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ACC > Disease management > Flashcards

Disease management Flashcards

1
Q

What is the treatment of ACS?

A

-Morphine
-Oxygen 15L
-Nitrates
-Aspirin 300mg
-Ticagrolol 180mg then 90mg
NSTEMI: PCI in 14days PLUS Echo
STEMI: PCI within 2hours

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2
Q

What is the treatment of an aortic dissection?

A

Unstable: 0.5-1micro NorA/Dobutamine & resus
Acute: 1-5mg IV Labetalol, Morphine, Vasodilators, surgery
Ongoing: Metoprolol

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3
Q

What is the treatment of PE?

A 
High Suspicion: 
15L high flow O2 & ventilation
500ml fluids
15mg Rivaroxaban/ 1mg Enoxaparin
CTPA: Alteplase
0.5-1micro IV NorA/Dobutamine
Acute confirmed PE:
15L high flow & ventilation
500ml fluids
100mg IV Alteplase over 2hours
15mg Rivaroxaban
0.5-1micro IV NorA/Dobutamine

Failed Thrombolysis:
Above
IVC filter placement&Surgery

Fondaparinux/LMWH for 5days till INR>2 for 24hours

First Unprovoked no RF: 3months anticoagulation
First Unprovoked w/RF: 3months anticoagulation then review

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4
Q

What is the treatment of DVT?

A 
Proximal & distal DVT of the leg:
15mg Rivaroxaban
Physical Activity
Gradient stockings
Pregnancy:
LMWH (Enoxaparin/Heparin)
Active bleeding: IVC filter
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5
Q

What is the treatment of tension pneumothorax?

A

Thoracocentesis- 14G catheter into 2nd intercostal space, mid-clavicular
Chest drain- Safety triangle, 5th intercostal space, mid-axillary
15L/min high flow oxygen

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6
Q

What is the treatment of acute exacerbation of COPD?

A

Short acting bronchodilator: 2.5-5mg Salbutamol, 0.25-0.5mg ipratropium
Systemic Corticosteroids: 30-60mg Prednisolone
Inhaled corticosteroids (50-100micro Beclometasone)
Assist ventilation: NIV, mechanical/invasive ventilation
Oxygen
Antibiotics: 100mg Doxycycline/250mg Tetracycline
Consider: MI, PEN, CCF

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7
Q

What is the treatment of CAP?

A

CURB 0-1= Amoxicillin (allergy: Doxycycline)
CURB 2= Amoxicillin & Clarithromycin (allergy: Doxycycline/Levofloxacin)
CURB >3= IV Co-Amox & IV Clarithromycin (allergy: Cefuroxime & Clarithromycin)

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8
Q

What is the treatment for HAP?

A

Early: Doxycycline/ Co-Amox (allergy: Doxycycline/Levofloxacin)
Late: Co-Trimoxazole/ Amoxicillin & Temocillin (allergy: Linezolid & Ciprofloxacin)

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9
Q

What is the treatment for pseudomonas pneumonia?

A

IV Piperacillin/Tazobactam

Allergy: Linezolid & Ciprofloxacin

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10
Q

What is the treatment for pre-renal AKI?

A

Fluids: Crystalloid (Saline)
Vasopressor: 1 micro Dopamine/Epinephrine, NorE
Vol Overload: 20-40mg Furosemide
Renal replacement

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11
Q

What is the treatment for intrinsic AKI?

A

Treat underlying condition
Crystalloid
Vol Overload: 20-40mg Furosemide
Renal replacement therapy

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12
Q

What is the treatment for post-renal AKI?

A

Catheterization
Relieve obstruction: Stenting, lithotripsy, nephrostomy
Diuretic: 20-40mg Furosemide
Renal replacement therapy

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13
Q

What is the treatment for DKA?

A

Acute:
1-1.5L Fluids (Isotonic saline)
5% Dextrose w/0.5% NaCl when glucose= 11.1
IV insulin
IV 20-30mEq/L potassium phosphate w/fluids
5-10micro Dopamine
Mild: Isotonic Saline for 1hour then add potassium phosphate if K<3.3

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14
Q

What is the treatment for hyponatraemia?

A

Acute: 100-300mL Hypertonic 3% saline infusion
Supportive
Chronic/Asymptomatic: Isotonic 0.9% saline, Spironolactone
hypovolaemic: 250-1000ml 0.9% normal saline

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15
Q

What is the treatment for hyperkalaemia?

A

Significant: IV 10% CaCl/ 10% Ca gluconate
Nebulised Salbutamol 5mg
IV Insulin Dextrose 10u in 50mls w/50% dextrose
IV sodium bicarb
IV Furosemide
Severe: Haemodialysis
Emergency: Cardioversion

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16
Q

What is the treatment for cellulitis?

A

Severe: IV Vancomycin
Acute: Extremity= Fluclox, Orbital= Vancomycin & Ceftriaxone, Diabetic foot= amoxicillin & Doxycycline
Animal bite: Amoxicillin/ Trimethoprim

17
Q

What is the treatment for sepsis?

A

Oxygen
Respiratory: Cefotaxime/ Co-Amox/Moxifloxacin
MRSA cover: Vancomycin
Pseudomonas: Ciprofloxacin
IV Crystalloids
Adjunct: NorA, IV hydrocortisone, Dobutamine

18
Q

What is the treatment for cardiac arrest?

A

CPR & defibrillation
Adrenaline/Epinephrine 1mg every 3-5mins
Adjunct: Amiodarone, Magnesium (TdP)

19
Q

What is the treatment for anaphylaxis?

A

Oxygen
IM epinephrine every 5-15mins
IV saline 1-2L

20
Q

What is the treatment for a TIA?

A

Control underlying
Antiplatelet: Aspirin/Clopidogrel/Ticagrelol
Lipid agent: Statin
Stent/ carotid endarterectomy

21
Q

What is the treatment for a subarachnoid haemorrhage?

A 
Admit to ICU
CP support: Ventilation, intubation
Surgical clipping, endovascular coil embolization
Nimodipine (Ca channel blocker)
Senna/Docusate (Stool softner)
Oxycodone/Fentanyl/Morphine
Nitropresside (vasodilator)
22
Q

What is the treatment for a generalised/Grand mal seizure?

A

IV/rectal Diazepam/Midazolam/Lorazepam

Sodium Valproate

23
Q

What is the treatment for focal seizures?

A

IV/rectal Diazepam/Lorazepam

Carbamezepine

24
Q

What is the treatment for paracetamol overdose?

A

IV Acetylcysteine
Ondansetron
Liver transplant (unknown time or within 8-24hours)

25
Q

What is the treatment for alcohol withdrawal?

A 
Acute: Diazepam/Lorazepam
Phenobarbital
Thiamine
Folic acid
Magnesium Sulfate
Severe:
Above
Dexmedetomidine (sedative)
Propofol
26
Q

What is the treatment for a spontaneous pneumothorax?

A

Small: 15L/min high flow oxygen
Large: 15L/min high flow oxygen, chest tube thoracostomy, suction, video assisted thoracoscopy w/stapling of air leak & pleurodesis

27
Q

How is an arrested patient managed?

A

ABCDE
3 attempts Synchronised DC shock w/chest compressions
300mg IV Amiodarone 10-20mins AND 1mg Adrenaline IV
Adrenaline repeated every 3-5mins (alternate shocks)
Consider 150mg IV Amiodarone after 5 shocks

28
Q

How are broad QRS complexes treated?

A

Irregular: Seek specialist help
Regular: (VT) 300mg IV Amiodarone 20-60mins then 900mg over 24hours
(SVT w/BBB) treat as regular narrow tachycardia

29
Q

How are narrow QRS complexes treated?

A

Regular: vagal manoeuvers
IV Adensoine 6mg bolus no effect then 12mg
Monitor via ECG
sinus rhythm achieved= consider anti-arrhythmic prophylaxis
No sinus rhythm= seek expert help & beta blocker
Irregular: Rate control- Diltiazem/beta blocker
HF- Amiodarone/Digoxin, assess VTE risk & anticoagulation

30
Q

What is the treatment given to someone for life post-MI?

A

ACE inhibitor
Beta blocker
Statin
Dual anti-platetlet agents (Aspirin, Ticagrolol)

31
Q

In a PE, what are the indications for thrombolysis?

A

Saddle thrombi

Haemodynamically unstable

32
Q

Why is a beta blocker and an ACEi given after an MI?

A

Prevent heart failure

Turns dead tissue into scar tissue

ACC (21 decks)

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