20 cards

Question 1

What can the serum ascites albumin gradient differentiate between

Answer 1

Portal HTN and non portal HTN causes of ascites

Gradient > 11g/l sugggests portal HTN as the cause

Question 2

MCC of ascites in children

Answer 2

Chronic liver disease

Others: nephrotic syndrome, TB, ca

Question 3

Which gender is more likely to develop acute angle closure glaucoma

Answer 3

wOMEN

Question 4

Mng of acute angle closure glaucoma

Answer 4

1. IV carbonic anhydrase inhibitor like acteazolemide
2. IV mannitol
   With topical pilocarpine, brimonidine and timolol + prednisolone acetate 1% to affected eye + analgesia

Question 5

Cerebral malaria clin f

Answer 5

Recent travel to endemic malaria areas
Fever, coma, splenomegaly

Thrombocytopenia, hypoglycemia

Question 6

Do normal CSF findings exclude cerebral malaria

Answer 6

NO

Question 7

Diseases requiring airborne precautions

Answer 7

Varicella, measles, TB, SARS

Question 8

The definition of serious trauma to any body region includes the following.

Answer 8

♦ Penetrating injury of:
— head
— neck
— chest
— abdomen
— perineum
— back.
♦ Head injury with:
— one or both pupils dilated
— open head injury
— severe facial injury.
♦ Abdominal injury with:
— distension
— rigidity.
♦ Spinal injury with:
— weakness
— sensory loss.
♦ Limb injury with:
— vascular injury with ischaemia of limb
— amputation
— crush injury
— bilateral femur fractures.

Question 9

Essential details needed in a ambulance to hospital hand over

Answer 9

IMIST AMBO

ID
Mechnanism
Injuries
Signs
Treatments and trends

Allergies
Meds
Background hx
Other issues

Question 10

Key injuries that need to be excluded during the primary survery

Answer 10

ATOM FC
Airway obstruction
Tension PTX
Massive hemothorax
Flail chest
Open PTX
Cardiac tamponade

Question 11

Injuries in MVA

Answer 11

♦ Frontal impact: cervical spine fracture, anterior flail chest, traumatic aortic disruption, pneumothorax, myocardial contusion, ruptured spleen or liver, posterior dislocation/fracture of hip/knee.
♦ Lateral impact: cervical spine fracture, lateral flail chest, traumatic aortic disruption, pneumothorax, diaphragmatic injury, ruptured spleen or liver, renal injury, fractured pelvis.
♦ Rear impact: cervical spine injury.
♦ Ejection: increased risk for any injury.
♦ Rollover: increased risk for any injury.

Question 12

Injuries in pedestrian MVAs

Answer 12

Remember the injury triad—impact with the bumper, impact with the bonnet and windscreen, and subsequent impact with the ground.

♦ Bumper: lower-limb fractures, fractured pelvis, torso injuries in children.
♦ Bonnet/windscreen: head injury, torso injuries.
♦ Ground: head injury, spinal injuries.

Question 13

Injuries in falls

Answer 13

Head, spine, torso, pelvis and multiple fractures (calcaneus, ankle, tibial plateau, hip and vertebral column).

Question 14

Canadian C spine rules

Answer 14

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Question 15

Indications for using an US to image abdominal trauma

Answer 15

Document free fluid if decreased BP

Question 16

Indications for using a diagnostic peritoneal lavage to image abdo trauma

Answer 16

Document bleeding if decreased BP

Question 17

Indications for using a CT to image in abdominal trauma

Answer 17

Document organ injury if BP normal

Question 18

Important factors to consider in a discharge checklist

Answer 18

1. Mobility - at home, getting into a chair, getting out of bed, getting to their residence
2. Social or family support- take them home, available overnight
   3.Nutrition, hygiene, comfort - can they attend to basic needs
3. Cognitive fx- are they likely to place themselve in a dangerous position
4. Discharge instructions