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accs em > Part B 07 > Flashcards

Part B 07 Flashcards

1
Q

Most common

Transfusion transmitted bacterial infx

A

Yersinia enterocolitica

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2
Q

HEART score

Used for

A

Cardiovascular disease assessment tool

Predicts 6 week adverse events

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3
Q

HCO3-

Normal values

A

22-26mmol

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4
Q

Giardiasis

Ix

A

Stool ova and parasite examination

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5
Q

Brugada syndrome

Genetics and defect

A

Autosomal dominant

Na channel defect

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6
Q

Brugada syndrome

Dx

A

> 2mm ST elevation in >1 lead V1-3
Followed by negative T wave

Plus 1 of
fHx sudden death 
fHx ECG changes 
VF or VT episode 
Suncopal episode
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7
Q

Brugada syndrome

Tx

A

ICD

Implantable cardioverter defibrillator

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8
Q

qSOFA score

A

sBP<100
RR>22
Reduced GCS

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9
Q

Amiodarone

Action

A

Membrane stabiliser

Increases duration of refractory period

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10
Q

Cough with red rash on face, exposure to birds

Dx and name of rash

A

Chlamydia psittaci

Horders spots

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11
Q

Pleural aspiration

Process

A 
Upright
Mid scapular line
(~10cm lat to spine)
Needle above upper border to rib
(1-2 ribs below fluid level)
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12
Q

Pleural aspiration

Indication

A

Tx: symptomatic relief

Ix: suspected unilateral educative effusion

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13
Q

Boerhaaves syndrome

Sx

A

Resp distress
Subcutaneous emphysema
Acute abdomen
Haematemesis

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14
Q

Duodenal ulcer

Complication

A

Perforation
GI haemorrhage
(Gastro duodenal artery)
Strictures causing obstruction

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15
Q

Acute diverticulitis

Nice reasons for admission

A 
Pain not managed 
Hydration not maintained 
Cannot tolerate oral Abx 
Frail patient, +++ comorbidity
Complication
- transfusion, perf, abscess, fistula 
Sx >48h despite conservative management at home
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16
Q

Raised amylase

Causes

A 
Pancreatitis 
Renal failure
DKA
Mesenteric ischaemia
Perforated duodenal ulcer 
Ectopic 
Pancreatic Ca 
Mumps
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17
Q

Genital warts

Aka

A

Condylomata acuminata

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18
Q

Signs fetal distress

A

Reduced movements
Increased/decreased HR
Decreased variability in HR
Late decelerations

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19
Q

Placental abruption without PV bleed

Aka

A

Concealed placental abruption

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20
Q

Digoxin therapeutic levels

A

1-1.5nmol/L

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21
Q

Von willebrands ds

Tx

A

Mild
- desmopressin
> releases vWF from endothelial cells

Severe > cryoprecipitate

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22
Q

ECG

Calculate rate

A

300/no large sq (R-R)

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23
Q

Atropine uses

A

Increase HR
Mydriatic
Decreases secretions
Tx organophosphate OD

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24
Q

Delayed haemolytic reaction

Cause

A

Low titre Ab too weak to detect in X match

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25
Q

Delayed haemolytic reaction

Ix

A

Positive Coombs test on presentation

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26
Q

Delayed haemolytic reaction

Management

A

Benign course

Monitor renal function and Hb

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27
Q

TACO

Stands for

A

Transfusion associated circulatory overload

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28
Q

HEART score

A 
0-2 for each
History 
ECG
Age (>45,>65)
RF (>1,>3)
Troponin (>normal limit, >3x)
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29
Q

HEART score

Management

A

0-3: discharge w’ FU
4-6: admit, serial trop, further Ix
>7: early PCI

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30
Q

Status epilepticus

Management

A

2x benzo
Phenytoin infusion
GA

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31
Q

Status epilepticus

If GA started continue for how long

A
  • anaesthesia continued for 12-24h after last clinical or EEG seizure
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32
Q

Status epilepticus

Dose phenytoin infusion

A

15mg/kg

50mg/min

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33
Q

Abx that increase effect of warfarin

A 
Ciprofloxacin 
Co trimoxazole 
Doxycycline 
Macrolides 
Metronidazole
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34
Q

LBBB

ECG appearance

A

Dominant S wave in V1
Broad monophonic R wave in lateral leads
QRS>120

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35
Q

Diagnose st elevation in presence of LBBB or paced rhythm

A

Sgarbossa criteria

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36
Q

Pericarditis

Sx

A

SOB
Pleuritic CP
Tachycardia
Pericardial friction rub

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37
Q

Pericarditis

ECG

A

Saddle ST elevation

PR depression

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38
Q

Pericarditis

Causes

A

80% viral
Eg coxsackie virus

Uraemia, Dressler’s syndrome, traumatic, autoimmune, paraneoplastic, drug induced

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39
Q

Pyelonephritis

Tx

A

Gent or cipro

?ceftriaxone

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40
Q

Seizures

Medical Tx

A

Benzo x2
+/- glucose +/- pabrinex
Phenytoin infusion
GA (propofol)

41
Q

Digoxin toxicity

Precipitating factors

A

Renal failure, Mi, Hypothyroid

Low: k, mg
High: Na, Ca, acidosis

Drugs: CCB, amiodarone, 
K lowering (loop diuretics)
42
Q

Normal anion gap

A

10-15

43
Q

Dabigatran

Action

A

Direct thrombin inhibitor

44
Q

Ascitic tap

CI

A 
Pregnancy 
Uncooperative patient 
Nil consent
Skin infection overlying 
Coagulopathy 
Bowel overlying
45
Q

