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Y5 > !!! > Flashcards

!!! Flashcards

1
Q

Asthma Tx

A

O2
Salbutamol NEB 5mg (back to back max 10mg/hour)
Ipratropium NEB 500mcg (4-6 hourly)
Hydrocortisone IV 100mg (6 hourly)/ Pred PO 40mg (OD)
Mg Sulphate 2mg infusion over 20 mins

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2
Q

PE treatment

A

LMWH

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3
Q

Tension pneumothorax decompression

A

2nd intercostal space mid clavicular line

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4
Q

Abx for COPD

A

Doxycycline PO 200mg loading then 100mg 12 hourly

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5
Q

ILS drugs

A

Adrenaline 10mls 1:10,000 = 1mg IV 3rd shock then every alternate shock (or ASAP then every alternate cycle)
Amiodarone 300mg IV 3rd shock

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6
Q

Defib charge

A

150J

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7
Q

4Hs

A

Hypothermia, hypoxia, hyperkalaemia, hypovolaemia

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8
Q

4Ts

A

Tension pneumothorax, Toxins, Tamponade, Thrombosis (PE / MI)

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9
Q

Mental state exam

A 
Appearance + behaviour
Speech
Mood (affect = objective + subjective)
Thoughts (form + content)
Perceptions
Cognition (memory, concentration, confusion)
Insight
\++++ RISK
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10
Q

Seizure

A

15L O2
Recovery position
IV access
IV Lorazepam 4mg / PR Diazepam 10mg

20 mins repeat
30 mins Phenytoin

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11
Q

Life threatening asthma

A

33 92 CHEST

PEFR <33% predicted
Sats < 92%

Cyanosis
Hypotention
Exhaustion
Silent chest
Tachycardia
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12
Q

ACS Tx

A

Morphine 10mg in 10mls 1ml at a time IV titrated
+ antiemetic
O2 if sats <94%
Nitrate GTN 2 puffs (watch for hypotension)
Aspirin 300mg PO
Clopidogrel 300mg PO

+ ACEI (Ramipril 2.5mg)
+ b blocker (Bisoprolol 2.5mg)
+ Statin (Atorvsatatin 80mg)
+ LMWH (Fondaparinux) 5 days

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13
Q

Meningitis Tx

A

IM Ben Pen
IV Ceftriaxone
PO Ciprofloxacin 500mg once

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14
Q

LVF + pulmonary oedema acute Tx

A 
PODMAN
Position
O2
Diuretic (Furosemide 40mg IV)
Morphine
Anti emetic
Nitrate (GTN 2 puffs)
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15
Q

LFV + pulmonary oedema chronic Tx

A

ACEI, b blocker, Diuretic

+ spironolactone) (+ digoxin

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16
Q

ABG ranges

A 
Ph 7.35-7.45
Po2 11-13
Pco2 4.5-6
HCO3 22-26
Lactate <2
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17
Q

Spirometry for lung diseases

A

Obstructive - FEV <80% FVC normal, FEV:FVC <0.7

Restrictive - FEV <80% FVC <80%, FEV:FVC >0.7

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18
Q

CURB 65

A 
Confusion
Urea >7
RR >30
BP <90 sys / <60 dias
65
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19
Q

Acute Tx alcohol withdrawal

A

Chlordiazepoxide

Pabrinex

20
Q

DKA Dx + Tx

A

Cap glucose >11
Cap ketones >3 (or ++ urinalysis)
Metabolic acidosis

1L 0.9% NaCl over 1 hour (then + K in subsequent bags)

Fixed rate 1U/kg/hour Actrapid infusion

+ LMWH

21
Q

Treatment of a hypo

A

150ml 10% dextrose IV STAT
or IM glucagon 1mg
= unconscious

Glucogel if can’t swallow

Glucotab / fruit juice + biscuit / toast

22
Q

Tx hyperkalaemia

A

IV Calcium Gluconate 10% 10mls

10 Units Actrapid + Glucose 50mls 50% IV

Salbutamol 10mg NEB

23
Q

Tx anaphylaxis

A

Secure airway + 15L O2

0.5mg IM Adrenaline
= 0.5mls 1:1000
x 3 Repeat every 5 mins

Hydrocortisone 200mg IV
Chlorphenamine 10mg IV

IV Fluids

Wheeze = 5mg Salbutamol NEB

24
Q

Stroke Tx

A

CT head to ensure ischaemia

Aspirin 300mg OD 2 weeks –> Clopidogrel 75mg

<4.5 hours = thrombolyse

<6 hours = thrombectomy

25
Q

Tx AF / A flutter

A

> 65 + IHD / no Sx / not suitable cardioversion
= rate control –> Bisoprolol +/- rate limiting CCB +/- Digoxin (if sedentary)

Rhythm control –> DC cardio version / flecanide / amiodarone

+ warfarin / DOAC

26
Q

AF risk scoring

A 
CHADSVASC = risk of stroke
HASBLED = risk of bleeding
27
Q

Stroke classification

A

TACS = hemisensory weakness, homonymous hemianopia, high cortical dysfunction (dysphasia)

PACS = 2/3

LACS = 1/3

POCS = cerebellar / Cr N

28
Q

Types of brain bleed

A 
Subarachnoid = blood within fissures of brain
Intercerebral = blood in brain tissue
Extradural =  lens shaped "lucid interval"
Subdural = crescent shaped "fluctuating conscious level, evolving stroke"
29
Q

BP drop postural hypotension

A

> 20 SBP

>10 DBP

30
Q

Meningitis examination

A

Brudzinskis = involuntary flexion hips and knees on flexion of the head

Kernig’s = pain on extending knee

31
Q

Capacity requirements

A

Make, understand, act on, communicate + remember decision

32
Q

Mental health act detention powers

A

EDC = 72 hours (Dr + MHO)

SDC = 28 days (Psych + MHO)

CTO = 6 months (Psych + MHO + Dr)

They have a mental disorder
Because of it their ability to make decisions about its tx are impaired 
Tx is available
It is necessary
There is a risk to safety
33
Q

Death confirmation

A 
A = response to verbal stimuli
B = Breath sounds (apexs + bases) 1 min
C = Carotid pulse (both) 1 min, HS (apex) 1 min
D = Pupillary reflexes (bilaterally fixed + dilated), response to painful stimuli 
E = signs of life total 5 mins
34
Q

GCS

A

E 4
V 5
M 6

E1 = no response
E2 = opens eyes to pain
E3 = opens eyes to voice
E4 = opens spontaneously 
V1 = no response 
V2 = sounds
V3 = confused words
V4 = confused sentences
V5 = responsive + oriented
M1 = no response
M2 = abnormal extension to pain
M3 = abnormal flexion to pain
M4 = withdraws from pain
M5 = localises to pain
M6 = obeys commands
35
Q

STEMI ECG leads

A

I, II, aVF = inferior (RCA)
V3-V4 = anterioseptal (LAD)
V3-V4 + I + aVL = anteriolateral (LAD +/- L circumflex)
I, aVL + V5-V6 = lateral (L Circumflex)
V1 - V2 tall R wave + ST depression = posterior (L circumflex +/- RCA)

36
Q

ALARMS

A 
Anaemia
Loss of weigh
Anorexia
Recent onset + progressive
Malena
Swallowing difficulty
37
Q

First rank symptoms of schizophrenia

A

A - auditory hallucinations
B - broadcasting thoughts
C - control delusions
D - delusional perceptions (anyone after you?, events relate to you?)

38
Q

Core sx depression

A

Low mood, anhedonia

Sleep disturbance, lack of energy

Hopelessness, suicidal

39
Q

Paeds history

A

BFGD

Birth

Feeding (+ toilet)

Growth

Development (school concerns)
–> speaking + walking by 1 1/2

++++++ IMMUNISATIONS

40
Q

Alcohol dependance

A

3+

Tolerance
Withdrawal
Cravings
Continue to drink despite harmful consequences
Neglects other interests (primacy)
Difficulty giving up use
41
Q

RA hands

A 
Loss of knuckle guttering
Z deformity of thumb
Ulnar deviation
Palmar subluxation
Swan neck deformity
Boutinerres deformity
42
Q

OA hands + X-ray

A

Bouchards nodes
Heberdens nodes

Loss of joint space
Osteophytes
Subchondral sclerosis
subchondral cysts

43
Q

Ortho exam sequence

A 
Look
Feel
Move (passive + active)
Special tests 
Function
44
Q

Present a CXR

A

Patient + hospital info
PA / AP
Quality - rotation, inspiration, exposure
A - tracheal deviation
B - lung fields (patchy, dense)(upper, lower, middle)
C - heart size, aortic knuckle, deviated mediastinum
D - flat / raised, costophrenic angles, free air
E - bones + soft tissue

Patchy = consolidation (can see bronchioles going into area) (pneumonia / oedema)

Dense = effusion (meniscus, mediastinum shift away from effected side. Exudate = malignancy + infection, Transudate = congestive cardiac failure), collapse (no bronchioles, mediastinum shift to effected side)

Pneumothorax

45
Q

HF + pulmonary oedema CXR

COPD CXR

A 
Alveolar shadow (bats wing)
B-lines
Cardiomegaly
Dilated vessels in upper lobe
Effusion
Hyperinflated chest 
Flat diaphragm 
Bulla
Prominent hila
Reduced lung markings

Y5 (2 decks)

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