Untitled Deck Flashcards
What is meant by intention to treat analysis in a randomised controlled trial?
All participants are analysed based on their originally assigned treatment groups, regardless of whether they completed or received the intended treatment. This approach helps maintain the randomisation and avoids biases caused by crossover or dropout.
What are the differences in relative humidity in a ventilator circuit when using an ultrasonic nebuliser as opposed to a heat and moisture exchanger (HME)?
Ultrasonic nebuliser: exceeds 100% relative humidity
HME: achieves approximately 70% relative humidity
Which clinical features in someone with a burn may indicate the need for early intubation?
GCS < 8
Respiratory distress or failure
Noticeable swelling or blistering in the lips, tongue or oropharynx
Voice changes, e.g. hoarseness or stridor
Singed nasal hair
Carbonaceous sputum
Extensive burns of the face or neck, including circumferential burns
How does digoxin work in treating atrial fibrillation with a fast ventricular rate?
Inhibits cardiac Na+/K+-ATPase, leading to increased intracellular Na+, which promotes the exchange of Na+ for Ca2+ via the Na+/Ca2+ pump, resulting in increased intracellular Ca2+. This causes increased cardiac contraction and prolongs the refractory time of the bundle of His, resulting in prolongation of the refractory period at the AV node and bundle of His.
Which alternative drug can be used in the management of AVNRT if adenosine is contraindicated?
Verapamil 2.5–5 mg IV
Why may someone with primary hyperaldosteronism (Conn’s syndrome) develop muscle weakness and tetany?
Due to hypokalaemic metabolic alkalosis. Conn’s syndrome causes a low renin hypertension and is diagnosed by a ↑ aldosterone:renin ratio.
What modifications have been implemented in advanced life support algorithms for resuscitating individuals with hypothermia?
Refrain from administering adrenaline or any other drugs until the temperature is >30°C. When the temperature ranges from 30°C to 35°C, double the dose intervals for ALS drugs. In cases of VF, consider delivering up to three shocks if needed, but hold off on further shocks until the temperature is >30°C.
What is the most likely diagnosis if someone develops hypocalcaemia and seizures two days after starting chemotherapy?
Tumour lysis syndrome (TLS) – electrolyte abnormalities can precipitate neurological dysfunction. Common abnormalities include: ↓ Calcium, ↑ Phosphate, potassium, urate, LDH, lactate. TLS is due to the sudden and large-scale death of cells following the initiation of chemotherapy.
What are the most likely causes for developing drowsiness one week after undergoing endovascular coiling for a subarachnoid haemorrhage?
Delayed cerebral ischaemia (DCI) due to cerebral vasospasm, local hypoperfusion or disordered autoregulation, and non-convulsive seizures.
What’s the rationale for including clindamycin or linezolid alongside broad-spectrum antibiotics in the treatment of necrotising fasciitis?
For the termination of toxin production.
Besides hypothermia, what are some alternative reasons for the presence of J-waves on an ECG?
Normal variant (early repolarisation), hypercalcaemia, angina – vasospastic, brain injury including a subarachnoid haemorrhage, idiopathic ventricular fibrillation, type 1 Brugada syndrome.
When would you consider placing an inferior vena cava (IVC) filter after a pulmonary embolism (PE)?
If anticoagulation is contraindicated, e.g. the bleeding risk is very high; if thrombosis has recurred despite adequate anticoagulation; if temporary cessation of anticoagulation within one month is anticipated, e.g. pregnant patients within one month of the expected date of delivery.
What are the two pathways of coagulation?
Intrinsic Pathway (APTT)
12 -> 11 -> 9 -(8)-> 10
Prolonged APTT = Factors 8,9,11,12
Extrinsic Pathway (PT)
7 -(3)-> 10
Prolonged PT = Factor 7
Common Pathway
10 -(5)-> 2 prothrombin ->1 fibrinogen
Prolonged PT & APTT = Factors 2,5,10
