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Medical & Trauma Flashcards

1
Q

True or False - Most common triggers for anaphylaxis are food, drugs and venom

A

True

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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

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3
Q

4 common ways to sustain an allergic reaction

A

Ingestion, absorption, injection, inhalation

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4
Q

4 signs of anaphylaxis

A

tachycardia, palor, stridor, hypotension

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5
Q

3 drugs given for anaphylaxis

A

oxygen, salbutamol and adrenaline

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6
Q

5 types of shock

A

hypovalemic, distributive, cardiogenic, obstructive, dissociative

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7
Q

Hypovolaemic shock can be caused by what 3 things?

A

internal/external haemorrhage, extensive burns, severe diarrhoea + vomiting

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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

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9
Q

3 causes of distributive shock are

A

anaphylaxis/allergic reaction, sepsis, nervous system trauma e.g spinal cord injury

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10
Q

3 causes of cardiogenic shock are

A

arrhythmia, acute heart failure, myocardial infarction

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11
Q

3 causes of obstructive shock are

A

pulmonary embolism, cardiac tamponade, Tension Pneumothorax

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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.

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13
Q

4 signs and symptoms of shock are

A

tachycardia, bradycardia, tachypnoea, pallor, unusual behaviour, dizzy/faint, delayed cap refill, sweating, dilated pupils

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14
Q

4 management points of shock are

A

DR CACBCDE, high % oxygen administration, constant reassurance, lay flat with head raised

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15
Q

What is an infection of the lungs and airways?

A

A chest infection

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16
Q

What are the 2 main types of chest infection?

A

Bronchitis + pneumonia

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17
Q

Most bronchitis causes are caused by …….., whereas most pneumonia causes are due to ……

A

Viruses & bacteria

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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

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19
Q

True or False - Most chest infections are not serious and will recover in a few days or weeks

A

True

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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

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21
Q

Blood clots are most common in what area of the body?

A

Lungs

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22
Q

A clot that breaks off will enter the heart at the …..?

A

right atrium

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23
Q

What type of shock could be caused by a pulmonary embolism?

A

Obstructive shock

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24
Q

What does COPD stand for?

A

Chronic Obstructive Pulmonary Disease

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25
Q

What are the 2 main types of COPD?

A

Emphysema, Bronchitis

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26
Q

………. 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.

A

Acute bronchitis, Chronic bronchitis

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27
Q

Emphysema is characterised by ………. of the alveoli.

Lung tissue loses its ……….

A

distension and destruction

Elasticity

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28
Q

Patients can present with one of four presentations of asthma. Name them:

A

moderate, severe, life threatening, near fatal

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29
Q

True or False - Asthma is rare in the elderly

A

True

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30
Q

In asthma patients, airways almost continuously are sensitive and ……….., this increases excess ……….. Bronchial muscles become irritates and ………..

A

inflamed
mucus secretion
contract

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31
Q

Regarding a recent asthma review, patients who use an inhaler over ……. times a year is a red f lag.

A

12

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32
Q

Respiratory distress is also known as

A

hyperventilation

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33
Q

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

A

False

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34
Q

True or False - Sepsis is a syndrome and not an illness

A

True

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35
Q

There are an estimated ……. sepsis cases annually

A

150,000

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36
Q

True or False - Mortality rate for sepsis is high

A

True

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37
Q

True or False - You are 3 times more likely to die from sepsis than ACS or stroke

A

FALSE - 6 x more likely

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38
Q

4 groups at risk of sepsis are:

A

elderly, immuno compromised, diabetes sufferers, cancer patients, recent surgery

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39
Q

Define poison:

A

exposure of a substance that may result in mortality or morbidity

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40
Q

4 ways poison can enter the body:

A

injection, inhalation, ingestion, absorption

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41
Q

5 common types of poison:

A

household products, alcohol, fungi, cleaning products, chemicals, cosmetics

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42
Q

3 main bullet points of poison treatment that management should be based on:

A

identification of poison, specific treatment for specific poisons, rapid access to hospital

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43
Q

4 underlying causes of diabetes mellitus generally fall into what 4 categories?

A

Age, weight genetics, ethnicity

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44
Q

Briefly explain the difference between type 1 and type 2 diabetes

A

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.

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45
Q

True or False - Type 2 diabetes is controlled by insulin only

A

False

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46
Q

……….. is the amount of glucose in the blood

A

Blood glucose level

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47
Q

List 4 autonomic hypoglycaemia sigs and symptoms:

A

sweat, shaking, hunger, palpitations

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48
Q

List 4 neurological hypoglycaemia signs and symptoms:

A

confusion, drowsiness, odd behaviour, speech difficulty, un-coordination, aggression, fitting, unconsciousness

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49
Q

………. is low levels of glucose and …….. is high levels of glucose

A

Hypoglycaemia, hyperglycaemia

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50
Q

True or False - There are 200 different types of cancer

A

True

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51
Q

True or False - 35% off people will get cancer in their lifetime

A

False

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52
Q

What are the 5 types of cancer?

A

Carcinomas, lymphomas, leukaemia, brain tumour, sarcomas

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53
Q

……….. is used to treat and kill cancer cells or stop them from spreading

A

Chemotherapy

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54
Q

This is a potentially fatal complication of cancer treatment

A

neutropenic sepsis

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55
Q

This type of therapy uses X-rays to damage the DNA of cells

A

radiotherapy

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56
Q

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?

A

atherosclerosis

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57
Q

Ischaemic chest pain from a reduction of the blood supply to the myocardium can cause?

A

angina pectoris

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58
Q

True or False - Angina pectoris causes no pain at rest but can cause pain during exertion

A

True

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59
Q

An abnormality of cardiac structure of function is called?

A

heart failure

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60
Q

Cardiac output is?

A

stroke volume x heart rate

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61
Q

……… is the volume of blood stretching the resting heart muscle at the end of diastole

A

Preload

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62
Q

……… of the forcefulness of the muscle contraction

A

Contractility

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63
Q

…….. is the pressure needed to inject blood from the left ventricle

A

Afterload

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64
Q

ACS stands for :

A

acute coronary syndrome

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65
Q

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

A

True

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66
Q

True or False - Atypical presentations of ACS are not uncommon

A

True

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67
Q

True or False - Sickle cell is a hereditary or non-hereditary condition affecting the haemoglobin within red blood cells

A

False

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68
Q

The life span of red blood cells is ………, the life span of sickle cell is ………

A

120 days

19 days

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69
Q

When sickle shaped RBCs clump together to occlude microvasculature causing schema and pain is also known as ………..

A

sickle cell crisis

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70
Q

Name 4 signs and symptoms of sickle cell crisis:

A

severe pain (especially at joints), tachycardia, hypotension, difficulty breathing

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71
Q

True or False - You cannot give O2 as management of sickle cell crisis

A

False

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72
Q

True or False - Abdominal pain is an uncommon presenting symptom to the ambulance service

A

False

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73
Q

True or False - 20% of patients contact the ambulance service with abode pain have serious underlying conditions

A

False - 25%

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74
Q

True or False - Abdominal pain can arise from both acute and chronic abdo conditions

A

True

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75
Q

True or False - Appendicitis/pancreatitis are both acute abdo conditions

A

True

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76
Q

Name a chronic abdominal condition

A

Hernias, IBS, inflamatory bowel syndrome, Gastric and Duodenal ulcers

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77
Q

This condition is very common and affects memory, thinking and language:

A

dementia

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78
Q

This condition comes from a reduction of dopamine in the brain, which helps regulate movement and can cause involuntary shaking

A

Parkinsons

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79
Q

This is an autoimmune disease that atatcks the myelin sheath in the brain which slows impulses

A

Multiple Sclerosis

80
Q

True or False - Ataxia is damage to cerebellum from H/I, MS and hypoxia

A

True

81
Q

Most weakness or incomplete loss of muscle function is called?

A

Paralysis

82
Q

Describe the following: Monoplegia, hemiplegia, quadriplegia, paraplegia

A

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
Q

What does CVE stand for?

A

Cerebrovascular event

84
Q

True or False - CVE is the 3rd most common death in England

A

True

85
Q

Blood supply to the brain that is interrupted is also known as what?

A

Stroke

86
Q

TIA stands for -

A

Transient Ischaemic Attack

87
Q

How does a TIA and stroke differ?

A

A TIA will resolve within 24 hours or less whereas a stroke will last longer than this

88
Q

What is the difference between an ischemic stroke vs a haemorrhagic stroke?

A

Ischemic = blockages, haemorrhagic = bleed

89
Q

4 symptoms of CVE include :

A

numbness, weakness or paralysis, slurred speech, blurred vision, confusion, severe headaches

90
Q

What does FAST stand for in relation to a stroke?

A

Face, arms, speech, time

91
Q

True or False - Convulsions are a voluntary contraction and relaxation of the muscles

A

False

92
Q

What is a term used to describe the tendency to have recurrent unprovoked convulsions?

A

Epilepsy

93
Q

A ……… convulsion affects a large part of the cerebral cortex where as a ……….. convulsion affects a localised part of the cortex

A

generalised

partial

94
Q

What does BTCS stand for?

A

Bilateral tonic-clonic seizures

95
Q

What happens in the tonic stage?

A

The patient experiences body wide rigidity, they may fall, cry out and/or bite their tongue as the jaw clenches

96
Q

What happens in the clonic stage?

A

The patient experiences consisted convulsions/jerking which may eventually slow/stop, the patient may be incontinent

97
Q

What could you expect from a patient in the ‘post ictal phase’? -

A

the patient will be extremely tired and disorientated

98
Q

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

A

True

99
Q

What does SUDEP stand for?

A

Sudden unexpected death in epilepsy

100
Q

True or False - SUDEP most often occurs during the day

A

False

101
Q

True or False - Autoimmune Addisons affects 1-20,000

A

False

102
Q

True or False - Autoimmune Addisons is common in the young and middle aged people

A

True

103
Q

Damage to the adrenal cortex that causes them to not be able to make enough cortisol and aldosterone is called?

A

Addison’s disease

104
Q

…………… is caused by a de-functioning pituitary gland not signalling the adrenal glands to make cortisol

A

Secondary Addison’s disease

105
Q

Cortisol and aldosterone help by doing what 5 things?

A

Regulates blood pressure, helps the immune system, balances the effect of insulin, assists the body responding to stress, regulates salts in the blood

106
Q

True or False - Meningococcal disease is the leading cause of death from infection in mature adults

A

FALSE, leading cause in children and young adults

107
Q

……….. is the infection of the meninges

A

Meningitis

108
Q

……….. is infection of the blood stream

A

Septicaemia

109
Q

True or False - A coma could be described as an absence or loss of consciousness

A

True

110
Q

Name 4 conditions that could leave to a coma

A

stroke, convulsions, epilepsy, hypo/ hyperglycaemia, overdose, meningitis, hypothermia, carbon monoxide, clinical shock, cardiac arrhythmias, hypokalaemia, persistent hyperventilation, inadequate airway/respiration

111
Q

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.

A

direct

indirect

112
Q

Name 5 musculoskeletal injuries:

A

Amputations, fractures, dislocation, strains, sprains

113
Q

Four signs and symptoms of a fracture:

A

pain, swelling at the area, deformity, erythema (redness)

114
Q

This type of fracture is also called a simple fracture and is where no puncturing to the skin has occurred

A

Closed

115
Q

This type of fracture has a wound at the site entry, cause by bone pushing through the skin

A

Open (compound)

116
Q

This is caused when there is a horizontal break through the bone splitting into 2 parts

A

Transverse

117
Q

This type of fracture is caused by a twisting force

A

Spiral

118
Q

This type of fracture is when a bone is broken diagonally along its shaft

A

Oblique

119
Q

This type of fracture result in the long bone being split into more than two parts

A

Comminuted

120
Q

This type of fracture is common in children and is a incomplete fracture where is only breaks on one side

A

Green stick

121
Q

An abnormal separation of joint surfaces is called a?

A

Dislocation

122
Q

A ligamental injury that involves a partial or complete tear of a ligament is called?

A

Sprain

123
Q

A …….. is a stretch and/or tear of muscle fibres and/or tendon

A

Strain

124
Q

The 6 ‘P’s of ischaemia are:

A

Pain, Pallor, Perishing cold, pulselessness, paralysis, parasthesia

125
Q

True or False - Mid shaft femoral fractures are time critical

A

True

126
Q

True or False - 50% of deaths in trauma happen within minutes of taking place

A

True

127
Q

True or False - The major cause of death in trauma is blood loss

A

True

128
Q

True or False - Most trauma victims are the elderly

A

False

129
Q

List a risk of serious injury for each age group:

A

Young and healthy adults = alcohol and drugs
older people = multiple medical problems and medications
children = no concept of danger

130
Q

Anti coagulants can put the elderly at risk when trying to stop bleeding. Name four common anti-coagulants:

A

dabigatran (Pradaxa), rivaroxaban ,(xarelto) apixaban (eliquis), edoxaban (savaysa)

131
Q

True or False - Minimising time on scene at a major trauma is not a main priority

A

False

132
Q

What does mechanism of injury mean? (MOI)

A

How the injury was sustained including direction, force and time

133
Q

True or False - Any patient with a serious head injury or loss of consciousness has a spinal injury until proven otherwise

A

True

134
Q

True or False - Pelvic fracture are common fractures in adults -

A

FALSE - 3-6% OF ALL FRACTURES

135
Q

True or False - Most Pelvic injuries occur in men

A

True

136
Q

True or False - When surveying the pelvis area for signed and symptoms of injury you should ‘spring’ the pelvis

A

False

137
Q

True or False - Pelvic injuries can lead to fatal haemorrhaging

A

True

138
Q

Name 4 mechanisms of injury that could a cause a spinal injury -

A

rotation, compression, hyeprflexion, hyperextension

139
Q

True or False - Most spinal injuries happen from falls and RTC’s

A

True

140
Q

What is caudal equine syndrome?

A

when the nerves at the base of the spine are severely compressed or inflamed

141
Q

List four common signs and symptoms of spinal injury:

A

pain anywhere along the neck/back, lots of sensation, loss of movement, altered sensation

142
Q

List 3 potential complications when managing a patient with spinal injuries:

A

airway problems, increased intracranial pressure, restricted respiration, dysphagia, skin ulceration/pressure sores, pain

143
Q

What is trauma?

A

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
Q

What is major trauma?

A

Major trauma is when an injury is likely to cause in permanent injury or death

145
Q

True or False - Major trauma is the leading cause of death in patients under 40

A

True

146
Q

The most common time of day for major trauma to occur is between 12:00-15:59

A

FALSE (4pm - 00:00)

147
Q

What system can be used to assess patients to make sure they are transported to the appropriate MTC or hospital

A

Trauma tree

148
Q

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

A

True

149
Q

True or False - When using the trauma tree, the step triggered does not need to be documented on the PRF

A

False

150
Q

Regarding falls from height, a significant MOI in adults is a fall from more than ………… and in children is a fall from ………….

A

6m or 2 stores

3 metres or 2 x the height of the child

151
Q

List four special considerations that should lower the threshold for providing a trauma alert:

A

pregnant patients, patients over 55, morbidly obese patients, paediatrics under 12, patients taking anti-coagulants

152
Q

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

A

True

153
Q

5 common causes of maxillofacial injuries are:

A

assaults, alcohol, road traffic accidents, sportrelated, falls

154
Q

Briefly explain what an orbital fracture is:

A

where the orbit ‘blows out’ and fractures usually due to a blow to the eye

155
Q

Name four signs and symptoms of a blowout fracture:

A

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
Q

What are the 3 classic patterns to categorise maxillofacial fractures:

A

separation from the skull

157
Q

What are four immediate complications to consider with max-pac injuries:

A

airways compromise, aspiration, haemorrhage, infection

158
Q

What are two long term injuries to consider:

A

scaring/facial deformity, nerve damage

159
Q

What are 5 considerations when dealing with the management of unconscious max-pac injured patients?

A

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
Q

What are the four category types for eye injuries?

A

Chemical burns, corneal abrasions, blunt trauma, foreign bodies

161
Q

How long should you try to irrigate a patients eye when a chemical burn is suspected?

