Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MRCP Part 1 > Acute Care > Flashcards

Acute Care Flashcards

(55 cards)

Start Studying
1
Q

What scores are the GCS components out of?

A

Eyes 4

Verbal 5

Motor 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the GCS values for Eyes

A

Eyes

  1. Spontaneously
  2. Speech
  3. Pain
  4. None
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the GCS for verbal response

A

5 Orientation to time, person and place
4 Confused
3 Inappropriate words
2 Incomprehensible
1 None

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the GCS for motor

A

6 Obeys command
5 Moves to localised pain
4 Withdraws from pain
3 Abnormal flexion
2 Abnormal extension
1 None

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What posture is this and what is the

a) Signifiance
b) Potential progression

A

Decorticate: Abnormal flexion due to significant head trauma

Can progress to decererbate, indicating brain herniation (uncal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Who gets a 1hour CT following a head injury?

A

GCS <13 on initial assessment

GCS <15 after 2 hours

Suspected skull or basilar skull fracture

Post-traumatic seizure

Focal neuro deficit

>1 episode of vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Who gets an 8 hour CT following head injury

A

>65 years

Bleeding/clotting disorders

High velocity/height (>1m or 5 stairs)

>30 mins retrograde amnesia of events prior to injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What criteria indicates immediate CT for children?

A

GCS < 14, <15 if under 1 year

LOC or amnesia >5 mins

>3 vomiting episodes

Sign of skull, basilar fracture

Dangerous mechanism (fall >3m, high velocity)

SUSPICION OF NAI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you manage a GCS of

<8

3-8

A

<8 means intubate

ICP monitoring (must do if CT abnormal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do toxidromes affect pupil responses

A

Dilate: Anticholinergics, sympathomimetic

Pinpoint: Cholinergics, opioids

No change: Sedative hypnotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you distinguish between overdoses of

anticholinergics (atropine, antihistamine, tricyclics, olazapine, quetiapine)

sympathomimetic (Caffeine, cocaine, (meth)amphetamines, ritalin, LSD, theophylline, MDMA)

A

Anticholinergics: no RR change, bowel sounds or sweating

Sympathomimetics: Raised RR, bowel sounds present and sweating

Both have dilated pupils, raised HR and warm skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you tell the difference between

cholinergics (mushrooms, pilocarpine, -cholines)

opioids (morphine, codeine, tramadol, heroin, fentanyl)

sedative-hypnotics (benzodiazepines, muscle relaxants, antiepileptics, anti-anxiety meds

A

Both cholinergics and opioids have pinpoint pupils

Cholinergics: Bowel sounds + sweaty; no changes to numbers (HR,RR, temp)

Opioids: No bowel sounds, dry skin. Reduced HR, RR and skin temp

Sedative-hypnotics: As per opioids but no pupil changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Toxin Treatments

Paracetamol

A

N-acetylcysteine (+activated charcoal if <1hr)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Toxin treatments

Aspirin/salicylates

A

IV bircarbonate

+/- haemodialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Toxin treatments

Opioids/opiates

A

Naloxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Toxin Treatments

Benzodiazepines

A

Flumazenil
The majority of overdoses are managed with supportive care only due to the risk of seizures with flumazenil. It is generally only used with severe or iatrogenic overdoses.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Toxin treatments

Tricyclic antidepressants

A

Prevent arrythmias: IV bicarbonate

Manage arrhythmias

lignocaine (NOT quinidine, flecainide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Toxin treatments

Lithium

A

mild-moderate: fluid resuscitation

Severe: haemodialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Toxin treatments

Warfarin

A

Vitamin K, prothrombin complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Toxin treatments

Heparin

A

Protamine sulphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Toxin treatments

Beta-blockers

A

bradycardic then atropine

Glucagon if resistant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Ethylene glycol

A

fomepizole 1st line

Haemodialysis if refractory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Toxin treatments