Ascitic tap

Indications

A 
Ix vs Tx
SBP
Aeitiology ascites
Malignancy
Transudate vs exudate

Therapeutic relief pain/ resp distress

46
Q

ALS
Unstable tachyarrhythmia

Tx

A

3 shocks
300mg amiodarone 15min
Repeat shock
900mg amiodarone infusion over 24h infusion

47
Q

C. difficile

Tx

A

Oral metronidazole

2nd Oral Vanc

48
Q

SVCO

Tx

A

O2

Steroids

49
Q

Thromboylsis

Recommended drug

A

Alteplase

50
Q

Part of conducting system affected by Mobitz T2

A

His purkinje system below AV node

51
Q

Giardiasis

Sx

A

Chronic diarrhoea

52
Q

Giardiasis

Organism

A

Giardia lamblia

53
Q

Giardiasis

Ix

A

Stool sample often negative
?parasite and ova screen

Small bowel biopsy:
subtotal villous atrophy

54
Q

Giardiasis

Tx

A

Metronidazole

55
Q

Bifasicular block

Types

A

RBBB + left ant fasc block
(Most common)

RBBB + left post fasc block

56
Q

Bifasicular block

RF

A

IHD
HTN
AS, anterior MI, lenegres ds

57
Q

Bifasicular block

Comp and Tx

A

1% progress to complete HB

Tx pacemaker

58
Q

Bloody diarrhoea

Tx

A

Clarithromycin (campylobacter)

Or
Ciprofloxacin

59
Q

Bloody diarrhoea

Causes

A 
Campylobacter jejuni 
Shigella spp 
Salmonella spp
Clostridium difficile
Enteroinvasive e coli 
Amoebiosis 
Yersenia spp
Shistomiasis
60
Q

Amoebiasis

Pathogen

A

Entamoeba histolytica

61
Q

Passive rewarming

Methods

A

Blanket and bair hugger

62
Q

Active re warming

Methods

A

Warmed humidified O2
Warmed IV fluids
Cardiopulmonary bypass

63
Q

Pneumothorax (primary)

Tx

A

Tx if large
(>2cm between lung and chest wall at level of hilum)

Aspirate > chest drain if unsuccessful

64
Q

CURB65

BP score

A

BP <90/60

65
Q

Canadian c spine rules

Low risk factors allowing c spine range of movement assessment

A 
Simple rear ended RTA
Sitting position in ED
Ambulatory at time
Delayed onset neck pain
No midline tenderness
66
Q

Jefferson #

Aka

A

C1 bust #

67
Q

Jefferson #

Neurological signs

A

Usually no neurological deficit

68
Q

Jefferson #

Tx

A

Conservative management

Immobilise in hard collar

69
Q

Swiss staging hypothermia

A

1: conscious, shivering
2: low GCS, no shivering
3: unconscious
4: not breathing
5: death due to irreversible hypothermia

70
Q

Croup steroid dose

A

Dex: 0.15mg/kg

Budesonide 2mg in 5ml saline

71
Q

BP contraindication

Thromboylsis

A

> 180/110

72
Q

Tx reduce BP
In stroke
For thrombolysis

A

10mg IV labetolol (1-2min)
Or
Nitrate infusion
(1-10mg/hr: titrate to BP)

73
Q

ECG leads

Anteroseptal

A

V1-3

74
Q

ECG leads

Anterior

A

V2-4

75
Q

ECG leads

Anterolateral

A

V5-6

76
Q

ECG leads

Lateral

A

I, II, aVL, V6

77
Q

ECG leads

Right ventricle

A

VI, V4R

78
Q

ECG leads

Posterior

A

V7-9

79
Q

Right ventricle infarction

Changes to management

A

Hold nitrates
V preload sensitive
Causes severe hypotension

Tx with fluid loading

80
Q

Induction agents

And dose

A 
Propofol 2mg/kg
Ketamine 2mg/kg
Thiopental sodium 
Etomidate
Midazolam
81
Q

Froments sign

Demonstrates

A

Ulnar nerve palsy

82
Q

Froments sign

Positive sign due to..

A

Unable to adduct (ulnar palsy)
Compensation with thumb flexion

Flexor pollicis longus
IPJ flexes

83
Q

SALTER Harris #

Define

A

1: same
2: above (away from end)
3: low (toward end)
4: through
5: ram

84
Q

Most common Salter Harris #

A

Type 2

85
Q

Schedule 1 drug

A

Not used medically

Possession and supply prohibited

86
Q

Schedule 2 drug

A

Subject to control

Requires prescription

87
Q

Authorities that commission nhs services

A

NHS England
CCGs
(Clinical commissioning groups)

88
Q

Travelers diarrhoea

Pathogen

A

80% enterotoxic e. Coli

Can cause bloody diarrhoea

89
Q

SBP

Tx

A

Ceftriaxone

90
Q

Ascitic tap

Aka

A

Diagnostic paracentesis

91
Q

Whooping cough

Comp

A

Petechia
Subconjunctival haemorrhage
Hernia
Secondary pneumonia

92
Q

Bronchiolitis

Most common age

A

3-6m

93
Q

Bronchiolitis

Tx

A

O2 <92%

NG feed if cannot feed

94
Q

Avulsion # ASIS

Pathology

A

Sartorius avulses attachment at ASIS

95
Q

Avulsion # ASIS

Population

A

Usually adolescents

96
Q

Avulsion # ASIS

Sx

A 
Pop or snap 
Pain and weakness anterior thigh
Tender ASIS
Weak hip flx, knee ext
Limping
97
Q

Avulsion # ASIS

Ix

A

XR

CT or MRI

98
Q

Avulsion # ASIS

Tx

A

Conservative
Analgesia and crutches

ORIF if displaced >3cm

accs em (11 decks)

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