Part B 09 Flashcards
Position and path of internal jugular vein
Earlobe down to sternoclavicular joint
Lateral to carotid
DVLA time off driving
PCI
CABG
TIA
PCI - 1 week off driving
CABG - 4 week’s off
TIA - 4 weeks
Form to evidence period in hospital
Med 10
Work >6h
Working time directive
Prescribed break = xmins
20 mins
Schedule 3 drugs
Prescription only
Do not require a register
CN 6 aka
Abducens
Ptosis
Muscles involved
Horners syndrome
V
CN3 palsy
Horners syndrome — superior tarsal muscle V CN3 palsy — levator palpebrae
Holmes - adie pupil
Describe
Dilated
slow to respond to light
Normal accommodation
Holmes adie pupil
Cause
?viral infection
Causing damage to parasympathetic innervation
Report required diseases to …
And in what time frame
Consultant communicable disease control
24h urgent
72h non urgent
Bell’s palsy
Causes by
Swelling facial nerve
W/i Petrous temporal bone
?2* HSV/VZV
Septal haematoma
Tx
Needle aspiration
Packed
Co amoxiclav
Incomplete miscarriage
Implies
Retained products of conception
Incomplete miscarriage
Comp
Endometritis
Myometritis
Septic shock
DIC
Incomplete miscarriage
Ix
USS
Incomplete miscarriage
Tx
Medically managed
- misoprostol
Surgically
- ERPC
ERPC
Stands for
Evacuation of retained products of conception
Bacterial vaginosis
Pathogen
Gardnerella vaginalis
Bacterial vaginosis
Dx
Pos whiff test - fishy smell Clue cells - stippled epithelium pH >4.5
Winging scapula
Effected muscle
Serratus anterior
Lisfranc #
Description
Tarso metatarsal # dislocation
Aciclovir
Dose
Oral
IV
Oral - 400mg 5x/d
IV - 5mg/kg TDS
5 days Tx
Pancreatitis
Late comp
Pseudo cyst
Pancreatic abscess
IDDM
Chronic pancreatitis
Pancreatitis
Early comp
Shock AKI DIC ARDS Pancreatic encephalopathy Multi organ failure
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
X
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
