Part B 09 Flashcards by spencer shaw

Position and path of internal jugular vein

Earlobe down to sternoclavicular joint

Lateral to carotid

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DVLA time off driving

PCI
CABG
TIA

PCI - 1 week off driving
CABG - 4 week’s off
TIA - 4 weeks

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Form to evidence period in hospital

Med 10

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Work >6h
Working time directive
Prescribed break = xmins

20 mins

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Schedule 3 drugs

Prescription only

Do not require a register

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CN 6 aka

Abducens

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Ptosis
Muscles involved

Horners syndrome
V
CN3 palsy

Horners syndrome
— superior tarsal muscle 
V
CN3 palsy
— levator palpebrae

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Holmes - adie pupil

Describe

Dilated
slow to respond to light
Normal accommodation

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Holmes adie pupil

Cause

?viral infection

Causing damage to parasympathetic innervation

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Report required diseases to …

And in what time frame

Consultant communicable disease control
24h urgent
72h non urgent

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Bell’s palsy

Causes by

Swelling facial nerve
W/i Petrous temporal bone
?2* HSV/VZV

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Septal haematoma

Needle aspiration
Packed
Co amoxiclav

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Incomplete miscarriage

Implies

Retained products of conception

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Incomplete miscarriage

Comp

Endometritis
Myometritis
Septic shock
DIC

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Incomplete miscarriage

USS

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Incomplete miscarriage

Medically managed
- misoprostol

Surgically
- ERPC

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ERPC

Stands for

Evacuation of retained products of conception

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Bacterial vaginosis

Pathogen

Gardnerella vaginalis

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Bacterial vaginosis

Pos whiff test 
- fishy smell
Clue cells 
- stippled epithelium 
pH >4.5

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Winging scapula

Effected muscle

Serratus anterior

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Lisfranc #

Description

Tarso metatarsal # dislocation

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Aciclovir
Dose
Oral
IV

Oral - 400mg 5x/d
IV - 5mg/kg TDS
5 days Tx

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Pancreatitis

Late comp

Pseudo cyst
Pancreatic abscess
IDDM
Chronic pancreatitis

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Pancreatitis

Early comp

Shock
AKI
DIC
ARDS
Pancreatic encephalopathy
Multi organ failure

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Acute appendicitis sign | Flx hip causes pain

Psoas sign

Duodenal ulcer causing +++ bleeding Vessel

Gastroduodenal artery

Biphasic anaphylactic reaction Time after event % anaphylactic pt

4-6h | 20% biphasic

IO access | Comp

# Infection Compartment syndrome Failure

Etomidate | SE

Adrenocorticoid suppression

Line sepsis | Tx

1st: vancomycin Immunocomprimised - taz or meropenem

Allen’s test | Colour should return within

5-15sec

TCA | OD Tx

``` Na bicarbonate Lidocaine IV Mg sulphate Glucagon Adrenaline - hypoTN Benzos - seizures ```

Cardiogenic oscillations On capnography Seen in

Physiological Small Pt Low tidal volume Low RR

ARDS | Ventilator settings

Low volume ventilation 6ml/kg Reduces VALI

VALI | Stands for

Ventilator associated lung injury

ARDS | Defined

Widespread | Alveolar Capillary membrane injury

ARDS | Diagnosis

Non cardiogenic p edema + acute resp failure Severe hypoxaemia refractory to O2 Requires assured ventilation

Discharge criteria post sedation

- Pt at baseline - Vital signs normal - Pain and discomfort addressed

Digoxin toxicity | Levels above

>2nmol/L

Acute lithium poisoning | Predominately x Sx

GI Sx

Chronic lithium poisoning | Predominately x Sx

Neuro Sx

Lyme disease | Pathogen

Borrelia burgdorferi

Transfusion transmitted bacterial infection | Sx

Soon after transfusion started Fever. Chills, rigors N+V Shock

Guidewire embolus

Obstetric Cholestasis | Sx

Itchy palms, soles, abdomen

Galeazzi # | Description

``` # distal third radius Dislocation distal radio ulnar joint ```

Nexus criteria C spine XR if any of the following

``` Focal neuro deficit Midline tenderness Altered level consciousness Intoxication Distracting injury ```

Offensive yellow frothy PV discharge Strawberry cervix Itchy

Trichomoniasis

Test for severity of radiation exposure

48h absolute lymphocyte count

Symptomatic hyponatraemia Tx

100ml 3% NaCl up to 3x | Aim 5mmol increase

Normal anion gap acidosis is from

Decreased acid excretion or loss of bicarbonate

Cyanide poisoning; Tx

Amyl nitrate, dicobolt edetate | Or Hydroxycobalamin

Serotonin syndrome Tx

Cyprohepatdine or chlorpromazine

Cholinergic toxicity Tx

Atropine, pralodoxime

Pemphigoid;

itchy blisters (intact)

Thompsons test;

positive is Achilles’ tendon rupture (aka simmonds)

fractured penis: what injured

Ruptured tunica albunginea

Sulfonylurea toxin Tx

Octreotide

VBG finding pyloric stenosis

Stomach acid: HCl | Loss = hypochloraemic alkalosis 2nd low K

Actions heparin and NOACs

Heparin stimulate antithtombin 3 Xa or X in name Xa inhibitor Dabigatran = Thrombin inhibitor

FIB obs

5,10,15,30mins

Osmolar gap

Oslmolar gap: Nax2 + glucose + urea (<10) | High ?ethylene glycol or methanol

Rhabdomyolysis Dx

Rhabdo = 5x upper limit CK

Sections and time able to detain

``` Section 2= 28d (assess) Section 3= 6m (treat) Section 4= 72h admission (rare) Section 5= 72h holding S136= 24h ```

LA and toxicity levels

Bupivicaine 2mg/kg Lidocaine 3mg/kg Prilocaine 6mg/kg

SMART aim

Specific, measurable, achievable, relevant, time specific