20 cards

Question 1

Clin F of hypoglycemia

Answer 1

Confusion
Dizzy
Diaphoresis
Tremor
Pallor
Nausea
Hunger

Question 2

Red flags for hypoglycemia

Answer 2

Historical- diabetes, insulin overdose, alcohol abuse or recent XS ingestion, pancreatitis or pituitary insufficiency, liver disease, addison disease

Clincal- AMS, agitation, seizures, suspected drug OD, hypothermia, visual disturbance, speech difficulties

Question 3

Management of hypoglycemia

Answer 3

If BGL less than 4 mmol/L with NO decrease in level of consciousness (Yellow Zone criteria):

give quick-acting carbohydrate: sugary soft drink, fruit juice or 40% glucose gel, up to 15 g, buccal
reassess BGL in 15–30 minutes and repeat treatment until BGL over 4 mmol/L
If BGL less than 4 mmol/L WITH a decrease in level of consciousness (Red Zone criteria) OR the patient is unable to tolerate oral intake:

give 40% glucose gel, up to 15 g, buccally in incremental doses, as tolerated, while establishing IV access
give 10% glucose 200 mL by IV infusion over 15 minutes, once only
if delay in IV access, give glucagon 1 mg IM, once only
reassess BGL in 15 minutes
If the patient is unconscious or peri-arrest:

give 50% glucose 50 mL by slow IV injection, once only. Use with caution as extravasation can cause necrosis
if delay in IV access, give glucagon 1 mg IM, once only
reassess BGL in 15 minutes
Once stabilised, give patient long-acting carbohydrate and continue to check BGL hourly, or as clinically indicated

Question 4

Definitive treatment for biliary pacnreatitis

Answer 4

Laparoscopic cholecystectomy

Question 5

WHen is ERCP with sphincterotomy indicated

Answer 5

Bilary pancreatitis with concurrent cholangitis or CBD obstruction

Question 6

What is Ludwig’s angina

Answer 6

Rapidly spreading bacterial infection in the floor of the mouth - most often due to dental infection –> if untreated can rapidly spread into the submadibular and sublingual spaces via the loose connective tissue and fascial neck planes

Question 7

How are supracondylar fractures classified

Answer 7

Gartland classification

Question 8

What is a positive Sidel test

Answer 8

Waterfall appearance of aqeous humor on fluroscein dye instillment –> indicates globe perforation

Question 9

Confirmative investigation of small bowel adhesive obstruction

Answer 9

Plain XR

Question 10

When is a gastrografin follow through vs a gastrograffin enema used

Answer 10

Follow through - failure of obstruction to resolve with conservative management
Enema - fecal impaction

Question 11

When does the ductus arteriosus close,

Answer 11

Between 4-10 days

Question 12

Coarctation of the aorta- main clin f

Answer 12

Absent femoral pulses

Decreased feeding, SOB, vominting

Question 13

Immediate management of coarctation of aorta

Answer 13

Prostaglandin infusion to maintain patency

Carefully monitor as infusion can cause apnea and hypotension

Surgery considered once metabolic acidosis is settled- fluid restricition is required beforehand

Question 14

https://app.emedici.com/storage/media/fd244924-6a7d-4c37-8d2c-083cd0035c9a.jpg

Answer 14

follicular inflammation on subtarsal conjunctiva - early trachoma

Question 15

What is trachoma caused by

Answer 15

Chalmydia trachomatis serotypes A, B, Ba and C
Which are not the sexually transmitted strains

Question 16

Cx of trachoma

Answer 16

Scarring, entropion, blindness from corneal damage

Question 17

When is terlipressin used

Answer 17

Tx for acute variceal bleed
Caution in severe IHD or peripheral vas disease

Question 18

Alternative to terlipressin if patient has IHD , PVD

Answer 18

Octreotide

Question 19

When is propanolol used in GI bleed

Answer 19

Lowers portal venous pressure
Primary prevention if non bleeding varices are identified on EGD or secondary prevention to prevent recurrent variceal bleeds

Question 20

https://app.emedici.com/storage/media/b228fb99-8822-4b74-8246-e7b91f63d4bf.jpg

Answer 20

Splenic hematoma

Question 21

Mng of splenic hematoma

Answer 21

If stable, splenic artery embolisation
If unstable, splenectomy

Question 22

Med for delirium/ agitation in patients with Parkinson’s disease

Answer 22

Quetiapine

Haloperidol, risperidone and olanzepine can cause EPS

Question 23

Tx of severe pyelonephritis

Answer 23

1. gentamicin and amoxicillin
   If penicillin HSN, then just IV gentamicin is okay for first 72 hours

If emperical therapy is still required after 72 hours, cease gentamciin regime and use ceftriaxone or cefotaxime as above

Question 24

MCC of overt, painless GI hemorrhage in children <2yo

Answer 24

Meckle’s diverticulum

Other causes: intussusception, enterocolitis, malrotation

Question 25

Why does Meckle's diverticulum result in bleeding

Answer 25

A Meckel's diverticulum is a true diverticulum and is often characterised by the presence of ectopic gastric mucosa within the diverticulum. Acidic secretions can ulcerate adjacent small intestinal mucosa, leading to bleeding. A helpful memory aid is the "rule of twos" - a Meckel's diverticulum is usually located 2 feet proximal to the ileocecal valve, presents before the age of two years, is seen twice as commonly in males than in females and is found in 2% of the population.

Question 26

Ix for Meckle's diverticulum

Answer 26

Technetium 99m PERTECHNETATE scan