Part B 08 Flashcards
1
Q
Henoch schonlein pupura
Complications
A
Nephritic/nephrotic
Renal failure
Seizures
Intussusception
2
Q
Advance directive
Define
A
Decisions Re EoL care ahead of time
3
Q
BRUE
Low risk features
A
> 2m old (>40/40)
No CPR
1st event
Lasted <1min
4
Q
BRUE
Ix
A
ECG
Pertussis swab
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
6
Q
Indications for O2 on airline flight
A
Hb<7.5 Regular O2 Angina >class III CCF >class III Cyanotic congenital heart ds
7
Q
Cluster headache
Autonomic involvement
A
Conjunctival injection Rhinorrhea Lacrimation Miosis Ptosis
8
Q
Cluster headache
Tx
A
High flow O2
6mg sumatriptan SC
9
Q
Torsade de pointes
Tx
A
IV magnesium sulphate
10
Q
Loud S2
Cause
A
Systemic HTN
High output state
11
Q
Soft S2
Cause
A
Aortic regurg
12
Q
Widely split S2
A
Deep inspiration
RBBB
13
Q
Reversed splitting S2
A
Deep expiration
LBBB
14
Q
Dabigatran
Action
A
Direct thrombin inhibitor
15
Q
Moderate hyperkalaemia
A
6-6.4mmol/L
16
Q
Meckles diverticulum
Comp
A
Haemorrhage
Obstruction
Diverticulitis
Perforation
17
Q
Neuroleptic malignant syndrome
Sx
A
Fever
Low GCS
Severe rigidity
18
Q
Extrapyramidal SE
A
Rigidity Bradykinesia Dystonia Tremor Akathesia Tardive dyskinesia
19
Q
Surface rewarming hypothermia
Complication
A
Hypotension
Core temperature after drop
Bother due to cutaneous vasodilation
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
21
Q
HEART score
Management
A
0-3: discharge w early F/U
4-6: admit further Ix
(Provocative testing)
>6 early PCI
22
Q
Troponin level peaks at
A
24h
23
Q
4th HS
Due to
A
Vibration w/i ventricles
Usually due to resistance to filling due to stiff walls
24
Q
4th HS
Sign of
A
Hypertrophy 2nd HTN
Cardiomyopathy
25
CURB score BP
<90/60
26
Brugada syndrome
Drugs to avoid
TCA
Lithium
LA
Propofol
27
Cricothyroidotomy
| Process
```
Large canula (12G)
Between thyroid and cricoid
Aspirate air
High flow O2
1s on 4s off
Up to 45mins
```
28
Biers block
Process
```
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
```
29
Biers block
Max and min time cuff up
Min 20m max 45m
30
Biers block
Cuff pressure
100mmHg above sBP
Or 300mmHg
Whichever greater
31
Biers block
After injection prilocaine
How long until reduction
5 mins
32
LA toxicity
Tx
Intralipid 20%
1.5ml/kg bolus
33
LA toxicity
Sx
```
Low GCS
Agitation
Peri oral anaesthesia
Muscle twitching
Convulsions
Arrhythmia, Bradycardia, Hypotension
```
34
Placental abruption
Abdo signs
Hard woody
Frequent contractions
Contracts on touch
Difficulty palpating fetal parts
35
Placental abruption
Definitive Tx
C section
36
Prilocaine
Comp
Methaemaglobinaemia
37
AACG
Tx
```
Top pilocarpine drops (every 15 min)
Top timolol
IV morphine + anti emetic
IV acetazolamide 500mg
Refer ophthalmology
```
38
Etomidate
SE
Pain
N+V
Apnea
Adrenocorticoid suppression
39
Salter Harris #
Comp
Growth plate arrest
| AVN
40
Supracondylar humural #
Tx
Manipulation under anaesthesia
Backslab
Collar cuff
6-8w
41
Haemorrhaging shock
Class I
Volume lost and %
<750ml
| <15%
42
Haemorrhaging shock
Class I
Bpm
RR
Pulse pressure
Bpm <100
RR<20
Normal pulse pressure
43
Haemorrhaging shock
Class I
U/O
>30ml/h
44
Haemorrhaging shock
Class I
Mental state
Anxious
45
Haemorrhaging shock
Class III
Vol lost and %
1500-2000ml
30-40%
46
Haemorrhaging shock
Class III
Bpm
Pulse pressure
RR
120-140
Reduced pulse pressure
RR 30-40
47
Haemorrhaging shock
Class III
U/O
5-20ml
48
Haemorrhaging shock
Class III
Mental state
Confused
49
Staghorn calculus
Tx
Percutaneous nephrolithotomy
50
Abx causing theophylline toxicity
Macrolides
| Quinolones
51
MetHb
O2 says typically
80-85%
| False reading
52
Intracapsular FNOF
Types
Subcapital
| Transcervical
53
Intracapsular FNOF
Tx
Garden classification
1-2: DHS
3-4: hemiarthroplasty
54
Extracapsular FNOF
Types
Intertrochanteric
| Subtrochanteric
55
Intracapsular FNOF
Tx
DHS
Or
IM nail
56
Canadian C spine rules
High risk factors
Requiring XR
Age >65
Paraesthesia in extremities
Dangerous mechanism
- bicycle, >3feet, 5 steps, axial loaf, high speed MCV, ejection
57
Canadian c spine rules
Apply to
GCS15
Stable trauma patients
With concern for c spine
58
Canadian c spine
| Low risk factors allowing assessment of ROM
```
Rear end
Sitting position ED
Ambulatory at any time
Delayed onset
Absence mid line tenderness
```
59
Hyperemesis gravidum
Tx
1st:
Cyclizine, Promethazine
2nd
Metoclopramide, ondansetron
60
CTG
Stands for
Cardiotocography
61
CTG
Measures
Fetal HR
And
Contractions
62
CT head fro children if
1 major criteria
>1 minor criteria
1 minor criteria
> monitor for 4h
> CT head if
- GCS<15, further vomiting, abnormal drowsiness
63
Paeds
CT head
Minor criteria
```
LOC >5min
Amnesia >5min
Abnormal drowsiness
>2 vomits
Dangerous mechanism
```
64
Kawasaki ds
Comp
Coronary artery aneurysm
65
Kawasaki ds
Tx
IV Ig
| Aspirin
66
Cricoid pressure
Aka
Sellick manoeuvre
67
Inflamed gland of penis
Aka
Balanitis
68
APLS seizure
Benzo drugs and doses
Loraz - 0.1mg/kg
| Midaz/diaz - 0.5mg/kg
69
Paeds
DKA cerebral oedema
Tx
```
Hypertonic saline (3%)
Mannitol infusion 3ml/kg
```
70
Graves ds
Shin rash aka
Pretibial myxoedema
71
Graves ds
Specific Ix
TSI assay
| Thyroid stimulating immunoglobulin
72
Benign stridor in infancy
Laryngomalacia
73
TFCC
Aka
Triangular fibrocartilage complex
74
TFCC damage
Sign
Piano key sign
- protruding ulnar head
- can be pushed down
- come back up
75
TFCC damage
Ix
MRI
76
TFCC damage
Tx
Conservative
| Splint/ plaster cast
77
Anterolateral thoracotomy
Approaches
Left sided approach
- traumatic arrest
- left sided injury
Right sided approach
- profound hypotension
- right sided injuries
78
Anterolateral thoracotomy
Process
Incision along 4-5th intercostal space
From sternum to posterior axillary line
Enter pleural cavity
Rib spreader to visualise
79
Clamshell thoracotomy
Aka
Bilateral anterolateral thoracotomy
80
Supraspinatus entrapment
Aka
Subacromial impingement
81
Thyroglossal cyst
Comp
Inflammation and pain
Infection
Thyroglossal fistula
82
Mannitol CI
```
Severe HF
P edema
Intracranial bleeding
Dehydration
Anuria
```
83
Loading dose keppra
1g IV
84
SUFE
Tx
Surgical pinning
85
Body responsible for training nationally
Health education England
86
5 year revaluation requirements
```
250 CPD credits
1 full audit cycle
1 colleague survey
1 pt survey
R/V of all formal complaints
```
87
Body that ensures standards of confidentiality in NHS
Caldicott guardian
88
Digoxin toxicity
ECG signs
Brady
Downsloping ST depression
Prolonged PR, QRS
89
Digoxin toxicity
Precipitating factors
Low K
| Renal failure
90
Flumazenil
Dose
IV 200micro gram
91
Flumazenil
CI
Dependent benzo users
| Cause withdrawal seizures
92
Mechanism of antipsychotics and SE
Reduce dopamine
SE extrapyramidal SE
- parkisonism, dystonia, akathesia, tardive dyskineasia
