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ACCS EM > Part B 05 > Flashcards

Part B 05 Flashcards

1
Q

Chancroid

Pathogen

A

Haemophilus ducreyi

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2
Q

Chancroid

Sx

A

Painful ulcers
“Kissing ulcers” (labia)
Painful lymphadenopathy
> abscesses (buboes)

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3
Q

Chancroid

Tx

A

Azithromycin PO 1g once only
Or
IM ceftriaxone

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4
Q

Chicken pox and pregnancy

Complication

A

Foetal varicella syndrome

1%

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5
Q

Foetal varicella syndrome

Sx

A

Eye defects
Limb hypoplasia
Skin scar
Neuro abnormality

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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

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7
Q

Chickenpox complications in adults

A

Pneumonia
Encephalitis
Hepatitis

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8
Q

Mother contracted chicken pox during pregnancy

Tx

A

> 20/40 consider aciclovir

<20/40 caution

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9
Q

Genital warts

Pathogen

A

HPV 6+11

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10
Q

Uterine rupture

RF

A 
Multiparity 
Previous c section 
Previous uterine surgery
Dysfunctional labour 
Augmented labour
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11
Q

Eclampsia

Pathology

A

Due to cerebral edema

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12
Q

Eclampsia

Tx

A

IV mg sulphate 4g IV

Delivery of foetus and placenta

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13
Q

Monitoring required during entonox

A

Pulse oximetry

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14
Q

Mod, deep and dissociative sedation

Location

A

Resus only

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15
Q

Mod, deep and dissociative sedation

Staff requirements

A

Doctor sedation
Doctor or ENP operator
Nurse

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16
Q

Mod, deep and dissociative sedation

Monitoring

A

ECG
nIBP
Pulse ox
Capnography

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17
Q

Propofol

Induction dose

A

2mg/kg

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18
Q

Propofol

Maintenance dose

A

4-12mg/kg/h

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19
Q

Propofol

SE

A 
Pain on injection
Drops BP
Negative inotrope 
Decreases CO by ~25%
Transient apnea
Coughing
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20
Q

Panda eyes

Aka

A

Peri orbital ecchymosis

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21
Q

Neck immobilisation airway manoeuvres

A

Jaw thrust

Chin lift

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22
Q

Oxygen cylinders

A 
C - 170L
D
CD - 460L
E 
F - 1300L
HX
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23
Q

RF

testicular torsion

A 
Bell clapper deformity 
Previous torsion
fHx  
 Large testicular size 
Testicular tumour
Trauma
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24
Q

Surgical correction
Testicular torsion
Saves x % testis

A

90%

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25
Q

Causes of bowel obstruction

A 
Malignancy
Hernia
Adhesions
Volvulus
Diverticulitis
IBD
Constipation/impaction
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26
Q

Malignant HTN

Aka

A

Accelerated HTN

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27
Q

Malignant HTN

Define

A

BP>220/120
+
End organ damage

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28
Q

Malignant HTN

Comp

A 
P edema 
Encephalopathy
Angiopathic haemolytic anaemia
Pappiloedema
Eclampsia
Nephropathy
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29
Q

Addison’s ds

Biochemical changes

A

Low Na, glu
High K, Ca
Metabolic acidosis

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30
Q

Thyroid storm

Aka

A

Thyrotoxic crisis

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31
Q

Gentamicin

Comp

A

Renal tubular acidosis

Damage to vehicular apparatus in inner ear

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32
Q

Malignant HTN

Signs

A 
Focal neuro deficit 
Pappiloedema
Ankle edema
Pallor
Encephalopathy
3rd HS
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33
Q

Warfarin

Action

A

Inhibits Vit K dependent clotting factors

2,7,9,10 and protein C/S

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34
Q

Major bleed on warfarin

Tx

A

5-10mg Vit K IV
+- PCC (F2,7,9,10)
Or FFP

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35
Q

INR>8 and minor bleed

Tx

A

Stop warfarin
1mg Vit K IV
Or 5mg Vit K PO
Restart warfarin when <5 INR

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36
Q

Burst # C1

Aka

A

Jefferson #

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37
Q

Jefferson #

Description

A

Burst # C1

Lateral displacement of lateral masses

38
Q

Brown sequard

Sx

A

Ipsilateral: motor and proprioception

Contralateral: pain and temp

39
Q

Massive haemothorax signs

A

Decreased
expansion
Breath sounds
Dullness to percussion

40
Q

Open mouth X-ray aka

A

Odontoid peg view

41
Q

Osteomyelitis

Commonest pathogen.

A

Staph aureus

42
Q

Osteomyelitis
Abx
And duration

A

Flucloxacillin
Clindamycin (pen)

6 week’s

43
Q

Central cord syndrome

Classical mechanism

A

Neck hyper extension in elderly with c spine stenosis

44
Q

Most common incomplete spinal cord injury

A

Central cord syndrome

45
Q

Central cord syndrome

Sx

A

Motor loss upper>lower
Variable sensory loss
Bladder dysfunction and urinary retention

46
Q

Central cord syndrome

Cause of injury

A

Vascular comp anterior spinal artery

47
Q

Central cord syndrome

Recovery

A

Lower limb
> bladder function
> proximal limb
> hands

48
Q

C.I.

Procedural sedation

A 
High risk aspiration (eg EtOH)
ASA grade 4 or above (unless emergency)
No trained individual
No monitoring
Allergy/hypersen
49
Q

Schneider’s 1st rank Sx

A

1) Auditory hallucinations
2) thought passivity
3) delusions
4) Neg sx

50
Q

Schneider’s 1st rank Sx
Types
Auditory hallucinations

A

3rd person
Thought echo
Commentary on actions

51
Q

Schneider’s 1st rank Sx
Types
Thought passivity

A

Thought insertion
Withdrawal
Broadcast

52
Q

Schneider’s 1st rank Sx
Types
Delusions

A

Primary

Secondary

53
Q

Schneider’s 1st rank Sx
Types
Negative sx

A 
Social withdrawal 
Reduced activity
Depression
Flat affect
Poverty of thought/speech
54
Q

CIWA score

Criteria

A 
Nausea 
Tremor
Sweating 
Anxiety
Agitation
Tactile/auditory/visual disturbance 
Headache
Clouding sensorium
55
Q

LBBB

Causes

A 
IHD
Anterior MI
HTN
AS
Cardiomyopathy
Lenegre ds
High k
Digoxin toxicity
56
Q

Lenegre ds

Pathology

A

Primary fibrosis of conducting system

Heart - causes BBB

57
Q

Goodpastures syndrome

Sx

A

Pulmonary haemorrhage

Glomerulonephritis

58
Q

Goodpastures syndrome

Pathology

A

Anti GBM Abs

59
Q

Troponin I
Rise in
Peak
Normal after

A

Rise 3-12h
Peak 24h
Normal after 3-10d

60
Q

Weakest cruciate ligament

A

ACL

61
Q

Test for ACL tear

A

Lachmans

Pivot shift test

62
Q

Lachmans test

Process

A

Flx 30 degrees

Tibia pulled forward

63
Q

Abx

Septic arthritis

A

1st Fluclox
Clindamycin (pen aller)
Vanc (Mrsa)
Gram neg/ gonnococcal (cefotaxime)

64
Q

Entonox

Ratio N2O to O2

A

50:50

65
Q

Indication for

Procedural sedation

A

Behavioural and analgesia management not sufficient

For procedure/examination

66
Q

Intussusception

Peak incidence

A

5-10m

67
Q

Dances sign

A

Absence of bowel RLQ

Intussusception

68
Q

APLS guideline

Seizure

A 
>5min: Loraz - 0.1mg/kg
>10min: 2nd dose benzo
>20min: phenytoin infusion
— 20mg/kg over 20min
>40min : anaesthetist and RSI
69
Q

CI

Central venous catheterisation

A 
Obstructed vein 
Overlying skin infx
No consent
Uncooperative pt 
Coagulopathy 
Resp arrest
70
Q

Ketamine

Actions

A

Analgesic
Hypnotic
Amnesiac

71
Q

Ketamine

SE

A 
Psychotic 
Diplopia
Nystagmus
Rash 
Nausea
72
Q

Ketamine

Doses

A

IM - 10mg/kg

IV 2mg/kg

73
Q

Laryngoscope view
Structure
Medial to arytenoids

A

Corniculate tubercle

74
Q

Laryngoscope view
Structure
Overlying arytenoids

A

Cuneiform tubercle

75
Q

Transferring intubated patient
Sudden desaturation

Most likely cause

A

Dislodged ET tube

76
Q

Bleeding

Aka

A

Haemorrhaging

77
Q

FAST

Stands for

A

Facial droop
Arm weakness
Speech difficulties
Time to call 999

78
Q

> 1 TIA in a week

Dx

A

Crescendo TIA

79
Q

Trifascicular block

ECG shows

A

Primary HB
RBBB
And L ant/post block

80
Q

Trifascicular block
Comp
Tx

A

Precursor to complete HB

~50% need pacemaker

81
Q

Acute severe asthma

Dx

A

PEFR 33-50%
RR>25
HR>110
Unable to complete sentence

82
Q

Life threatening asthma

Dx

A 
PEFR<33%
Sats<92%
pO2<8kPa
Normocapnia
Silent chest
Cyanosis
Poor respiratory effort
Arrhythmia 
Low GCS
Hypotension
83
Q

Near fatal asthma

Dx

A

High CO2

Ventilation with raised pressure

84
Q

Congenital prolonged QT

A

Romano ward syndrome

85
Q

Metabolic causes long QT

A 
Low:
TSH
Calcium
K
Mg
Temp
86
Q

Malaria

Most common pathogen

A

Plasmodium falciparum

87
Q

Malaria

Tx

A

Plasmodium falciparum
- artensunate

P vivax, malariae, ovale
- chloroquine

88
Q

Blind pericardiocentesis

Process

A

Only in emergencies

Subxiphoid (1cm below)
Sat up at 30-45deg
Needle at 30deg angle aimed at midpoint of left clavicle

89
Q

Classification tibial plateau fracture

A

Schatzker classification system

90
Q

Tibial plateau #

Ix

A

Requires CT knee

91
Q

Tibial plateau #

Tx

A

ORIF

ACCS EM (11 decks)

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