MEDICINE Flashcards
Causes of pneumothorax- AIRTIGHT
Asthma- secondary Injury that penetrates the chest Rupture of sub-pleural bleb TB Lung infection Growth ie lung carcinoma Hereditary ie cystic fibrosis Connective tissue disorders eg Marfan, Ehlers Danlos
Presentation of pneumothorax- PTHORAX
Pleuritic chest pain Tracheal deviation Hyperresonance to percussion Asymptomatic if pneumothorax small Xray shows collapse
Symptoms of hypercalcemia
Stones- renal
Bones- bone pain
Groans- abdominal pain, nausea and vomiting
Thrones- polyuria
Psychiatric overtones- confusion, cognitive dysfunction, depression, anxiety, insomnia, coma
Causes of hypercalcemia
Primary hyperparathyroidism
Malignancy
Features of neuroleptic malignant syndrome
Pyrexia Tachycardia Hypotension Confusion RIgidity
acutely ill
respiratory rate >20
Important predictor of cardiac arrest
Respiratory rate >27
How to spot a sick patient
NEWS
How the patient looks/sounds/smells
Patient’s clinical examination
New investigations (nearside vs. distant tests)
Causes of breathing problems
CNS depression
Poor respiratory effort from muscle weakness
Disorders of lung function e.g. pneumothorax, haemothorax, asthma, COPD, ARDS, Oedema
Chest wall problems
How breathing problems kill
Hypercapnia and apnoea
pulmonary oedema
Causes of circulatory problems
MI Ischaemia Arrhythmia Myocarditis Cardiac failure Tamponade
Hypotension
SBP <90MMhG, map <60mmHg
Decrease greater than 40 0r 30% from patient’s baseline
Assessing hypotension
Heart rate
Volume status
Cardiac performance
Systemic vascular resistance e.g. sepsis, anaphylaxis
primary survey in trauma care
to identify life threatening injuries A- AIRWAY maintenance with cervical spine protection B- Breathing and ventilation C- Circulation with haemorrhage control D- Disability and neurologic status E- Exposure and environmental control
secondary survey
to identify all other injuries
severe, minor, occult
Definitive care
completion of treatment of injuries
Falls screen
FBC U&Es Inflammatory markers- evidence of infection Blood glucose Resting ECG Urinalysis Lying-standing BP
