PassTest Acute Care Flashcards

1
Q

If you are alone and find a responsive patient, what does the guideline suggest?

A

Leave patient to summon help

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2
Q

If a patient begins breathing after CPR, what does the guideline suggest?

A

Placing the patient in the recovery position

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3
Q

What do you do before starting chest compressions?

A

Check airway

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4
Q

What is the treatment for a post Dural puncture headache?

A

Blood patch - am injection of blood down the epidural tract

Once blood enters the epidural space it clots and forms a seal

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5
Q

Treat hyperkalaemia a

A

Give calcium gluconate 10% 10mls by slow IV injection
Then
10 units act rapid in 100ml of 20% glucose
Salbutamol nebs
Calcium resonium 15g orally or rectally

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6
Q

Where can you fit a CVC?

A

Internal jugular
Subclavian vein
Femoral vein
Venous cutdown on the basilic vein

(Depends on whether peripheral or central vein cannulation is required)

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7
Q

What prep is needed for insertion and maintenance of a CVC?

A

Patients coag status and platelet count should be normalised before insertion
Sterile insertion

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8
Q

After a subclavian or internal jugular catheter is inserted what needs done?

A

Chest radiograph

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9
Q

To prevent cardiac arrhythmias catheters in the right atrium or ventricle should be withdrawn until the

A

Tip is within the superior vena cava

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10
Q

What are the complications involved with CVC?

A

Pneumothorax
Accidental arterial cannulation
Sepsis

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11
Q

Who needs to diagnose brain death?

A

Two doctors at least one a consultant and both registered for 5 years

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12
Q

Causes of confusion in the ICU

A
Cerebral hypoxia 
Hypoglycaemia 
Sepsis or toxins
Anaesthetic and other drugs 
Head injury
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13
Q

Anyone that has an anaphylactic reaction gets what home with them

A

Two adrenaline autoinjectors

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14
Q

Treat Addisonian crisis

A

Give 100mg hydrocortisone IM STAT

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15
Q

Dose of adrenaline for anaphylaxis in a kid under 6

A

150 micro grams IM

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16
Q

Dose of adrenaline for anaphylaxis in a kid between ages 6-12

A

300 micro grams IM

17
Q

How are patients with traumatic brain injury treated ?

A

Maintain pco2 of 4.5
Maintain po2 above 13
Maintain oxygen above 95%
In extreme patients hyperventilation may help

18
Q

Mild aspirin overdose presents as

A

Tinnitus nausea vomiting

In severe cases you can get hallucination sconfusions seizures and pulmonary oedema

19
Q

When does hepatic necrosis develop after paracetamol overdose

A

After 24 hours

20
Q

How do you treat laryngeal oedema and bronchospasm associated with inhalation burns?

A

Bronchodilators and steroids
Positive pressure ventilation
Prophylactic systemic antibiotic cover
IV crystalloid

21
Q

Why is sodium nitroprusside in a bag?

A

Used to treat malignant hypertension and comes in a silver bag to be protected from sunlight which degraded it to cyanide

Treat cyanide poisoning with dicobalt edetate. If unavailable give sodium nitrate or sodium thiosulphate

22
Q

Abdo pain nausea and then develops SOB (bilateral pulmonary infiltrates seen)

A

Is it ARDS associated with acute pancreatitis?

23
Q

Raised j wave on ecg

A

Hypothermia

24
Q

Woman on ocp with extreme abdo pain

A

Could it be acute porphyria?

25
List three things that cause SIRS other than sepsis
Acute pancreatitis Major trauma Burns
26
Give criteria for SIRS
Temp >38 or less than 36 HR>90 Resp rate >20 WBC >12000 or <4000
27
What is wernikes encephalopathy
Eye movement disorders ataxia and confusion | Thiamine deficiency
28
Treat digoxin toxicity
Digifab | If not available treat ventricular arrhythmias with phenytoin or lidocaine
29
What causes a stress ulcer in a critically ill patient?
Ischaemic injury time gastric mucosa loss of cytoprotectabts and disruption of the gastric mucosal barrier to acid injury
30
What are the main risk factors in ICU for a stress ulcer?
``` Resp failure Coagulopathy Sepsis Hypotension Hepatic/ renal failure ```
31
How do you prevent Cushings ulcer? And what is the main complication of this?
PPI H2RA Pneumonia
32
What factors are involved in blood transfusion reactions?
Allergens | Gram negative endotoxins
33
What is the effect of transfusion reactions on liver function and clotting factors ?
Acute liver failure and hepatic coma are rare complications Acute intravascikar coagulation