Specialties info cards

Question 1

Normal ICP

Answer 1

<15mmHg

Question 2

Cheyne-Stokes breathing: character and cause?

Answer 2

Rapid shallow breathing followed by periods of apnoea. Caused by hypoperfusion of respiratory centre of brain

Question 3

Uncal herniation signs

Answer 3

(Inferomedial temporal lobe through temporal notch)

1) Compression of CN3 -> dilated ipsilateral pupil then ophthalmoplegia
2) Contralateral hemiparesis + coma

Question 4

Cerebellar herniation

Answer 4

Increased pressure in posterior fossa -> forces cerebellar tonsil through foramen magnum

• Ataxia
• Upgoing plantars
• CN6 palsies
  Then
• LOC, irregular breathing, apnoea

Question 5

Cingulate herniation

Answer 5

Frontal mass -> medial frontal lobe forced under rigid falx cerebrum

If compression of cerebral artery too -> stroke

Question 6

Suspected meningococcal meningitis?

Answer 6

1.2g IM BenPen

Question 7

VT ECG findings

Answer 7

• Marked LAD
• • QRS concordance in chest leads
• AV dissociation in 25% or 2:1/3:1 AV block
• Fusion beats or capture beats

Question 8

Adverse cardiac signs

Answer 8

Shock (BP<90, Pulse>100)
Syncope
Heart failure
Chest pain/ischaemia on ECG

Question 9

Causes of torsades des points

Answer 9

Congenital eg Tx with beta blockers

Drugs eg anti-dysarrhythmics, TCA, anti-psych, anti-malarials

Question 10

Digoxin toxicity presentation (ie electrophysiologically)

Answer 10

SVT with AV block

- give Digoxin specific Ab fragments

Question 11

What is the score to assess whether anticoag is indicated in AF patients? What does it predict?

Answer 11

Score of 2 = 2.2% annual risk of stroke

CHA2DS2VASc score

Question 12

What is the HAS-BLED score used for?

Answer 12

Score predicts bleeding in anticoagulated AF patients to assess risk benefit in their care

Question 13

In most people what does the right coronary artery supply in the heart?

Answer 13

SAN and AVN

- so pts can get bradycardic after inferior MI

Question 14

What is beck’s triad?

Answer 14

Low BP, muffled heart sounds, raised JVP

Question 15

What is Kussmaul’s sign?

Answer 15

Raised JVP on inspiration

Question 16

ECG criteria for thrombolysis

Answer 16

1. ST elevation >1mm in 2 limb leads or >2mm in 2 chest leads
2. New onset LBBB
3. Posterior changes eg deep ST depression and tall R waves in V1-3

Question 17

Why should beta blockers not be used with verapamil?

Answer 17

Can precipitate asystole

Question 18

What is the grace score used for?

Answer 18

Predict in-hospital, 6mth-3yr mortality in patients with diagnosed ACS

Question 19

Pancreatitis score

Answer 19

PaO2 <8kPa
Age >55
Neutrophils >15 
Calcium <2
Renal, urea >16 
Enzymes, 
LDH >600, AST >200iu/l
Albumin <32 
Sugar, glucose >10