crisis:
severe pain (especially at joints), tachycardia, hypotension, difficulty breathing
71
True or False - You cannot give O2 as management of sickle cell crisis
False
72
True or False - Abdominal pain is an uncommon presenting symptom to the ambulance service
False
73
True or False - 20% of patients contact the ambulance service with abode pain have serious underlying conditions
False - 25%
74
True or False - Abdominal pain can arise from both acute and chronic abdo conditions
True
75
True or False - Appendicitis/pancreatitis are both acute abdo conditions
True
76
Name a chronic abdominal condition
Hernias, IBS, inflamatory bowel syndrome, Gastric and Duodenal ulcers
77
This condition is very common and affects memory, thinking and language:
dementia
78
This condition comes from a reduction of dopamine in the brain, which helps regulate movement and can cause involuntary shaking
Parkinsons
79
This is an autoimmune disease that atatcks the myelin sheath in the brain which slows impulses
Multiple Sclerosis
80
True or False - Ataxia is damage to cerebellum from H/I, MS and hypoxia
True
81
Most weakness or incomplete loss of muscle function is called?
Paralysis
82
Describe the following: Monoplegia, hemiplegia, quadriplegia, paraplegia
paralysis of 1 limb
paralysis of both limbs on one side of the body
paralysis of all 4 limbs
paralysis of both lower limbs
83
What does CVE stand for?
Cerebrovascular event
84
True or False - CVE is the 3rd most common death in England
True
85
Blood supply to the brain that is interrupted is also known as what?
Stroke
86
TIA stands for -
Transient Ischaemic Attack
87
How does a TIA and stroke differ?
A TIA will resolve within 24 hours or less whereas a stroke will last longer than this
88
What is the difference between an ischemic stroke vs a haemorrhagic stroke?
Ischemic = blockages, haemorrhagic = bleed
89
4 symptoms of CVE include :
numbness, weakness or paralysis, slurred speech, blurred vision, confusion, severe headaches
90
What does FAST stand for in relation to a stroke?
Face, arms, speech, time
91
True or False - Convulsions are a voluntary contraction and relaxation of the muscles
False
92
What is a term used to describe the tendency to have recurrent unprovoked convulsions?
Epilepsy
93
A ……… convulsion affects a large part of the cerebral cortex where as a ……….. convulsion affects a localised part of the cortex
generalised
| partial
94
What does BTCS stand for?
Bilateral tonic-clonic seizures
95
What happens in the tonic stage?
The patient experiences body wide rigidity, they may fall, cry out and/or bite their tongue as the jaw clenches
96
What happens in the clonic stage?
The patient experiences consisted convulsions/jerking which may eventually slow/stop, the patient may be incontinent
97
What could you expect from a patient in the ‘post ictal phase’? -
the patient will be extremely tired and disorientated
98
True or False - Continuous convulsions of 5 min or longer, for a series of convulsions at 3 or more an hour with little recovery period is also known as status epilepticus
True
99
What does SUDEP stand for?
Sudden unexpected death in epilepsy
100
True or False - SUDEP most often occurs during the day
False
101
True or False - Autoimmune Addisons affects 1-20,000
False
102
True or False - Autoimmune Addisons is common in the young and middle aged people
True
103
Damage to the adrenal cortex that causes them to not be able to make enough cortisol and aldosterone is called?
Addison’s disease
104
…………… is caused by a de-functioning pituitary gland not signalling the adrenal glands to make cortisol
Secondary Addison’s disease
105
Cortisol and aldosterone help by doing what 5 things?
Regulates blood pressure, helps the immune system, balances the effect of insulin, assists the body responding to stress, regulates salts in the blood
106
True or False - Meningococcal disease is the leading cause of death from infection in mature adults
FALSE, leading cause in children and young adults
107
……….. is the infection of the meninges
Meningitis
108
……….. is infection of the blood stream
Septicaemia
109
True or False - A coma could be described as an absence or loss of consciousness
True
110
Name 4 conditions that could leave to a coma
stroke, convulsions, epilepsy, hypo/ hyperglycaemia, overdose, meningitis, hypothermia, carbon monoxide, clinical shock, cardiac arrhythmias, hypokalaemia, persistent hyperventilation, inadequate airway/respiration
111
When a bone breaks at the point of impact is known as ……….. force. ……….. force is when force applied to a region of the body is transmitted through the skeleton until it reaches the structurally weakest point causing it the fracture.
direct
| indirect
112
Name 5 musculoskeletal injuries:
Amputations, fractures, dislocation, strains, sprains
113
Four signs and symptoms of a fracture:
pain, swelling at the area, deformity, erythema (redness)
114
This type of fracture is also called a simple fracture and is where no puncturing to the skin has occurred
Closed
115
This type of fracture has a wound at the site entry, cause by bone pushing through the skin
Open (compound)
116
This is caused when there is a horizontal break through the bone splitting into 2 parts
Transverse
117
This type of fracture is caused by a twisting force
Spiral
118
This type of fracture is when a bone is broken diagonally along its shaft
Oblique
119
This type of fracture result in the long bone being split into more than two parts
Comminuted
120
This type of fracture is common in children and is a incomplete fracture where is only breaks on one side
Green stick
121
An abnormal separation of joint surfaces is called a?
Dislocation
122
A ligamental injury that involves a partial or complete tear of a ligament is called?
Sprain
123
A …….. is a stretch and/or tear of muscle fibres and/or tendon
Strain
124
The 6 ‘P’s of ischaemia are:
Pain, Pallor, Perishing cold, pulselessness, paralysis, parasthesia
125
True or False - Mid shaft femoral fractures are time critical
True
126
True or False - 50% of deaths in trauma happen within minutes of taking place
True
127
True or False - The major cause of death in trauma is blood loss
True
128
True or False - Most trauma victims are the elderly
False
129
List a risk of serious injury for each age group:
Young and healthy adults = alcohol and drugs
older people = multiple medical problems and medications
children = no concept of danger
130
Anti coagulants can put the elderly at risk when trying to stop bleeding. Name four common anti-coagulants:
dabigatran (Pradaxa), rivaroxaban ,(xarelto) apixaban (eliquis), edoxaban (savaysa)
131
True or False - Minimising time on scene at a major trauma is not a main priority
False
132
What does mechanism of injury mean? (MOI)
How the injury was sustained including direction, force and time
133
True or False - Any patient with a serious head injury or loss of consciousness has a spinal injury until proven otherwise
True
134
True or False - Pelvic fracture are common fractures in adults -
FALSE - 3-6% OF ALL FRACTURES
135
True or False - Most Pelvic injuries occur in men
True
136
True or False - When surveying the pelvis area for signed and symptoms of injury you should ‘spring’ the pelvis
False
137
True or False - Pelvic injuries can lead to fatal haemorrhaging
True
138
Name 4 mechanisms of injury that could a cause a spinal injury -
rotation, compression, hyeprflexion, hyperextension
139
True or False - Most spinal injuries happen from falls and RTC’s
True
140
What is caudal equine syndrome?
when the nerves at the base of the spine are severely compressed or inflamed
141
List four common signs and symptoms of spinal injury:
pain anywhere along the neck/back, lots of sensation, loss of movement, altered sensation
142
List 3 potential complications when managing a patient with spinal injuries:
airway problems, increased intracranial pressure, restricted respiration, dysphagia, skin ulceration/pressure sores, pain
143
What is trauma?
Trauma is when an injury occurs due to an external force of energy transfers to the body faster than the body can sustain or dissipate it.
144
What is major trauma?
Major trauma is when an injury is likely to cause in permanent injury or death
145
True or False - Major trauma is the leading cause of death in patients under 40
True
146
The most common time of day for major trauma to occur is between 12:00-15:59
FALSE (4pm - 00:00)
147
What system can be used to assess patients to make sure they are transported to the appropriate MTC or hospital
Trauma tree
148
True or False - To establish good trauma care, the seriousness of the injury should be identified on scene asap and transferred to MTC as soon as major trauma is recognised
True
149
True or False - When using the trauma tree, the step triggered does not need to be documented on the PRF
False
150
Regarding falls from height, a significant MOI in adults is a fall from more than ………… and in children is a fall from ………….
6m or 2 stores
| 3 metres or 2 x the height of the child
151
List four special considerations that should lower the threshold for providing a trauma alert:
pregnant patients, patients over 55, morbidly obese patients, paediatrics under 12, patients taking anti-coagulants
152
True or False - The laws of energy and motion as well as kinetic energy and thermodynamics should be followed to help assist you in understanding the MOI
True
153
5 common causes of maxillofacial injuries are:
assaults, alcohol, road traffic accidents, sportrelated, falls
154
Briefly explain what an orbital fracture is:
where the orbit ‘blows out’ and fractures usually due to a blow to the eye
155
Name four signs and symptoms of a blowout fracture:
eye goes into the socket, double vision/ loss upwards vision, pulse at different levels to each other, loss of sensation above the eyebrow/over cheek
156
What are the 3 classic patterns to categorise maxillofacial fractures:
separation from the skull
157
What are four immediate complications to consider with max-pac injuries:
airways compromise, aspiration, haemorrhage, infection
158
What are two long term injuries to consider:
scaring/facial deformity, nerve damage
159
What are 5 considerations when dealing with the management of unconscious max-pac injured patients?
Postural drainage &/or suction, OPs ar enot always helpful, NP’s are better tolerated, application of BVM can be challenging, Advanced airway and pain management are usually required
160
What are the four category types for eye injuries?
Chemical burns, corneal abrasions, blunt trauma, foreign bodies
161
How long should you try to irrigate a patients eye when a chemical burn is suspected?
20 minutes
162
What category is a superficial injury to the surface of the cornea called?
Corneal abrasion
163
What category of eye injury is caused by mechanisms such as a blow from a first or ball?
Blunt trauma
164
True or False - An embedded object in the eye should be removed and direct pressure applied
False
165
What are 3 complicated injuries when dealing with eyes?
Lacerations and contrusions, burns, avulsed eyelid, laceration of eyeball, avulsion of eye
166
Name 5 instances a nosebleed (epistaxis) can occur:
direct trauma to nose, bleeding conditions, nose picking, blowing the nose too hard, inside of the nose being too dry, some medications
167
True or False - A patient with a nosebleed should put their head back
False
168
True or False - A nasal fracture is the most common facial injury
True
169
What are 3 causes associated with ear emergencies?
Foreign bodies in the ear, sudden change in pressure, loud noises
170
Name four signs and symptoms associated with ear injuries -
pain, bleeding/CSF from ears, loss of hearing, dizziness, vomitting/nausea, bruising/redness, swelling, visible object in ear, noises in ear
171
True or False - You should apply direct pressure to a cut to the outside of the ear
True
172
Name four things you should not do when dealing with a blocked ear canal -
try and remove the blockage by probing, place objects/liquids inside the ear, block any drainage leaving the ear, try to clean or wash the inside of the ear
173
What does TBI stand for?
Traumatic brain injury
174
Name 4 common causes of TBI’s -
RTCs, falls, assault, direct blows to the head
175
The worse outcomes associated with TBI’s are:
penetrating injury, non accidental injuries in patients younger than 5, ejection from vehicles, cyclists/pedestrians
176
A primary brain injury is described as what?
Instantaneous injury resulting from the impact itself
177
True or False - A primary brain injury can be treated and fixed
False
178
What are 3 complications of a brain injury?
Hypoxaemia, Hypotension, Intracerebral
179
Name four suggestive symptoms of TBI:
lacerations, contusions, haematomas, boggy areas, visible fractures/deformities, ‘panda eyes’, CSF leaking, cushings triad, dizziness, nausea + vomitting, abnormal pupil/reactions, visual disturbances, severe headache, altered level of consciousness, repetitive, amnesia, paraesthesia/paralysis of extremities, convulsions, posturing, abnormal respirations
180
True or False - A scalp laceration may appear worse than they are
True
181
True or False - Scalp injuries in children can cause hypovolaemia
True
182
Periorbital ecchymosis is also known as:
panda eyes
183
What 3 things are associated with cushings triad? Hypertension, brachycardia, respiratory irregularity
Hypertension, brachycardia, respiratory irregularity
184
What does ICP stand for?
Inter cranial pressure
185
What are four pre-hospital aims when managing TBI’s?
Prevent hypoxia, treat hypotension, maintain EtCO2, transport quickly
186
True or False - Isolated head injuries cause hypotension or tachycardia
False
187
True or False - Chest injuries account for directly 25% of all trauma deaths and contributes to approximately another 50%
True
188
What are three common causes of chest trauma?
RTCs, industrial accidents, sporting injuries
189
Name four signs and symptoms of a chest injury:
shallow respiration + use of accessory limbs, anxiety, pain/tenderness, hypoxia, dyspnoea, tachyponea, bradyponea, obvious blood loss/shock, reduced level of consciousness, deformity/swelling
190
This is caused by blunt trauma by blunt trauma to the sternum, which may result in cardiac rhythm disturbances
myocardial contusion
191
True or False - Rib fracture are the most common type of chest injury
True
192
True or False - Less than a quarter of patients with a sternum fracture will die -
FALSE (more than a quarter will die)
193
This type of injury is when 2 or more rib and sternum fractures in 2 or more places
flail chest
194
When air enters the pleural space between the visceral and parietal pleura is called a ……..
pneumothorax
195
This type of pneumothorax results from penetrating trauma to the chest wall which allows air to enter and exit the pleural space -
open pneumothorax (sucking chest wound)
196
What type of pneumothorax allows air to enter the thoracic cavity but not escape?
Tension pneumothorax
197
This is the name of when blood enters the thoracic cavity -
haemothorax
