Points To Remember Flashcards
Glasgow coma scale
E
4 spontaneous
3 verbal
2 pain
1 no response
Glasgow coma scale V
5 oriented (TPP)
4 confused
3 inapp words
2 incomprehensible sounds
1 no response
Glasgow coma scale M
6 obeys commands
5 moves to loc pain
4 flexion withdrawal from pain
3 decorticate (abn flexion)
2 decerebrate (abn ext)
1 no response
NEXUS criteria (to remove cervical collar or not)
N - neuro deficit
S - pinal tenderness
A - lt. LOC
I - ntoxication
D - istracting injury
Innocent murmur
Bet 5-7yo
No symptoms
Normal exercise tolerance
Not cyanosed
Doesn’t suffer from recurrent chest infxns
Soft midsystolic No radiation Varies with posture and respi No diastolic component No thrill
Low Ferritin
IDA
Hemodialysis
Snake bite.
What to look for:
DRSABC
cardiac Respi Bleeding Neuro Renal
Features of alcoholic cirrhosis
ABCDEFGHI SPIT
A- sterixis/ ascites
B ruising
Caput medusae
Dermatologic changes
Edema/ encephalopathy
Fetor hepaticus
Gynecomastia
Hepato renal/ pulmonary syndrome
Icterus
Spider nevi
Palmar erythema
Icterus
Testicular atrophy
IgM
Current or recent infection
IgG
Immunization or previous infection
No breastfeed
HIV
Active TB
Dysphagia for solids
Stricture
Tumor
(STRUCTURAL solid)
Dysphagia for liquids and solids
Oesophageal motility disorder
Visual acuity NOT improved by pinhole test
Macular degeneration
Cataract
Glaucoma
Retinal detachment
Central vision affected
Macular degeneration
Peripheral vision affected
Chronic glaucoma
Pituitary tumor
Vision decreased with light
Cataract
Floaters
Retinal detachment
Vitreous hge
Complications of myopia
Retinal detachment
Chronic glaucoma
Macular degeneration
No light perception
Amaurosis
Glaucoma
Haloes around lights
Cataract
Always ask in hx OB
Blood grp
Hgb
Hepa
A ntibiotics
B lood transfusion
P iercinh
F ood
I V drug use
T ravel
N eedle stick injury
o
SEX
All females (Ask P)
P eriod P regnancy P ills P apsmear P artner
Postpartum (Ask B)
B reast B aby B lues B leeding Bladder
Pneumonia (admit/not)
C onfusion
U rea > 7 mmol/L
R R > 30/min
B P
COMA cocktail
T hiamine
O xygen
N aloxone
G lucose
Hypochromic
Microcytic
Anemia
S ideroblastic
I DA
T halassemia
S ickle cell
*Alpha thalassemia silent 1 abn
trait. 2
HbH. 3
Surgery complications
B leedings
A nesthesia
D amage to surr tissues
I nfection
High ESR (chronic inflamm)
P olymyalgia rheumatica
T emporal arteritis
Haemochromatosis sx
C irhhosis
H eart failure
S kin changes
D M
Chorionic Villous Sampling
T1
Amniocentesis > 12 weeks
T2
High bHCG
High INH
Low AFP
Low Estriol
Do fundoscopy for all..
Headaches
DM
Neuro symptoms
Heart failure meds
A CE I
B eta blockers
D igoxin
D iuretics
STI screen
S yphillis
G onorrhea
C hlamydia
H IV
H EPA A B C
- HSV
Immunizations
Birth: hepB
2/4/6 mos: DTP, HepB, O/IPV, Hib, Pneumococcal, Rotavirus
12 mos: MMR, Hib, MenC
18 mos: MMR, Varicella, DTP
4 yo: DTP, O/IPV
12-13 yo: Varicella, HPV, DTP
Don’t do Per Vaginal exam
- not sexually active
- placenta previa (antepartum hge)
- HSV2
INR
Ther range: 2-3
w/ prosthetics: 2.5-3.5
INR more than therapeutic range
Stop warfarin
If INR normalized..
Low dose warfarin
INR 5-9
No bleeding
Stop warfarin
Vit K (high risk)
INR @ 6-12H..
