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Year 4 ACC > Skills > Flashcards

Skills Flashcards

1
Q

When are ABGs superior to VBGs?

A

If you need PaO2 or in severe shock/Hypercapnia/Lactate >2

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2
Q

Causes of respiratory acidosis

A

Decreased respiratory drive
Decreased chest wall movement
Chronic obstruction

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3
Q

Causes of respiratory alkalosis

A

Increased rep drive

Hypoxaemia induced- Altitude

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4
Q

What does an increased anion gap mean?

A

Increased acid production or ingestion

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5
Q

What does a decreased anion gap mean?

A

Decreased acid excretion or loss of HC03

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6
Q

Increased anion gap metabolic acidosis causes

A 
Lactate 
Urea
Ketones 
Aspirin OD 
CO
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7
Q

Decreased anion gap metabolic acidosis causes

A

Lithium toxicity
Inc Ca
Inc K
Inc Mg

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8
Q

Normal gap metabolic acidosis causes

A

Addisons, RTA

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9
Q

What does Aspirin OD cause

A

Metabolic acidosis and Respiratory alkalosis as compensation

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10
Q

Causes of metabolic alkalosis

A

GI loss of H+

Renal loss of H+- Nephrotic, Diuretics, Conn’s

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11
Q

What does base excess >2 mean?

A

Increased Bicarb

Met alkalosis or comp.Resp acidosis

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12
Q

What does base excess

A

Decreased Bicarb

Met acidosis or comp.Resp Alkalosis

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13
Q

In terms of compensation what does a normal PH indicate?

A

Fully compensated

If still abnormal then it is partially compensated

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14
Q

System for CXR interpretation

A

Demographics
RIPE
A->E

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15
Q

What does RIPE mean in relation to CXR interpretation?

A

Rotation- Clavicles and spinous processes
Inspiration- 5-6 Ant.Ribs
Penetration- Vertebrae through mediastinum
Exposure- Can you see it all?

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16
Q

What is ABCDE in relation to CXR interpretation?

A

Airway- Deviation?
Breathing- Pleura, Collapse, Consolidation, hilar, reticular shadowing
Circulation- Heart size, Heart position, shape, Great vessels
Diaphragm- Shape, Costophrenic angles, Air below?
Extra- Bones and soft tissue

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17
Q

Sail sign?

A

Lower lobe collapse

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18
Q

Veil sign

A

Upper lobe collapse

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19
Q

System to interpret an AXR?

A 
Demographics 
Bowels (+ pother organs)
Bones 
Calcification 
(BBC)
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20
Q

Diameter of the DB, LB and caecum?

A

3, 6, 9 CM

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21
Q

What does the coiled spring sign suggest?

A

SB obstruction

Valvulae conniventes become more prominent

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22
Q

How does faeces look on an AXR?

A

Mottled

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23
Q

What does the coffee bean sign suggest

A

Volvulus

Can also be the ‘fetal sign’ in the sigmoid

24
Q

What suggests pneumoperitoneum?

A

Double wall sign- inner and outer wall visible of abdomen
SHOULD ONLY SEE INNER WALL
Also look for air under diaphragm on CXR

25
Q

What is a lead pipe sign?

A

No haustra LB suggests IBD

26
Q

What does toxic mega colon look like on AXR?

A

Dilated colon

27
Q

Possible causes of calcification/artefact on AXR?

A

Gallstones, Renal calculi, Pancreatic/vascular/costochondral calcification
Surgical clips
Ureteric stents

28
Q

Structure for ECG interpretation

A 
Demographics 
Rate and Rhythm 
Axis
P wave
PR 
QRS Rhythm strips 
QRS V1-V6
ST
T
Other- QT
29
Q

How to calculate rate on an ECG

A

Total R X6

30
Q

How to work out Axis on an ECG

A

I +II
1 +VE II -VE LAD
1 -VE 2 +VE RAD

31
Q

P wave height

A

< 2 small squares

32
Q

Normal PR length

A

3-5 small squares

33
Q

Decreased PR?

A

Accessory conduction pathway

34
Q

Explain what R wave progression is?

A

V1= Dominant S
V6= Dominant R
V3/4 is the transition point

35
Q

What does it mean if the R wave transition point is after V4 on an ECG?

A

Chronic lung disease

RVH

36
Q

What could it suggest if there is a dominant R wave in V1/2?

A

RVH

Post.MI

37
Q

QRS length?

A

< 3 small squares

38
Q

RBBB has what V1 and V6 QRS pattern?

A 
V1= RSR1
V2= qRS

M->W

39
Q

LBBB has what V1 and V6 pattern?

A 
V1= rS 
V6= Monophasic R wave 
V5/6= Bunny ears

WM

40
Q

Height of QRS in V5/6?

A

< 4 Big squares

If > 5 Big sqaures then LVH

41
Q

Dominant R wave in V1 could suggest?

A

RVH

42
Q

What defines ST elevation/Depression?

A

> 1 small sq

43
Q

What causes a saddle ST segment?

A

Pericarditis

Tamponade

44
Q

What causes a reverse flick ST segment?

A

Digoxin toxicity

45
Q

Flat T waves

A

Hypokalaemia

46
Q

In which leads is T wave inversion normal

A

III + aVR + V1

47
Q

What should a normal QT be?

A

< 450ms

48
Q

What does an enlarged QT predispose you to?

A

Polymorphic VT

49
Q

Narrow Tachy and abn P

A

SVT

50
Q

Broad tachy and no p

A

VT/VF

51
Q

What represents a severe fluid deficit?

A

> 8% body Wx lost, Profound oliguria, CNS collapse

52
Q

What do crystalloids do?

A 
Water soluble 
Diffuse through semi-permeable membrane 
Can infuse rapidly in large volumes 
Short duration in circulation 
Saline/Hartmann's/Dextrose
53
Q

What do Colloids do?

A

Not a solution
Suspension of finely divided particles in a continuous medium
If capillary permeability is normal then the particles stay in circulation and keep fluid with them!
Gelatins/Albumin/Blood/Starches

54
Q

What is the sensitivity and specificity of D-Dimer?

A

50% Specificity 95% Sensitivity

Good for ruling people out

55
Q

When is D-Dimer confounded?

A

Sepsis, Trauma, Surgery, Pregnancy

56
Q

What does the PESI score do?

A

Predicts 30 day outcomes for PE

57
Q

What is D-Dimer?

A

Fibrin degradation product

Year 4 ACC (3 decks)

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