Methanol poisoning

Study These Flashcards
A

fomepizole or ethanol

haemodialysis

24
Q

Toxin treatments

Organophosphate insecticides

25
Toxin treatments Digoxin
Digoxin-specific antibody fragments
26
Toxin treatments Iron
Desferrioxamine
27
Toxin treatments Lead
Dimercaprol calcium edetate
28
Toxin treatments Carbon monoxide
100% oxygen hyperbaric oxygen
29
Toxin treatments Cyanide
Hydroxocobalamin Also combination of amyl nitrite, sodium nitrite, and sodium thiosulfate
30
When are the 5 doses of tetanus vaccine given?
2,3,4 months 3-5 years 13-18 years
31
For tetanus, what is considered a clean wound?
\<6 hours old non-penetrating with negligible damage
32
For tetanus, what is a prone wound?
Puncture typee injuries in contaminated envirnoment Wounds containing foreign bodies Compound fractures Wound/burns with systemic sepsis Animal bites + scratches
33
What is a high-risk tetanus wound?
Soil, manure contaiminated wounds Wounds with excessive devitalised tissue Wounds requiring surgical intervention
34
Shot or not? Full dose with final \< 10 years ago Full course with final \>10 years ago Unknown/incomplete vaccination status
No shot or Ig needed Reinforce if tetanus prone, +IgG if high risk Reinforce regardless, + Ig if high risk
35
What is a common complication of N-acetylcysteine and how do you manage this?
AnaphylacticOID reaction (non-IgE mediated) Stop drug, give neb salbutamol and recommence at slower rate
36
What from the following would predispose someone to hepatotoxcity following paracetamol overdose? Alcohol intake Epilepsy treatment Smoking Depression treatmetn
Epilepsy treatment Carbamazepine is an enzyme inducer
37
What class of drug leads to a mixed resp alkalosis and metabolic acidosis?
Aspirin/salicylate resp alkalosis then later acidosis
38
How would you diferrentiate between sertraline and amitriptyline?
Both produce dilated pupils TCAs produce dry skin, sertraline does not TCAs cause QTc prolongation, SSRIs bar citalopram do not
39
What is the most important monitor for paracetamol overdose?
pH as \<7.3 after 24 hours ingestion is bad
40
What are the King's College Hospital criteria for liver transplantation?
**Arterial pH \<7.3 after 24 hours** or all 3 of: - PT \>100s - Creatinine \>300umol/l grade III/IV encephalopathy
41
Where is dialysis useful in tricyclic overdoses?
Its not
42
What is the impact of alcohol on paracetamol overdose toxicity?
Not much and may be protective
43
What do ALTs and ASTs in the 10,000s indicative of?
Paracetamol overdose
44
What causes hyponatraemia?
Depletion of sodium Excess of water
45
Outline the complication of hyponatraemia when untreated Overtreated
Untreated Cerebral oedema --\> uncal herniation (ipsilateral dilated pupil, contralateral paralysis) Overtreated Osmotic demyelination syndrome (paralysis, mouth problems, coma, locked in syndrome)
46
How do the causes of hyponatraemia differ if the urinary sodium is... \>20mmol/L \<20mmol/L
\>20mmol/L Low BP (renal loss): Diuretics, Addison's, renal failure Normal BP: SIADH (osmolality \>500mmol/kg), hyothyroidism \<20mmol/L Low BP (extra-renal): diarrhoea, vomiting, burns, sweating High BP (water excess): hyperaldosteronism, nephrotic syndrome, IV dextrose, psychogenic polydipsia
47
How do you do you treat Chronic, severely symptomatic hyponatraemia? Acute, severly symptomatic hyponatraemia?
Chronic hypovolaemic: isotonic saline Eu/hypervolaemic: Fluid restrict to 500-1000ml/day Acute Close monitoring with hypertonic saline (3%) to correct faster
48
What is the rate of sodium correction in hyponatraemia?
4-6mmol/L in 24hrs
49
How do you manage a haemothorax post ABCDE
36F wide bore chest drain Thoracotomy if \>1.5L loss initially or ongoing loss of 200ml/hour for \>2 hours
50
How to treat anaphylaxis initially (with doses)
IM adrenaline to anterolateral middle third of thigh **\<6m: 100-150ug** **\<6yrs: 150ug** **\<=12yrs: 300ug** **\>12yrs: 500ug** Repeat dose every 5 mins
51
What is a common pitfall for adrenaline anaphylaxis dosing?
Anaphylaxis: **1:1000 IM** Cardiac arrest: 1:10,000 IV (100mcg in 1ml) **ANAPHYLAXIS USES 10X THE STRENGTH**
52
What is a normal anion gap in metabolic acidosis? What conditions have a raised anion gap?
(Na+ + K+) - (HCO3- + Cl-) = 8-14 Raised anion gap (introduction of acid into the body) Lactate (shock, hypoxia) Ketoacidosis (diabetic, alcoholic) Uric acid (renal failure) Acid poisoning (salicylates, methanol)
53
What things tend to cause metabolic alkalosis?
GI or renal upset
54
What things cause a respiratory acidosis?
When you can't blow off enough CO2 - COPD - Decompensation - Sedatives
55
Respiratory alkalosis tends to be caused by what?
Where you're hyperventilating so not getting enough CO2 Anxiety Pulmonary embolism Salicylate poisoning CNS disorders Altitude Pregnancy

MRCP Part 1 (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions