Part B 06 Flashcards
1
Q
Most common site c-spine injury
A
Atlanto-axial region
2
Q
Separation of nail from nail bed
Aka
A
Oncholysis
3
Q
Septic arthritis
Tx
A
Analgesia
Aspirate joint to dryness
IV abx
If >3 aspirations/day
Or soft tissue affected
Or no response w/i 5 days
> washout
4
Q
Brugada syndrome
Inheritance
A
Autosomal dominant
5
Q
Salmonella typhi
Complications
A
Intestinal haemorrhage Intestinal Perf Secondary pneumonia Encephalitis Myocarditis Septic shock
6
Q
Stroke
Definition
A
Rapidly developing Focal neurology Lasting >24h Or leading to death No apparent cause other than vascular
7
Q
Advice with mydriatic drops
A
Sensitive to light: sunglasses
Blurry vision
Risk of AACG - return to ED of eye pain
8
Q
Orbital blowout #
Define
A
# of orbital wall Rim of orbit remains in tact
9
Q
Orbital blowout #
Sx
A
Diplopia esp upward gaze — inferior rectus Orbital emphysema Malar region numbness — inferior orbital nerve Enophthalmus Hypoglobus - inferior displacement globe
10
Q
Orbital blowout #
Indication for surgery
A
Significant enophthalmus
Significant diplopia
Muscle entrapment
Large #
11
Q
Malar region numbness (nose)
Affected nerve
A
Inferior orbital nerve
12
Q
Blowout #
Diplopia on upward gaze
Entrapment which muscle
A
Inferior rectus
From inferior blowout
13
Q
Painful 3rd nerve palsy
With blown pupil
Most common pathology
A
Posterior communicating artery aneurysm
14
Q
ATLS
Life threatening chest injuries
A
ATOMFC Airway obstruction Tension pneumo Open pneumo Massive haemothorax Flail chest Cardiac tamp
15
Q
Hill Sachs deformity
Define
A
Depression posterior aspect humeral head
Impact against glenoid rim
16
Q
Tension pneumothorax
Initial Tx
A
Needle thoracocentesis
17
Q
Raised ICP
Signs
A
Headache
Vomiting
Pappiloedema
18
Q
Action of mannitol for Tx raised ICP
A
Decrease rate CSF production
Draws fluid across BBB
19
Q
SIGN guideline
GI bleed admit for early endoscopy if
A
>70yo Witnessed haematemesis or haematochezia Haemodynamic disturbance Known liver ds or varices
20
Q
SVCO
Stands for
A
Superior vena cava obstruction
21
Q
CURB-65
Scoring
A
Confusion Urea>7 RR>30 sBP<90 Age
22
Q
Atypical pneumonia
Organisms
A
Mycoplasma pneumonia
Chlamydia pneumoniae
Legionella pneumophillia
23
Q
FAST scan
Views
A
Longitudinal RUQ, LUQ
Transverse subxiphoid
L+T suprapubic
24
Q
FAST scan
RUQ view looking at
A
Hepatorenal recess
Aka
Morrison’s pouch
25
FAST scan
| LUQ looking at
Splenorenal recess
26
FAST scan
| Blood first seen in
Hepato renal recess
Aka
Morrison’s pouch
27
eFAST scan
| Includes
L and R thoracic
| To look for pneumothorax
28
Empty can test
| Test for
Supraspinatus injury
Or
Suprascapular nerve palsy
29
Empty can test
| Process
Abduct horizontally
Palm down
Resist downward pressure
30
RA X-ray findings
Joint space narrowing
Erosions
Subchondral cysts
Soft tissue swelling
31
Vestibular Schwanoma
| Site
Cerebellopontine angle
32
Vestibular schwannoma
| CN effected
5th - trigeminal
| 8th - vestibulocochlear
33
Otitis media
| Organism
Streptococcus pneumoniae
34
Otitis media
| Abx for
Children <2 w’ bilateral infx
Purulent discharge from ear
Systemically unwell
Recurrent infection
35
Otitis media
| Abx for Tx
Amoxicillin
Or
Erythromycin
5 days
36
Otitis media
| Complication
```
Mastoiditis
Brain abscess
Sepsis
Meningitis
TM perforation
Hearing loss
Facial nerve palsy
```
37
Otitis externa
| Pathogen
Pseudomonas aeriginosa
38
Otitis externa
| Tx
```
Sofradex
Gentisone
Ciprofloxacin
+/- aural toilet
+/- pope wick
```
39
Detecting ST elevation in presence of LBBB
Use
Sgarbossa criteria
40
Sgarbossa criteria
Used for
Detect st elevation in
LBBB
And
Ventricular paced rhythm
41
Sgarbossa criteria
>1mm concordant ST elevation w’ positive QRS
>1mm concordant ST dep in leads V1-3
>5mm discordant ST elevation w’ neg QRS complex
42
Asthma
| Mg sulphate dose
1.2-2g IV over 20min
43
Asthma
| Aminophylline dose
5mg/kg over 20min (loading dose)
44
Arterial line placement
| CI
Absent pulse
Full thickness burn at site
Arterial insufficiency distal
Vascular injury proximal
45
Pre oxygenation
| Process
15L non rebreathe
| For 3 min
46
RSI paralytic agents
Suxamethonium 1mg/kg
| Thiopentone
47
Intubation in asthma
Induction
And
Paralytic agents
Induction:
Ketamine 2mg/kg
Para:
rocuronium, sux
48
Intubation in asthma
| Indication
Severe hypoxia
Confusion
Failure meds/NIV
Resp arrest
49
Pericarditis and high trop
| Ddx
Myopericarditis
Or
Missed MI and dressler syndrome
50
Hydrofluoric acid
| Tx
Irrigate
Calcium gluconate and KY jelly (top)
>10% calcium gluconate inj
>10ml 10% Ca gluconate intra arterial inj
51
Biliary colic
| Pathology
Gallstone transiently obstructs either cystic duct or Hartman’s pouch
52
Prostatitis
| Pathogens
E. coli
S aureus
Neiserria gonorrhea
53
Prostatitis
| Abx and course length
Not STI related
Cipro or trimethoprim
28d
54
Testicular cancer
| Ix
USS testis
55
Testicular cancer
| Types
Seminoma
| Teratoma
56
Gilbert syndrome
| Pathology
Deficient conjugation bilirubin
57
Gilbert syndrome
Genetics
% pop
Autosomal recessive
| 5% pop
58
Anorexia nervosa
| Metabolic disturbances
Low K, Mg
High amylase, urea, LFT
Anaemia and low Plt
59
Anorexia nervosa
| Admission criteria
Risk self harm/ suicide
BMI<15
Bradycardia, low glucose, electrolyte disturbance
60
Cyanosis of hands and feet
| Aka
Acrocyanosis
61
Osteomyelitis
| Tx
Fluclox (6w)
+/- rifampicin (1st 2w)
Clindamycin (pen allergic)
Vanc (MRSA)
62
Osteomyelitis
| Pathogens
```
Staph aureus
Streptococcus sp
Enterobacter sp
Haemophilus influenza
Salmonella sp
```
63
Ankle ligaments
Medial
V
Lateral
```
Medial - deltoid
Lateral
- anterior talofibular lig
- calcaneofibular lig
- posterior talofibular lig
```
64
Coeliac
| Ix
Serum IgA tTGA
(Tissue transglutaminase)
Intestinal biopsy
65
Carcinoid syndrome
| Ix
24h urinary 5HIAA
66
ABCD2
High risk score =x
And
Management plan
Score>3
| R/V within 24h
67
APGAR
| Normal score
>7
68
APGAR
| Scoring
```
Appearance 0-2
1= blue extremities
Pulse
1 = <100
Grimace (Reflex)
2 = cry on stimulation
Activity
1 = some flexion
Respiratory effort
1 = weak and irregular
```
69
TCA overdose
| Sx start w/i
1-2h of overdose
70
TCA OD
| Potential life threatening
>10mg/kg
71
TCA overdose
Severe OD
Leading to cardiotoxicity and coma
>30mg/kg
72
TCA overdose
| Sx
```
Shock
Dilated pupils
Increased tone
upward plantar
Ataxia, jerky limb movements
Reduced GCS
Seizure
Arrhythmia
```
73
TCA overdose
| ECG signs and reason for them
Broad QRS
- blocked Na channels
Prolonged QT
- blocked K channels
74
TCA overdose
Do not give which drugs
Anti arrhythmiacs
Eg amiodarone
Worsens hypotension
75
TCA overdose
| Tx
A to E
Activated charcoal
Na bicarbonate
Adrenaline for hypotension
76
Colles #
| Comp
```
Malunion
Median nerve palsy
Carpal tunnel syndrome
Reflex sympathetic dystrophy
OA
Extensor pollicis longus rupture
```
77
Transient global amnesia
| RF
>50yo
Associated with migraine
After strenuous exercise , cold temp or traumatic event
78
Transient global amnesia
| Sx
```
Transient loss short term memory
Rapid onset
Perseveration
- asks same Qs repeatedly
Unable to recall episode once recovered
```
79
Transient global amnesia
| Resolves within
Usually w/i hours
| Completely resolves within 24h
80
Ranson criteria
```
Age>55
WCC>16
BG>10
AST>250
LDH>350
```
>3 severe pancreatitis
81
Most common positions of appendix
```
Ascending retrocaecal (64%)
Subcaecal (32%)
```
82
C. Difficile
| Ix
Stool cytotoxin assay
83
Dabigatran reversal agent
Idarucizumab
| Praxbind
84
Acute peripheral vertigo
| Tx
Prochlorperazine
| Cinnarizine
85
Pretibial laceration
| Comp
Haematoma formation
86
Bed position for ventilated patient
15-30deg head up
87
Calculate tidal volume
| Ventilator
7xIBW
| Ideal body weight (kg)
88
Endotracheal tube size
| Paeds
3mm - neonate
4mm - 6m
4.5 - 1 yr
7. 5 - female
8. 5 - male
89
Paeds
Meningococcal septicaemia
Most common pathogen
Neiserria meningitidis group B
90
Paeds
Meningococcal septicaemia
Tx
Ceftriaxone 80mg/kg
91
Paeds
| IO access
```
Prox humerus
- 1cm above surgical neck
Prox tib
- 3cm below tibial tuberosty
Distal tib
- 3cm prox to most prominent medial malleolus
```
