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ACCS EM > Part B 08 > Flashcards

Part B 08 Flashcards

1
Q

Henoch schonlein pupura

Complications

A

Nephritic/nephrotic
Renal failure
Seizures
Intussusception

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2
Q

Advance directive

Define

A

Decisions Re EoL care ahead of time

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3
Q

BRUE

Low risk features

A

> 2m old (>40/40)
No CPR
1st event
Lasted <1min

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4
Q

BRUE

Ix

A

ECG

Pertussis swab

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5
Q

CI to flying

Cardiovascular

A 
MI w/i 7 days 
CABG w/i 10d
Unstable angina
CVA w/i 3d
Decompensated HF
Uncontrolled arrhythmia 
Uncontrolled HTN
Severe valvular heart ds
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6
Q

Indications for O2 on airline flight

A 
Hb<7.5
Regular O2 
Angina >class III
CCF >class III
Cyanotic congenital heart ds
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7
Q

Cluster headache

Autonomic involvement

A 
Conjunctival injection 
Rhinorrhea
Lacrimation 
Miosis
Ptosis
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8
Q

Cluster headache

Tx

A

High flow O2

6mg sumatriptan SC

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9
Q

Torsade de pointes

Tx

A

IV magnesium sulphate

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10
Q

Loud S2

Cause

A

Systemic HTN

High output state

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11
Q

Soft S2

Cause

A

Aortic regurg

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12
Q

Widely split S2

A

Deep inspiration

RBBB

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13
Q

Reversed splitting S2

A

Deep expiration

LBBB

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14
Q

Dabigatran

Action

A

Direct thrombin inhibitor

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15
Q

Moderate hyperkalaemia

A

6-6.4mmol/L

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16
Q

Meckles diverticulum

Comp

A

Haemorrhage
Obstruction
Diverticulitis
Perforation

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17
Q

Neuroleptic malignant syndrome

Sx

A

Fever
Low GCS
Severe rigidity

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18
Q

Extrapyramidal SE

A 
Rigidity 
Bradykinesia
Dystonia
Tremor
Akathesia
Tardive dyskinesia
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19
Q

Surface rewarming hypothermia

Complication

A

Hypotension
Core temperature after drop

Bother due to cutaneous vasodilation

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20
Q

HEART score

Scoring

A 
History 2- highly suspicious 
ECG 1- non specific 
Age 1: 45-60
RF 1: 1-2RF
Trop 1: 1-3x normal limit
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21
Q

HEART score

Management

A

0-3: discharge w early F/U
4-6: admit further Ix
(Provocative testing)
>6 early PCI

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22
Q

Troponin level peaks at

A

24h

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23
Q

4th HS

Due to

A

Vibration w/i ventricles

Usually due to resistance to filling due to stiff walls

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24
Q

4th HS

Sign of

A

Hypertrophy 2nd HTN

Cardiomyopathy

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25
Q

CURB score BP

A

<90/60

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26
Q

Brugada syndrome

Drugs to avoid

A

TCA
Lithium
LA
Propofol

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27
Q

Cricothyroidotomy

Process

A 
Large canula (12G)
Between thyroid and cricoid
Aspirate air
High flow O2
1s on 4s off 
Up to 45mins
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28
Q

Biers block

Process

A 
Elevate arm 3min
(Exsanguinate)
Double cuff
Inflate 100mmHg above sBP
- or max 300mmHg 
(whichever greater)
Check absent pulse
Inject prilocaine (5m)
Reduce > XR
Min 20m max 45m
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29
Q

Biers block

Max and min time cuff up

A

Min 20m max 45m

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30
Q

Biers block

Cuff pressure

A

100mmHg above sBP
Or 300mmHg
Whichever greater

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31
Q

Biers block

After injection prilocaine
How long until reduction

A

5 mins

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32
Q

LA toxicity

Tx

A

Intralipid 20%

1.5ml/kg bolus

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33
Q

LA toxicity

Sx

A 
Low GCS 
Agitation 
Peri oral anaesthesia
Muscle twitching 
Convulsions 
Arrhythmia, Bradycardia, Hypotension
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34
Q

Placental abruption

Abdo signs

A

Hard woody
Frequent contractions
Contracts on touch
Difficulty palpating fetal parts

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35
Q

Placental abruption

Definitive Tx

A

C section

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36
Q

Prilocaine

Comp

A

Methaemaglobinaemia

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37
Q

AACG

Tx

A 
Top pilocarpine drops (every 15 min)
Top timolol 
IV morphine + anti emetic 
IV acetazolamide 500mg
Refer ophthalmology
38
Q

