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4th year > Acute care > Flashcards

Acute care Flashcards

1
Q

How long before surgery should aspirin be stopped?

A
  • 7 days prior
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2
Q

Normal fasting time for surgery?

A
  • 6hrs
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3
Q

How can warfarin for heart valves be bridged for surgery?

A
  • stop warfarin
  • LMWH injections
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4
Q

What must be done regarding diabetic medications for surgery?

A
  • normal up till day of surgery
  • first on surgical list
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5
Q

Define toxidrome?

A
  • toxin + syndrome
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6
Q

Patient presents with dry mouth, dilated pupils, increased HR. What toxidrome?

A
  • anticholinergic
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7
Q

Patient presents with increased saliva, blurry vision, pinpoint pupils. What toxidrome?

A
  • cholinergic
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8
Q

Slowed heart rate, slowed response rate, pin point pupils?

A
  • opioid
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9
Q

Increased heart rate, increased respiratory rate, dilated pupils?

A
  • sympathomimetic
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10
Q

Decreased HR and resp rate. Cold temp. What toxidrome?

A
  • sedative
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11
Q

What symptom may aspirin poisoning present with?

A
  • tinnitus
  • vomiting
  • double vision
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12
Q

What is the toxic metabolite of a paracetamol overdose?

A
  • NAPQI
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13
Q

When should bloods for a paracetamol overdose be done?

A
  • 4hrs post ingestion
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14
Q

What may mimic as an MI on ECG in a young person?

A
  • cocaine usage
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15
Q

What is given in a paracetamol overdose?

A
  • N-acetylcystine
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16
Q

Antidote for tricyclic antidepressants?

A
  • sodium bicarbonate
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17
Q

Antidote for beta blockers?

A
  • Glucagon
18
Q

Antidote for car defrost

A
  • ethanol
19
Q

antidote for opioids

A
  • naloxone
20
Q

antidote for benzodiazepines

A
  • flumazenil
21
Q

When should a synchronised DC shock be given on ECG and why

A
  • on the QRS complex
  • avoid over T wave as may cause VF
22
Q

Side effect of N-acetylsystine

A
  • anaphylactic like side effects
23
Q

Treatment of ventricular tachycardia

A
  • IV Amiodarone
  • DC cardioversion
24
Q

Treatment of SVT

A
  • Vagal manoeuvres
  • IV Adenosine
25
Q

How does adenosine work?

A
  • Blocks the AV node temporarily
26
Q

What are the harmful effects of under-treated pain

A

-tachycardia
- hypertension
- MI
- Decreased lung volumes
- Anxiety and fear

27
Q

What is the pain assessment scored from?

A
  • 0-3
    0 = no pain at rest or movement
    1 = no pain at rest, slight on movement
    2 = intermittent at rest, moderate on moving
    3 = continuous at rest, severe on movement
28
Q

What pain killers should be avoided in renal failure?

A
  • avoid NSAIDs
29
Q

How does paracetamol work?

A
  • inhibits prostaglandin synthesis in the CNS
30
Q

How does NSAIDs work?

A
  • inhibit the enzyme COX-1
31
Q

What are the contraindications for NSAIDs?

A
  • GI bleed
  • peptic ulcer
  • coagulopathy
  • renal impairment
32
Q

What must you ask asthmatics before giving NSAIDs?

A
  • ask about NSAID sensitivity
  • especially if has nasal polyps
33
Q

Where is morphine metabolised?

A
  • metabolised in the liver
  • excreted by the kidneys
34
Q

What drugs are good for neuropathic pain?

A
  • anticonvulsants and antidepressants
35
Q

What is the typical dose for PCA?

A
  • 1mg morphine with a 5 min lockout
  • max 12mg morphine/hr
  • takes 45 mins to receive 20mg morhpine
36
Q

How long does it take for the patient to receive 20mg morphine PCA?

A
  • 45mins
37
Q

What is the antiemetic given in trauma?

A
  • ondansetron
    ( caution due to prolonged QT)
38
Q

When is dexamethasone given?

A
  • chemotherapy patient, anti-emetic
39
Q

Side effects of hyoscine?

A
  • anti-cholinergic
  • tachycardia and dry mouth
40
Q

What antiseptic can be used in Parkinsons and why?

A
  • domperidone
  • doesn’t cross the blood brain barrier
41
Q

What makes up Cushing’s triad?

A
  • Bradycardia
  • irregular breathing
  • hypertension
42
Q

Protocol for CT head within 1hr?

A
  • GCS less than 13
  • GCS less than 15, 2hrs post injury
  • suspected base of skull fracture
  • neurological deficit
  • more than 1 episode of vomiting
  • post trauma seizure

4th year (4 decks)

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