A

20 minutes

162
Q

What category is a superficial injury to the surface of the cornea called?

A

Corneal abrasion

163
Q

What category of eye injury is caused by mechanisms such as a blow from a first or ball?

A

Blunt trauma

164
Q

True or False - An embedded object in the eye should be removed and direct pressure applied

A

False

165
Q

What are 3 complicated injuries when dealing with eyes?

A

Lacerations and contrusions, burns, avulsed eyelid, laceration of eyeball, avulsion of eye

166
Q

Name 5 instances a nosebleed (epistaxis) can occur:

A

direct trauma to nose, bleeding conditions, nose picking, blowing the nose too hard, inside of the nose being too dry, some medications

167
Q

True or False - A patient with a nosebleed should put their head back

A

False

168
Q

True or False - A nasal fracture is the most common facial injury

A

True

169
Q

What are 3 causes associated with ear emergencies?

A

Foreign bodies in the ear, sudden change in pressure, loud noises

170
Q

Name four signs and symptoms associated with ear injuries -

A

pain, bleeding/CSF from ears, loss of hearing, dizziness, vomitting/nausea, bruising/redness, swelling, visible object in ear, noises in ear

171
Q

True or False - You should apply direct pressure to a cut to the outside of the ear

A

True

172
Q

Name four things you should not do when dealing with a blocked ear canal -

A

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
Q

What does TBI stand for?

A

Traumatic brain injury

174
Q

Name 4 common causes of TBI’s -

A

RTCs, falls, assault, direct blows to the head

175
Q

The worse outcomes associated with TBI’s are:

A

penetrating injury, non accidental injuries in patients younger than 5, ejection from vehicles, cyclists/pedestrians

176
Q

A primary brain injury is described as what?

A

Instantaneous injury resulting from the impact itself

177
Q

True or False - A primary brain injury can be treated and fixed

A

False

178
Q

What are 3 complications of a brain injury?

A

Hypoxaemia, Hypotension, Intracerebral

179
Q

Name four suggestive symptoms of TBI:

A

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
Q

True or False - A scalp laceration may appear worse than they are

A

True

181
Q

True or False - Scalp injuries in children can cause hypovolaemia

A

True

182
Q

Periorbital ecchymosis is also known as:

A

panda eyes

183
Q

What 3 things are associated with cushings triad? Hypertension, brachycardia, respiratory irregularity

A

Hypertension, brachycardia, respiratory irregularity

184
Q

What does ICP stand for?

A

Inter cranial pressure

185
Q

What are four pre-hospital aims when managing TBI’s?

A

Prevent hypoxia, treat hypotension, maintain EtCO2, transport quickly

186
Q

True or False - Isolated head injuries cause hypotension or tachycardia

A

False

187
Q

True or False - Chest injuries account for directly 25% of all trauma deaths and contributes to approximately another 50%

A

True

188
Q

What are three common causes of chest trauma?

A

RTCs, industrial accidents, sporting injuries

189
Q

Name four signs and symptoms of a chest injury:

A

shallow respiration + use of accessory limbs, anxiety, pain/tenderness, hypoxia, dyspnoea, tachyponea, bradyponea, obvious blood loss/shock, reduced level of consciousness, deformity/swelling

190
Q

This is caused by blunt trauma by blunt trauma to the sternum, which may result in cardiac rhythm disturbances

A

myocardial contusion

191
Q

True or False - Rib fracture are the most common type of chest injury

A

True

192
Q

True or False - Less than a quarter of patients with a sternum fracture will die -

A

FALSE (more than a quarter will die)

193
Q

This type of injury is when 2 or more rib and sternum fractures in 2 or more places

A

flail chest

194
Q

When air enters the pleural space between the visceral and parietal pleura is called a ……..

A

pneumothorax

195
Q

This type of pneumothorax results from penetrating trauma to the chest wall which allows air to enter and exit the pleural space -

A

open pneumothorax (sucking chest wound)

196
Q

What type of pneumothorax allows air to enter the thoracic cavity but not escape?

A

Tension pneumothorax

197
Q

This is the name of when blood enters the thoracic cavity -

A

haemothorax

LAS (1 decks)

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