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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
Delayed haemolytic reaction Ix
Positive Coombs test on presentation
26
Delayed haemolytic reaction Management
Benign course | Monitor renal function and Hb
27
TACO Stands for
Transfusion associated circulatory overload
28
HEART score
``` 0-2 for each History ECG Age (>45,>65) RF (>1,>3) Troponin (>normal limit, >3x) ```
29
HEART score Management
0-3: discharge w’ FU 4-6: admit, serial trop, further Ix >7: early PCI
30
Status epilepticus Management
2x benzo Phenytoin infusion GA
31
Status epilepticus If GA started continue for how long
- anaesthesia continued for 12-24h after last clinical or EEG seizure
32
Status epilepticus Dose phenytoin infusion
15mg/kg 50mg/min
33
Abx that increase effect of warfarin
``` Ciprofloxacin Co trimoxazole Doxycycline Macrolides Metronidazole ```
34
LBBB | ECG appearance
Dominant S wave in V1 Broad monophonic R wave in lateral leads QRS>120
35
Diagnose st elevation in presence of LBBB or paced rhythm
Sgarbossa criteria
36
Pericarditis Sx
SOB Pleuritic CP Tachycardia Pericardial friction rub
37
Pericarditis ECG
Saddle ST elevation | PR depression
38
Pericarditis Causes
80% viral Eg coxsackie virus Uraemia, Dressler’s syndrome, traumatic, autoimmune, paraneoplastic, drug induced
39
Pyelonephritis Tx
Gent or cipro | ?ceftriaxone
40
Seizures | Medical Tx
Benzo x2 +/- glucose +/- pabrinex Phenytoin infusion GA (propofol)
41
Digoxin toxicity Precipitating factors
Renal failure, Mi, Hypothyroid Low: k, mg High: Na, Ca, acidosis ``` Drugs: CCB, amiodarone, K lowering (loop diuretics) ```
42
Normal anion gap
10-15
43
Dabigatran Action
Direct thrombin inhibitor
44
Ascitic tap CI
``` Pregnancy Uncooperative patient Nil consent Skin infection overlying Coagulopathy Bowel overlying ```
45
Ascitic tap Indications
``` Ix vs Tx SBP Aeitiology ascites Malignancy Transudate vs exudate ``` Therapeutic relief pain/ resp distress
46
ALS Unstable tachyarrhythmia Tx
3 shocks 300mg amiodarone 15min Repeat shock 900mg amiodarone infusion over 24h infusion
47
C. difficile Tx
Oral metronidazole 2nd Oral Vanc
48
SVCO Tx
O2 | Steroids
49
Thromboylsis Recommended drug
Alteplase
50
Part of conducting system affected by Mobitz T2
His purkinje system below AV node
51
Giardiasis Sx
Chronic diarrhoea
52
Giardiasis Organism
Giardia lamblia
53
Giardiasis Ix
Stool sample often negative ?parasite and ova screen Small bowel biopsy: subtotal villous atrophy
54
Giardiasis Tx
Metronidazole
55
Bifasicular block Types
RBBB + left ant fasc block (Most common) RBBB + left post fasc block
56
Bifasicular block RF
IHD HTN AS, anterior MI, lenegres ds
57
Bifasicular block Comp and Tx
1% progress to complete HB Tx pacemaker
58
Bloody diarrhoea Tx
Clarithromycin (campylobacter) Or Ciprofloxacin
59
Bloody diarrhoea Causes
``` Campylobacter jejuni Shigella spp Salmonella spp Clostridium difficile Enteroinvasive e coli Amoebiosis Yersenia spp Shistomiasis ```
60
Amoebiasis Pathogen
Entamoeba histolytica
61
Passive rewarming Methods
Blanket and bair hugger
62
Active re warming Methods
Warmed humidified O2 Warmed IV fluids Cardiopulmonary bypass
63
Pneumothorax (primary) Tx
Tx if large (>2cm between lung and chest wall at level of hilum) Aspirate > chest drain if unsuccessful
64
CURB65 BP score
BP <90/60
65
Canadian c spine rules Low risk factors allowing c spine range of movement assessment
``` Simple rear ended RTA Sitting position in ED Ambulatory at time Delayed onset neck pain No midline tenderness ```
66
Jefferson # Aka
C1 bust #
67
Jefferson # Neurological signs
Usually no neurological deficit
68
Jefferson # Tx
Conservative management Immobilise in hard collar
69
Swiss staging hypothermia
1: conscious, shivering 2: low GCS, no shivering 3: unconscious 4: not breathing 5: death due to irreversible hypothermia
70
Croup steroid dose
Dex: 0.15mg/kg Budesonide 2mg in 5ml saline
71
BP contraindication | Thromboylsis
>180/110
72
Tx reduce BP In stroke For thrombolysis
10mg IV labetolol (1-2min) Or Nitrate infusion (1-10mg/hr: titrate to BP)
73
ECG leads Anteroseptal
V1-3
74
ECG leads Anterior
V2-4
75
ECG leads Anterolateral
V5-6
76
ECG leads Lateral
I, II, aVL, V6
77
ECG leads Right ventricle
VI, V4R
78
ECG leads Posterior
V7-9
79
Right ventricle infarction | Changes to management
Hold nitrates V preload sensitive Causes severe hypotension Tx with fluid loading
80
Induction agents | And dose
``` Propofol 2mg/kg Ketamine 2mg/kg Thiopental sodium Etomidate Midazolam ```
81
Froments sign Demonstrates
Ulnar nerve palsy
82
Froments sign Positive sign due to..
Unable to adduct (ulnar palsy) Compensation with thumb flexion Flexor pollicis longus IPJ flexes
83
SALTER Harris # Define
1: same 2: above (away from end) 3: low (toward end) 4: through 5: ram
84
Most common Salter Harris #
Type 2
85
Schedule 1 drug
Not used medically Possession and supply prohibited
86
Schedule 2 drug
Subject to control | Requires prescription
87
Authorities that commission nhs services
NHS England CCGs (Clinical commissioning groups)
88
Travelers diarrhoea Pathogen
80% enterotoxic e. Coli Can cause bloody diarrhoea
89
SBP Tx
Ceftriaxone
90
Ascitic tap Aka
Diagnostic paracentesis
91
Whooping cough Comp
Petechia Subconjunctival haemorrhage Hernia Secondary pneumonia
92
Bronchiolitis Most common age
3-6m
93
Bronchiolitis Tx
O2 <92% | NG feed if cannot feed
94
Avulsion # ASIS Pathology
Sartorius avulses attachment at ASIS
95
Avulsion # ASIS Population
Usually adolescents
96
Avulsion # ASIS Sx
``` Pop or snap Pain and weakness anterior thigh Tender ASIS Weak hip flx, knee ext Limping ```
97
Avulsion # ASIS Ix
XR | CT or MRI
98
Avulsion # ASIS Tx
Conservative Analgesia and crutches ORIF if displaced >3cm

ACCS EM (11 decks)

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