Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Y5 Emergency Medicine > 1 - Induction Week > Flashcards

1 - Induction Week Flashcards

(57 cards)

Start Studying
1
Q

What risks do you need to consider when requesting imaging?

A

IRMER 2000

  • Radiation Risks: Carcinogenosis, Genetic, Fetal developmental risks
  • IV Contrast Risk: Anaphylaxis, Compartment Syndrome, Contrast-induced nephropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can be some of the issues with Gadolinium and Iodine contrast?

A

Iodine

  • Allergy/Anaphylaxis
  • Contrast induced nephropathy if eGFR<30
  • Compartment syndrome if soft tissue extravasation of contrast (ice and elevate arm)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some contraindications for an MRI?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which patients cannot have a CT colonogram as buscopan is required?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you make a referral for imaging?

A

SPOTIQR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you make a referral for interventional radiology?

A
  • Hb
  • G+S
  • Coagulation screen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you prepare a patient on the ward on the day of interventional radiology?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why do we need to be careful when requesting a CTPA for young women??

A

Risk of breast cancer as young and over heart/breast tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What condition should not be referred to liaison psychiatry?

A

DELIRIUM

Can use MCA for DOLS, doesn’t need MHA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the main issue with malnourishment in hospital?

A

SARCOPENIA

They lose muscle over fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you monitor patients on parenteral nutrition?

A

Make sure plastic bag stays on to prevent lipids and vitamins degrading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you monitor patients on parenteral nutrition?

A

Make sure plastic bag stays on to prevent lipids and vitamins degrading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the risks with PN?

A

THROMBOSIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What should you do if a patient has pyrexia and is on PN?

A

Only restart if temperature drops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some signs of a hickman line infection?

A
  • Pyrexia on feeding
  • Rigors on feeding
  • Muscle pains
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How much fluids do people require a day?

A

30ml/kg/day + losses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the issues with normal saline for maintenance fluids?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What should you do before prescribing fluids?

A

Check U+Es!!!!!

If potassium persistently low then check Mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When can you switch from IV to PO abx?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If a patient grows MRSA on a blood culture post-surgery, where could the source of infection be?

A
  • Wound site
  • Catheter
  • Line
  • Epidural site
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do gram-negative bacteria lead to septic shock?

A

Endotoxins that lead to vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do gram-negative bacteria lead to septic shock?

A

Endotoxins that lead to vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What antibiotic do you need to add to Benzylpenicillin for necrotising fascitis?

Study These Flashcards
A

Clindamycin

Consider early IVIG

23
Q

What is an inquest?