INR >9
No bleeding
Stop warfarin
Vit K
Rpt INR @6H
Taking warfarin
With bleeding
Stop warfarin
Prothrombinex + FFP
High dose Vit K
Monitor INR until
Urine specimen
3 yo. MSU
Zero order kinetics
High toxicity
A SA
P henytoin
E thanol
Post splenectomy vaccines needed
H ib once
I nfluenza Q year
M eningococc Q3-5 yrs
P CV Q5 yrs
Malaria and Babesiosis
Barking cough
Croup
Viral (influenza)
Steeple sign
Steroids/racemic epinephrine
Whooping cough
Pertussis
Macrolides
Hot potato voice
Epiglottitis
HiB
Edematous epiglottis & aryepiglottic fold & valeculla
Intubate
Ceftriaxone
PCN
Also: Peritonsillar abscess
Laryngomalacia
Congenital
Observe x 6mos
Surgery >2 yrs
Developmental milestones
1-6mos
1 1/2 smile
3 hold head up- recognize mom- coo
6 sit- babble
Developmental milestones 9mos- 24 mos
9 stand with support- grab with fingers- put in mouth (10)
12 walk - 1 word
24 1 sentence
- anything >18 mos abN
- no smile at 3 mos abN
Gas above liver
Intestinal perforation
Abruptio placenta
Severe abd pain
Vaginal bleed
No FHT
Tachy tachy
20ml/kg IV bolus
Hypertrophic pyloric stenosis
Cont. hungry
Brochiolitis
Air trapping–> lung hyperinflation
Perihilar infiltrates
Bronchial markings & atelectasis
Prostate Cancer tx
Early
- R adical prostatectomy (also remove seminal vesicle) +|- pelvic lymphadenectomy
Mets
- A ndrogen ablation
Goserelin
Prostate ca (old/co morbids)
Exteral beam radiation
Androgen ablation
Brachytherapy
- orchidectomy
- TURP
Prostate Ca grade
1 prostate
2 capsule (radical prostatect)
3a extra capsular
3b seminal vesicles (andro Abla, radiother)
4 mets (androgen ablation)
Ovulation
Shortest cycle -14 -6
Longest cycle -14 + 2
Mc urinary stones
Ca oxalate
Radioluscent urinary stones
Uric acid stones
Nephrolithiasis ix
1st Xray kub
2nd ct scan if positive
Urinary stones
Any site
Wait
STRAIN
Urinary stone
Kidney pelvis
2.5cm nephrolithotomy
Urinary stone
Upper 1/3 of ureter
ECSWL
> 1cm ecswl vs nephrolithotomy
Urinary stones
Lower 1/3 ureter
Ecswl
> 1 cm basket removal
Bladder
Urinary stones
3cm cystoscopy
Infection hx POUTS
Procedures
O ccup and exposure
U ti
Travel
Sexual
Blood test for hemolytic disease of NB
and explain
Direct coomb’s
Patient’s blood taken and serum with autoantibodies added
Agglutinate is +
Blood test for Rh -incompatibility prenatal screen
Indirect coomb’s
Serum from mom (Rh -)
Add normal rbc (Rh +)
Agglutinates because with autoantibodies
Depression sx
Two weeks everyday plus low mood or anhedonia for two weeks
S leep disturbance A ppetite G uilt E nergy low C oncentration low A nhedonia P sychomotor S uicidality
3ple whammy kidney failure
D iuretics
A CE I
NSAIDs
Drugs causing hyperK
NSAIDs
Cox 2inh
ACEI
ARBS
ALDACTONE
TRIMETHOPRIM
DIGOXIN
MODURETIC
Gestational diabetes complications to baby
P remarurity
Pre -eclampsia
Polyhydramnios
Placental abruption
Nephrotic syndrome
E dema
P roteinutia 3+
A lbuminuria
L ipid high
Primary Survey
D anger (safe environment)
R esponse
S end for help
A irway. Guedel
B reathing. Spontaneous?
C irculation. Pulse and BP.
D isability.
E xposure
5 P’s (all women)
M - Periods
O - pregnant?
G - papsmear
S - partner
C - pills
Post partum B’s
B reastfeeding
B aby
B lues
B leeding
Thins out womb lining
Progesterone
Endometrial atrophy
Post partum pyrexia
After Uni, Every Woman Should Marry
A telctasis U TI E ndometritis W ound infxn S eptic thrombophlebitis M astitis
Post menopause
4B 2P
B ladder
B owel
B reast
B one
P rolapse
Postmenopausal symptoms
Bilious vomiting after birth
Duodenal atresia
Non bilious vomiting
Always hungry
Pyloric stenosis
No meconium at 48H after birth
Hirschprung disease
What to give acidotic patient
NaHCO3
Prenatal screen check
FBE
BLOOD GROUP
RUBELLA
INDIRECT COOMBS
HEPA SEROLOGY
VDRL
MIDSTREAM URINE
PAPSMEAR
CHorionic villous sampling dona @
11-14 weeks AOG
Amniocentesis done @
15-18 weeks AOG
Nicotine quitting programme
Definite QUIT BY date
Aim for TOTAL ABSTINENCE
Review PREVIOUS ATTEMPTS
Inform FAMILY & FRIENDS
Alcoholism minimum intervention technique plan
1 Advise reduction to safe levels (no more than 2 SD on any day. No more than 4SD on any occassion)
2 outline benefits
3 self help pamphlet
4 diary
5 ff up
6 support grp
Woody dullness
Pneumonia
Stony dullness
Pleural effusion
Hyper resonance
Pneumothorax
Increased vocal fremitus
Pneumonia
Decreased vocal fremitus
Pleural effusion
Test for Parkinson’s
Glabellar tap
Piano test
Twiddling
Write on paper (micrognathia)
Test for PTL
Fibronectin