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OSCE > ABCDE - Specific > Flashcards

ABCDE - Specific Flashcards

1
Q

What should be added to the second bag of fluids in DKA in most cases?

A

40mmol KCl

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2
Q

What four drugs should you give to a patient with ACS? How would you give each one?

A

Morphine (IV), GTN (sublingual), aspirin and ticagrelor (oral)

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3
Q

You shouldn’t give IV furosemide to patients with pulmonary oedema who have what clinical sign? What should you do instead?

A

Hypotension - contact the critical care team

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4
Q

What dose of nebulised ipratropium bromide should be given in acute asthma/COPD?

A

500mcg

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5
Q

What should be done when blood glucose falls below 15mmol/l in DKA?

A

Start an infusion of 5% dextrose in 0.9% saline

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6
Q

What products will you be given upon activation of the major haemorrhage protocol?

A

4 x units of RBCs and 4 x units of FFP

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7
Q

What dose of IV lorazepam should be given for a seizure?

A

4mg

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8
Q

Assuming the patient has had no other benzodiazepines, how soon can a dose be repeated in a seizing patient?

A

After 5 minutes

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9
Q

What three drugs should you give to a patient with anaphylaxis? How would you give each one?

A

Adrenaline (IM), hydrocortisone (IV) and chlorphenamine (IV)

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10
Q

What dose of oral aspirin should be given in ACS?

A

300mg

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11
Q

How often can the dose of adrenaline be repeated in anaphylaxis?

A

Every 5 minutes

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12
Q

How often can nebulised salbutamol be repeated?

A

Every 15 - 30 minutes

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13
Q

What dose of oral ticagrelor should be given in ACS?

A

180mg

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14
Q

Patients with clinical evidence of a STEMI require what further intervention?

A

Primary PCI

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15
Q

What medications are given to drive potassium into cells in hyperkalaemia?

A

10 units Actrapid in 50ml 50% dextrose

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16
Q

What further intervention can be considered for patients with acute COPD who are not improving and have evidence of type 2 respiratory failure?

A

Non-invasive ventilation

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17
Q

What dose of IV amiodarone should be given in cardiac arrest?

A

300mg

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18
Q

What dose of IV metronidazole should be given to septic patients?

A

500mg (tds)

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19
Q

What investigation can be used to give you a rapid lactate measurement in septic patients?

A

ABG/VBG

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20
Q

What is the immediate emergency treatment for a tension pneumothorax?

A

Needle decompression into the 2nd intercostal space, mid-clavicular line (on the affected side)

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21
Q

How often can a dose of sublingual GTN be repeated in ACS?

A

Every 5 minutes, up to 3 times

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22
Q

If a patient with DKA has a systolic BP > 90mmHg, what fluids should be given?

A

1L of 0.9% saline over 1 hour

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23
Q

When should IV amiodarone be given in cardiac arrest?

A

After 3 shocks

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24
Q

If there is no response to benzodiazepines in a seizing patient, what drug should be tried next?

A

IV infusion of phenytoin

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25
Q

What dose of chlorphenamine should be given in anaphylaxis?

A

10mg

26
Q

What are some additional interventions if a COPD exacerbation is suspected to be infective?

A

Take blood and sputum cultures, give antibiotics

27
Q

What antibiotics should be given to patients with sepsis of unknown origin who are penicillin allergic?

A

IV vancomycin, metronidazole and gentamicin

28
Q

What dose of oral prednisolone should be given in acute COPD?

A

30mg

29
Q

What medication should be given to patients in acute pulmonary oedema?

A

IV furosemide 40mg

30
Q

What are the two treatment options for severe hypoglycaemia?

A

150ml 10% glucose over 10-15 minutes OR 1mg glucagon IM

31
Q

What is included in the sepsis 6 bundle?

A

Take blood cultures, serial lactate measurements and urine output; give oxygen, IV fluids and IV antibiotics

32
Q

What dose of IV morphine is a reasonable starting point for patients with ACS?

A

5mg (may consider giving less for frail patients)

33
Q

What dose of sublingual GTN should be given in ACS?

A

400mcg

34
Q

What additional medication may be given in trauma patients where the major haemorrhage protocol has been activated?

A

1g tranexamic acid IV

35
Q

What antibiotics should be given to patients with sepsis of unknown origin?

A

IV amoxicillin, metronidazole and gentamicin

36
Q

What dose of nebulised salbutamol should be given in acute asthma/COPD?

A

5mg

37
Q

Giving GTN for ACS is contraindicated in patients with which clinical sign?

A

Hypotension

38
Q

In trauma situations, in what ratio should RBCs and FFP be given in the major haemorrhage protocol?

A

1: 1

39
Q

What is the management for a patient with a massive PE (i.e. PE with haemodynamic instability)?

A

Thrombolysis with IV alteplase

40
Q

When should IV adrenaline be given in cardiac arrest?

A

Every 3-5 minutes

41
Q

What dose of naloxone should be given in opioid overdose?

A

400mcg IV

42
Q

What is the management for a patient with a PE without haemodynamic instability?

A

Oral rivaroxaban 15mg

43
Q

What dose of oral prednisolone should be given in acute asthma?

A

40-50mg

44
Q

What dose of IV hydrocortisone should be given in acute asthma?

A

100mg

45
Q

In non-trauma situations, in what ratio should RBCs and FFP be given in the major haemorrhage protocol?

A

2: 1

46
Q

What antibiotic should be given for an infective COPD exacerbation?

A

Oral amoxicillin 500mg

47
Q

What dose of IV adrenaline should be given in cardiac arrest?

A

1mg of 1: 10,000

48
Q

What dose of IV amoxicillin should be given to septic patients?

A

1g (tds)

49
Q

What dose of adrenaline should be given in anaphylaxis?

A

0.5mls 1: 1000 (500mcg)

50
Q

What dose of PR diazepam should be given for a seizure?

A

10mg

51
Q

What dose of hydrocortisone should be given in anaphylaxis?

A

200mg

52
Q

How should patients with DKA be given insulin?

A

Fixed rate infusion - 0.1 units/kg/hour

53
Q

What three drugs should you give to a patient with acute asthma? How would you give each one?

A

Salbutamol (neb), ipratropium bromide (neb) and prednisolone (oral)/hydrocortisone (IV)

54
Q

What dose of buccal midazolam should be given for a seizure?

A

10mg

55
Q

How may benzodiazepines be given in the treatment of seizures?

A

IV lorazepam, buccal midazolam or PR diazepam

56
Q

What insulin should be given in DKA?

A

50 units Actrapid in 50mls 0.9% saline

57
Q

How should patients with HHS be rehydrated?

A

0.9% saline infusion over 48 hours

58
Q

After initiating cardiac monitoring, what drug is given to stabilise the cardiac membrane in hyperkalaemia?

A

10mls 10% calcium gluconate

59
Q

What are the most important investigations to do in an individual with DKA?

A

ABG and ECG

60
Q

After treatment for DKA, when should individuals be switched from a fixed rate infusion to a sliding scale?

A

When blood glucose is < 11mmol/L

61
Q

What should be done with regards to an individual’s normal insulin regime when being treated for DKA?

A

Continue long acting insulin, stop short acting insulin

OSCE (14 decks)

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