Emergencies

Question 1

What are some symptoms of opioid overdose?

Answer 1

Reduced consciousness
Low resp rate
Bradycardia and hypotension

Question 2

What are some complications of opioid overdose?

Answer 2

Resp depression
Aspiration pneumonia
Rhabdomyolysis
Hypothermia

Question 3

How would you manage an opioid overdose?

Answer 3

A-E
Escalate to seniors
IV naloxone 400ug
Secure airway, give o2 if required
? Referral to local drug and alcohol services

Question 4

What is the MOA of naloxone?

Answer 4

Competitive opioid receptor antagonist

Question 5

What is given in anaphylaxis?

Answer 5

IM adrenaline to anterolateral thigh

500 micrograms, using adrenaline 1 in 1000 (1 mg/mL) injection, repeat dose after 5 minutes if no response

Question 6

What are some risk factors for PE?

Answer 6

Recent surgery
Immobility
Pregnancy
COCP/HRT
Malignancy
SLE
Thrombophilias
Long haul flight

Question 7

What scoring system is used to predict likelihood of PE?

Answer 7

Wells score for PE

Greater than 4 - do CTPA
Less than 4, do D-dimer

Question 8

What investigations should you do when investigating PE?

Answer 8

BP
HR
RR
O2
Temp
ECG
ABG - resp alkalosis, low CO2 may have low o2
D-dimer
CTPA (CT pulmonary angiogram)
Ventilation-perfusion scan

Question 9

ECG findings in PE

Answer 9

S1, Q3, T3

Question 10

How are PEs treated?

Answer 10

Analgesia
O2 if req
Monitor for deterioration

Apixaban - 3mths for reversible cause, beyond 3mths for unprovoked PE, 3-6mths for active cancer

Massive PE - thrombolysis

Question 11

What are the parameters forCURB-65?

Answer 11

Confusion
Urea >7mmol/l
RR >/= 30
BP syst <90 diast </=60

65</=

Question 12

What score on curb 65 required hosp admission?

Answer 12

2 or more

Question 13

What is part of the sepsis 6?

Answer 13

IV fluids
IV Abx - Meropenem 1g
Give o2 if required
Lactate
Urine output
X2 blood cultures