24
When does a coroner have to perform an inquest?
* Unexpected death * Custody inc MHA, DOLS, Custody
25
What should you do if a patient dies in your care and is likely to go to inquest?
Write an account in your own words as soon as possible!!!!
26
How do you write a statement to the coroner?
It is a factual summary, do not speculate or give hearsay (second or third hand) If asked a question and it is not in your area of expertise you should say this
27
What is a problem representation?
28
What is Murtagh's method for diagnostic reasoning?
* Most likely diagnoses * 2 less likely diagnoses * 2 not to be missed diagnoses
29
How do you receive a handover and what questions are important to ask when receiving this? (IMPORTANT CARD TO PRACTICE)
**ISBAR** * What is the NEWS and what are they scoring on? * PMHx * Does the senior know about this? * Do they have an escalation plan or a DNACPR? * What have you done already? * What would you like me to do?
30
What is included in a discharge letter?
* **Elective or Emergency?** * **Main Diagnosis** * **PMHx** * **Clinical Hx:** include if new DNACPR in place * **Ix** * **Follow up plans** Need extra letter for anticoagulation or emergency EoL plan
31
How do you commence warfarin in hospital?
LMWH bridging therapy until 2 INRs within therapeutic range
32
What should patients do if they miss a dose of warfarin for DVT treatment ?
**Target INR: 2-3** Just miss it and take the next dose as normal as warfarin has a long half life
33
If a patient has a VTE provoked by malignancy what treatment should they be given?
**DOAC \>LMWH** Usually Apixaban or Rivaroxaban. Avoid rivaroxaban in GI malignancy as associated with GI bleeds Dabigatran and Edoxaban require bridging
34
If a patient has a low eGFR and CKD but has septic shock how do you fluid resuscitate?
500mls over 15 minutes, shock takes priority and their eGFR may be low due to the sepsis
35
Which of the following drugs need to be stopped if there is an eGFR of less than 30? * Metformin * Citalopram * Ramipril * Gliclazide
* **Metformin:** risk of acidosis * **Gliclazide:** hypo risk, put on sliding scale * **Ramipril:** nephrotoxic Ciprofloxacin is hepatically excreted so can continue
36
What are the three principles of treatment for anaphylaxis?
**Adrenaline, Oxygen, Fluids** Can give non-sedating antihistamine once acute phase is over
37
If the source of sepsis is known how does this change your sepsis 6?
Use narrow spectrum antibiotics e.g Flucloxacillin IV for cellulitis origin
38
How are Gentamicin and Vancomycin prescribed?
Need to base next dose on levels before so daily levels are needed. Also need U+Es Be careful as Red Man Syndrome (antihistamine release) and Ototoxic!!!
39
Why do you need to be careful when stopping a prescription of oxybutynin in a patient with Parkinson's?
It is an anticholinergic and the ratio of acetylcholine:dopamine affects balance in Parkinson's
40
What sedation is appropriate for a patient with PD?
**Appropriate**: Lorazepam (can increase agitation in 10%), Olanzapine, Quetiapine **Not appropriate:** Haloperidol and Chlorpromazine as D2 antagonists
41
If a Parkinson's patient is NBM what can you switch their meds to?
Rotigotine patch but takes 24 hours to kick in so will be temporary drop in functioning
42
How do you confirm a death?
Time of death is when it is confirmed by Doctor not when they take their last breath for example
43
How do you certify a death?
Remember 1b caused 1a
44
What can you NOT write in 1a on a death certificate?
**1a** should be the **disease**, **illness** or **complication** which **led to death** and **not a mode of dying**
45
What are some reasons to refer a death to the coroner?
46
What is essential to be included on a cremation form 4?
If there is a pacemaker as it can explode
47
If a woman has a high output ileostomy how can we work out the fluid replacement including potassium needed? (IMPORTANT CARD)
**_Fluids (using fluid balance chart)_** * Work out maintenance for 24 hours (25ml x kg) * Work out deficit for 24 hours (do loss/hr x 24) * Add together * Take away fluid intake **_Potassium Replacement_** * 3.5 - actual potassium * Above x daily requirement x 0.4 gives deficit * Deficit plus daily requirement
48
When prescribing in DKA what is very important to continue prescribing?
**Normal long acting insulin in the background** DO NOT GIVE A MIXED INSULIN AS THEIR BACKGROUND
49
How should you adjust someone's insulin after a hypo?
20% decrease in dose
50
How should you adjust someone's insulin if there are having persistently high BMs?
10% increase
51
What can cause normal BM in DKA?
SGLT2 Inhibitors
52
How do you take someone off of a DKA protocol once their DKA has resolved?
**Eating and drinking:** Give them s/c insulin, let them eat, 30 minutes later take off **Not eating and drinking:** Go to sliding scale
53
What are the premises of prescribing in DKA?
**Insulin:** 0.1 units/kg/hr, if delay of more than half hour give stat of 10 units s/c **Fluids**: Start with sodium chloride, Add potassium to next bags if necessary but no more than 10mmol/hr Switch to 10% dextrose if BM\<14
54
How often should you check BM in sliding scale?
* Hourly * Use 5% dextrose with K+ as fluids * Keep long acting insulin prescribed, if NBM then decrease to 80%
55
Who should you not give glucagon to in a hypo and what should you give them instead?
Anyone with liver disease or emaciated e.g elderly with low muscle mass Give them 50ml/hr 20% IV dextrose
56
What is the difference in treatment between DKA and HHS?
Only give fluids in HHS If significant ketonuria give 0.05 units/kg/hr of insulin

Y5 Emergency Medicine (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions