Part B 05 Flashcards
1
Q
Chancroid
Pathogen
A
Haemophilus ducreyi
2
Q
Chancroid
Sx
A
Painful ulcers
“Kissing ulcers” (labia)
Painful lymphadenopathy
> abscesses (buboes)
3
Q
Chancroid
Tx
A
Azithromycin PO 1g once only
Or
IM ceftriaxone
4
Q
Chicken pox and pregnancy
Complication
A
Foetal varicella syndrome
1%
5
Q
Foetal varicella syndrome
Sx
A
Eye defects
Limb hypoplasia
Skin scar
Neuro abnormality
6
Q
Ix
Chicken pox exposure during pregnancy with unknown immunity
A
Test mother VZV Ig
If Neg give VZV Ig
Effective up to 10d post exposure
7
Q
Chickenpox complications in adults
A
Pneumonia
Encephalitis
Hepatitis
8
Q
Mother contracted chicken pox during pregnancy
Tx
A
> 20/40 consider aciclovir
<20/40 caution
9
Q
Genital warts
Pathogen
A
HPV 6+11
10
Q
Uterine rupture
RF
A
Multiparity Previous c section Previous uterine surgery Dysfunctional labour Augmented labour
11
Q
Eclampsia
Pathology
A
Due to cerebral edema
12
Q
Eclampsia
Tx
A
IV mg sulphate 4g IV
Delivery of foetus and placenta
13
Q
Monitoring required during entonox
A
Pulse oximetry
14
Q
Mod, deep and dissociative sedation
Location
A
Resus only
15
Q
Mod, deep and dissociative sedation
Staff requirements
A
Doctor sedation
Doctor or ENP operator
Nurse
16
Q
Mod, deep and dissociative sedation
Monitoring
A
ECG
nIBP
Pulse ox
Capnography
17
Q
Propofol
Induction dose
A
2mg/kg
18
Q
Propofol
Maintenance dose
A
4-12mg/kg/h
19
Q
Propofol
SE
A
Pain on injection Drops BP Negative inotrope Decreases CO by ~25% Transient apnea Coughing
20
Q
Panda eyes
Aka
A
Peri orbital ecchymosis
21
Q
Neck immobilisation airway manoeuvres
A
Jaw thrust
Chin lift
22
Q
Oxygen cylinders
A
C - 170L D CD - 460L E F - 1300L HX
23
Q
RF
testicular torsion
A
Bell clapper deformity Previous torsion fHx Large testicular size Testicular tumour Trauma
24
Q
Surgical correction
Testicular torsion
Saves x % testis
A
90%
25
Causes of bowel obstruction
```
Malignancy
Hernia
Adhesions
Volvulus
Diverticulitis
IBD
Constipation/impaction
```
26
Malignant HTN
| Aka
Accelerated HTN
27
Malignant HTN
| Define
BP>220/120
+
End organ damage
28
Malignant HTN
| Comp
```
P edema
Encephalopathy
Angiopathic haemolytic anaemia
Pappiloedema
Eclampsia
Nephropathy
```
29
Addison’s ds
| Biochemical changes
Low Na, glu
High K, Ca
Metabolic acidosis
30
Thyroid storm
| Aka
Thyrotoxic crisis
31
Gentamicin
| Comp
Renal tubular acidosis
| Damage to vehicular apparatus in inner ear
32
Malignant HTN
| Signs
```
Focal neuro deficit
Pappiloedema
Ankle edema
Pallor
Encephalopathy
3rd HS
```
33
Warfarin
| Action
Inhibits Vit K dependent clotting factors
2,7,9,10 and protein C/S
34
Major bleed on warfarin
| Tx
5-10mg Vit K IV
+\- PCC (F2,7,9,10)
Or FFP
35
INR>8 and minor bleed
| Tx
Stop warfarin
1mg Vit K IV
Or 5mg Vit K PO
Restart warfarin when <5 INR
36
Burst # C1
| Aka
Jefferson #
37
Jefferson #
| Description
Burst # C1
| Lateral displacement of lateral masses
38
Brown sequard
| Sx
Ipsilateral: motor and proprioception
Contralateral: pain and temp
39
Massive haemothorax signs
Decreased
expansion
Breath sounds
Dullness to percussion
40
Open mouth X-ray aka
Odontoid peg view
41
Osteomyelitis
| Commonest pathogen.
Staph aureus
42
Osteomyelitis
Abx
And duration
Flucloxacillin
Clindamycin (pen)
6 week’s
43
Central cord syndrome
| Classical mechanism
Neck hyper extension in elderly with c spine stenosis
44
Most common incomplete spinal cord injury
Central cord syndrome
45
Central cord syndrome
| Sx
Motor loss upper>lower
Variable sensory loss
Bladder dysfunction and urinary retention
46
Central cord syndrome
| Cause of injury
Vascular comp anterior spinal artery
47
Central cord syndrome
| Recovery
Lower limb
> bladder function
> proximal limb
> hands
48
C.I.
| Procedural sedation
```
High risk aspiration (eg EtOH)
ASA grade 4 or above (unless emergency)
No trained individual
No monitoring
Allergy/hypersen
```
49
Schneider’s 1st rank Sx
1) Auditory hallucinations
2) thought passivity
3) delusions
4) Neg sx
50
Schneider’s 1st rank Sx
Types
Auditory hallucinations
3rd person
Thought echo
Commentary on actions
51
Schneider’s 1st rank Sx
Types
Thought passivity
Thought insertion
Withdrawal
Broadcast
52
Schneider’s 1st rank Sx
Types
Delusions
Primary
| Secondary
53
Schneider’s 1st rank Sx
Types
Negative sx
```
Social withdrawal
Reduced activity
Depression
Flat affect
Poverty of thought/speech
```
54
CIWA score
| Criteria
```
Nausea
Tremor
Sweating
Anxiety
Agitation
Tactile/auditory/visual disturbance
Headache
Clouding sensorium
```
55
LBBB
| Causes
```
IHD
Anterior MI
HTN
AS
Cardiomyopathy
Lenegre ds
High k
Digoxin toxicity
```
56
Lenegre ds
| Pathology
Primary fibrosis of conducting system
| Heart - causes BBB
57
Goodpastures syndrome
| Sx
Pulmonary haemorrhage
| Glomerulonephritis
58
Goodpastures syndrome
| Pathology
Anti GBM Abs
59
Troponin I
Rise in
Peak
Normal after
Rise 3-12h
Peak 24h
Normal after 3-10d
60
Weakest cruciate ligament
ACL
61
Test for ACL tear
Lachmans
| Pivot shift test
62
Lachmans test
| Process
Flx 30 degrees
| Tibia pulled forward
63
Abx
| Septic arthritis
1st Fluclox
Clindamycin (pen aller)
Vanc (Mrsa)
Gram neg/ gonnococcal (cefotaxime)
64
Entonox
| Ratio N2O to O2
50:50
65
Indication for
| Procedural sedation
Behavioural and analgesia management not sufficient
| For procedure/examination
66
Intussusception
| Peak incidence
5-10m
67
Dances sign
Absence of bowel RLQ
| Intussusception
68
APLS guideline
| Seizure
```
>5min: Loraz - 0.1mg/kg
>10min: 2nd dose benzo
>20min: phenytoin infusion
— 20mg/kg over 20min
>40min : anaesthetist and RSI
```
69
CI
| Central venous catheterisation
```
Obstructed vein
Overlying skin infx
No consent
Uncooperative pt
Coagulopathy
Resp arrest
```
70
Ketamine
| Actions
Analgesic
Hypnotic
Amnesiac
71
Ketamine
| SE
```
Psychotic
Diplopia
Nystagmus
Rash
Nausea
```
72
Ketamine
| Doses
IM - 10mg/kg
| IV 2mg/kg
73
Laryngoscope view
Structure
Medial to arytenoids
Corniculate tubercle
74
Laryngoscope view
Structure
Overlying arytenoids
Cuneiform tubercle
75
Transferring intubated patient
Sudden desaturation
Most likely cause
Dislodged ET tube
76
Bleeding
| Aka
Haemorrhaging
77
FAST
| Stands for
Facial droop
Arm weakness
Speech difficulties
Time to call 999
78
>1 TIA in a week
| Dx
Crescendo TIA
79
Trifascicular block
| ECG shows
Primary HB
RBBB
And L ant/post block
80
Trifascicular block
Comp
Tx
Precursor to complete HB
~50% need pacemaker
81
Acute severe asthma
| Dx
PEFR 33-50%
RR>25
HR>110
Unable to complete sentence
82
Life threatening asthma
| Dx
```
PEFR<33%
Sats<92%
pO2<8kPa
Normocapnia
Silent chest
Cyanosis
Poor respiratory effort
Arrhythmia
Low GCS
Hypotension
```
83
Near fatal asthma
| Dx
High CO2
| Ventilation with raised pressure
84
Congenital prolonged QT
Romano ward syndrome
85
Metabolic causes long QT
```
Low:
TSH
Calcium
K
Mg
Temp
```
86
Malaria
| Most common pathogen
Plasmodium falciparum
87
Malaria
| Tx
Plasmodium falciparum
- artensunate
P vivax, malariae, ovale
- chloroquine
88
Blind pericardiocentesis
| Process
Only in emergencies
Subxiphoid (1cm below)
Sat up at 30-45deg
Needle at 30deg angle aimed at midpoint of left clavicle
89
Classification tibial plateau fracture
Schatzker classification system
90
Tibial plateau #
| Ix
Requires CT knee
91
Tibial plateau #
| Tx
ORIF