Etomidate

SE

A

Pain
N+V
Apnea
Adrenocorticoid suppression

39
Q

Salter Harris #

Comp

A

Growth plate arrest

AVN

40
Q

Supracondylar humural #

Tx

A

Manipulation under anaesthesia

Backslab
Collar cuff
6-8w

41
Q

Haemorrhaging shock
Class I

Volume lost and %

A

<750ml

<15%

42
Q

Haemorrhaging shock
Class I

Bpm
RR
Pulse pressure

A

Bpm <100

RR<20

Normal pulse pressure

43
Q

Haemorrhaging shock
Class I

U/O

A

> 30ml/h

44
Q

Haemorrhaging shock
Class I

Mental state

A

Anxious

45
Q

Haemorrhaging shock
Class III

Vol lost and %

A

1500-2000ml

30-40%

46
Q

Haemorrhaging shock
Class III

Bpm
Pulse pressure
RR

A

120-140
Reduced pulse pressure
RR 30-40

47
Q

Haemorrhaging shock
Class III

U/O

A

5-20ml

48
Q

Haemorrhaging shock
Class III

Mental state

A

Confused

49
Q

Staghorn calculus

Tx

A

Percutaneous nephrolithotomy

50
Q

Abx causing theophylline toxicity

A

Macrolides

Quinolones

51
Q

MetHb

O2 says typically

A

80-85%

False reading

52
Q

Intracapsular FNOF

Types

A

Subcapital

Transcervical

53
Q

Intracapsular FNOF

Tx

A

Garden classification

1-2: DHS
3-4: hemiarthroplasty

54
Q

Extracapsular FNOF

Types

A

Intertrochanteric

Subtrochanteric

55
Q

Intracapsular FNOF

Tx

A

DHS
Or
IM nail

56
Q

Canadian C spine rules
High risk factors
Requiring XR

A

Age >65
Paraesthesia in extremities
Dangerous mechanism
- bicycle, >3feet, 5 steps, axial loaf, high speed MCV, ejection

57
Q

Canadian c spine rules

Apply to

A

GCS15
Stable trauma patients
With concern for c spine

58
Q

Canadian c spine

Low risk factors allowing assessment of ROM

A 
Rear end
Sitting position ED
Ambulatory at any time
Delayed onset 
Absence mid line tenderness
59
Q

Hyperemesis gravidum

Tx

A

1st:
Cyclizine, Promethazine

2nd
Metoclopramide, ondansetron

60
Q

CTG

Stands for

A

Cardiotocography

61
Q

CTG

Measures

A

Fetal HR
And
Contractions

62
Q

CT head fro children if

A

1 major criteria
>1 minor criteria

1 minor criteria
> monitor for 4h
> CT head if
- GCS<15, further vomiting, abnormal drowsiness

63
Q

Paeds
CT head

Minor criteria

A 
LOC >5min
Amnesia >5min
Abnormal drowsiness
>2 vomits
Dangerous mechanism
64
Q

Kawasaki ds

Comp

A

Coronary artery aneurysm

65
Q

Kawasaki ds

Tx

A

IV Ig

Aspirin

66
Q

Cricoid pressure

Aka

A

Sellick manoeuvre

67
Q

Inflamed gland of penis

Aka

A

Balanitis

68
Q

APLS seizure

Benzo drugs and doses

A

Loraz - 0.1mg/kg

Midaz/diaz - 0.5mg/kg

69
Q

Paeds
DKA cerebral oedema

Tx

A 
Hypertonic saline (3%)
Mannitol infusion 3ml/kg
70
Q

Graves ds

Shin rash aka

A

Pretibial myxoedema

71
Q

Graves ds

Specific Ix

A

TSI assay

Thyroid stimulating immunoglobulin

72
Q

Benign stridor in infancy

A

Laryngomalacia

73
Q

TFCC

Aka

A

Triangular fibrocartilage complex

74
Q

TFCC damage

Sign

A

Piano key sign

  • protruding ulnar head
  • can be pushed down
  • come back up
75
Q

TFCC damage

Ix

A

MRI

76
Q

TFCC damage

Tx

A

Conservative

Splint/ plaster cast

77
Q

Anterolateral thoracotomy

Approaches

A

Left sided approach

  • traumatic arrest
  • left sided injury

Right sided approach

  • profound hypotension
  • right sided injuries
78
Q

Anterolateral thoracotomy

Process

A

Incision along 4-5th intercostal space
From sternum to posterior axillary line
Enter pleural cavity
Rib spreader to visualise

79
Q

Clamshell thoracotomy

Aka

A

Bilateral anterolateral thoracotomy

80
Q

Supraspinatus entrapment

Aka

A

Subacromial impingement

81
Q

Thyroglossal cyst

Comp

A

Inflammation and pain
Infection
Thyroglossal fistula

82
Q

Mannitol CI

A 
Severe HF
P edema
Intracranial bleeding 
Dehydration
Anuria
83
Q

Loading dose keppra

A

1g IV

84
Q

SUFE

Tx

A

Surgical pinning

85
Q

Body responsible for training nationally

A

Health education England

86
Q

5 year revaluation requirements

A 
250 CPD credits 
1 full audit cycle 
1 colleague survey
1 pt survey
R/V of all formal complaints
87
Q

Body that ensures standards of confidentiality in NHS

A

Caldicott guardian

88
Q

Digoxin toxicity

ECG signs

A

Brady
Downsloping ST depression
Prolonged PR, QRS

89
Q

Digoxin toxicity

Precipitating factors

A

Low K

Renal failure

90
Q

Flumazenil

Dose

A

IV 200micro gram

91
Q

Flumazenil

CI

A

Dependent benzo users

Cause withdrawal seizures

92
Q

Mechanism of antipsychotics and SE

A

Reduce dopamine
SE extrapyramidal SE
- parkisonism, dystonia, akathesia, tardive dyskineasia

ACCS EM (11 decks)

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