Presentations Flashcards

1
Q

What is the management of paracetamol overdose?

A
  • Activated charcol if <1 hour ago
  • N-acetylcysteine
  • liver transplant
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2
Q

What is the management of an opioid overdose?

A

Naloxone

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3
Q

What is the managment of a tricyclic antidepressant overdose?

A
  • IV bicarbonate
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4
Q

What is the managment of a lithium overdose?

A
  • normal saline fluid resus
  • haemodialysis if severe
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5
Q

What is the management of a warfarin overdose?

A
  • vitamin K
  • prothrombin complex
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6
Q

What is the management of a heparin overdose?

A

Protamine sulphate

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7
Q

What is the management of lead toxicity?

A
  • Dimercaprol
  • calcium edetate
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8
Q

What is the management of carbon monoxide poisoning?

A
  • 100% oxygen
  • hyperbaric oxygen
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9
Q

What are the features of a salicylate overdose?

A
  • hyperventilation
  • tinnitus
  • lethargy
  • sweating, pyrexia
  • nausea/vomiting
  • hyper and hypo glycaemia
  • seizure
  • coma
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10
Q

What is the presentation of anaphylaxis?

A
  • swelling of the throat and tongue causing hoarse voice and stridor
  • respiratory wheeze
  • dyspnoea
  • hypotension
  • tachycardia
  • pruritis, widespread erythematous or urticarial rash
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11
Q

MAnagement of anaphylaxis in under 6 months

A

Adrenaline 100-150 micrograms (1 in 1000)

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12
Q

Management of anaphylaxis in 6 month to 6 year olds

A

150 micrograms (0.15ml of 1 in 1000)

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13
Q

Management of anaphylaxis in 6-12 year olds

A

300 micrograms (0.3ml 1 in 1000)

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14
Q

Management of anaphylaxis in >12

A

500 micrograms (0.5ml 1in 1000)

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15
Q

Where is the best site for IM adrenaline injection?

A

Anterolateral aspect of the middle third of the thigh

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16
Q

What is refractory anaphylaxis?

A
  • respiratory and/or cardiovascular problems persist despite 2 doses of IM adrenaline
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17
Q

What are the causes of syncope?

A

Reflex:
- vasovagal: emotion, pain, stress
- situational
- carotid sinus syncope

Orthostatic
- Primary: parkinsons, lewy body dementia
- Secondary: diabetic neuropathy, amyloidosis, uraemia
- drug induced
- volume depletion: diarrhoea, haemorrhage

Cardiac:
- arrhythmia
- structural
- PE

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18
Q

What are the primary autonomic failure causes of syncope?

A
  • Parkinsons
  • Lewy body dementia
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19
Q

What are the secondary autonomic failure causes of syncope?

A
  • diabetic neuropathy
  • amyloidosis
  • uraemia
20
Q

What are the drug induced causes of syncope?

A
  • diuretics
  • alcohol
  • vasodilators
21
Q

What is the evaluation of syncope?

A
  • Cardiovascular examination
  • postural BP reading
  • ECG
  • carotid sinus massage
  • tilt table test
  • 24 hour ECG
22
Q

Post fall

A
  • history
  • collateral history
  • underlying cause: postural hypo, med review, infection
23
Q

Define a fall

A

Sudden, unintentional change in position from a higher surface to a lower surface coming to rest on the floor, an object, or the ground.

24
Q

Define a fall with harm

A

Any fall needing radiological intervention or resulting in harm

25
Q

What are the types of continence?

A

Stress or urge

26
Q

What is stress incontinence?

A

Cough/sneeze/laugh/increased pressure, are not able to control the bladder, weak pelvic floor and sphincter muscles

27
Q

What is urge incontinence?

A

Feel the need to go to the toilet but cannot make it on time. over activity of the detrusor muscle

28
Q

What are the risk factors for incontinence?

A
  • age
  • bmi
  • cognitiive impairment
  • neurological impairement
  • pregnancy
  • pelvic floor prolapse
  • post-menopausal
29
Q

How to you assess continency?

A
  • bi manual exam
  • urine dipstick - no acute cause
  • bladder scan: post void residual volume
  • urodynamic test - catheter
30
Q

What is the management of stress continency

A
  • Avoid triggers
  • weight loss
  • reduced fluid intake
  • supervised pelvic floor exercise
31
Q

What is the management of urge continence?

A
  • anticholinergics - oxybutynin
  • bladder retraining
32
Q

What is the treatment of alzheimers

A

Donepezil

33
Q

What is delerium?

A

An acute transient state of confusion

34
Q

Anticipatory care plan

A

Dynamic record developed over time through evolving conversations, collaborative actions and shared decision making.
- level of intervention preferred
- resus status
- preferred place of care
- post death wishes

35
Q

Just in case meds

A
  • pain relief morphine
  • breathlessness and agitation medazolam
  • anti emetic: based on cause (brain mets: dex cyclozine)
  • hyoscine bromide for secretion
36
Q

What are the types of pain?

A
  • nociecptive: injury, pressure, inflammation
    *somatic: skin muscle tendon bone
    *Visceral: pain arising from infiltration or compression of the viscera (liver capsule pain)
  • Neuropathic pain: damage to the central or peripheral nervous system
37
Q

Symptoms of dying phase

A
  • reduced GCS
  • low mood
  • withdrawn
  • profound weakness
  • poor appetite
  • difficulty swallowing
  • temperature change at extremities
  • terminal restlessness
38
Q

What is palliative care

A

An approach that improves the quality of life of patients and families facing problems associated with life threatening illness through prevention and relief of suffering

39
Q

chemo

A

Ondansetron

40
Q

Brain mets

A

cyclozine or dex

41
Q

Hypercalcaemia

A

Halliperidol

42
Q

Constipation related nausea

A

metoclopramide

43
Q

What makes you feel sick

A
  • vestibulocochlear
  • chemotactic: chemical or biochemical
  • gut
  • limbic
44
Q

Anterior artery stroke

A

lower more than upper

45
Q

Middle artery stroke

A

upper more than lower

46
Q

Anterior inferior cerebellar stroke

A

ipsillateral facial paralysis and deafness

47
Q

Nephrotic sydrome complications

A
  • infection: immunoglobulin
  • VTE: antithrombin III,
  • hyperlipidaemia
  • CKD
  • hypocalcaemia