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Acute Care (Y4) > Emergency Medicine > Flashcards

Emergency Medicine Flashcards

1
Q

What is the treatment for acute asthma attack?

A 
OSHITMAN
Oxygen
Salbutamol
Hydrocortisone
Ipratropium
Theophylline
Magnesium
ANaesthetics
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2
Q

What blood glucose suggests hypoglycaemia?

A

< 4 mmol/L

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3
Q

What is the management for hypoglycaemia if the patient can swallow?

A

4-5 glucotabs or 150-200ml fruit juice

Then banana, bread, biscuit

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4
Q

What is the management for hypoglycaemia if the patient is drowsy/confused?

A

Squeeze 1.5-2 tubes of glucogel into their mouth

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5
Q

What is the management for hypoglycaemia if the patient is unconscious?

A

75ml 20% dextrose IV or 1mg Glucagon IM

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6
Q

What is the treatment for DKA?

A

IV insulin infusion until < 12mmol/L, then start saline & 5% dextrose IV too to prevent hypoglycaemia

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7
Q

What Potassium level would suggest Hyperkalaemia?

A

> 5.5 mmol/L

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8
Q

What is the treatment for Hyperkalaemia?

A

10mls 10% calcium gluconate
Insulin/dextrose IV
Consider nebulised salbutamol

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9
Q

Which medication is used to stabilise the myocardium in hyperkalaemia?

A

10mls 10% calcium gluconate

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10
Q

Which medication is used to drive Potassium intra-cellularly in hyperkalaemia?

A

Insulin

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11
Q

What is the treatment for opiate overdose?

A

naloxone 400 micrograms IM - repeat after 2-3 mins if necessary

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12
Q

What is involved in the ‘sepsis six’?

A

Take 3:

  • Blood culture
  • Urine output
  • Lactate

Give 3:

  • Fluids
  • Antibiotics
  • Oxygen
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13
Q

What is the initial treatment for MI?

A 
MONA + T
Morphine
Oxygen
Nitrates eg. GTN
Aspirin
Tricagelor (if not going for PCI)
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14
Q

What are the definitive treatment options for MI?

A

medical, PCI or thrombolysis

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15
Q

Which scoring system is used to assess risk of PE?

A

Wells’ score

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16
Q

If a PE is likely, which investigation should be performed?

A

CTPA

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17
Q

What is the treatment for PE?

A

LMWH eg. dalteparin

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18
Q

What is a toxidrome?

A

Collection of symptoms and signs caused by a toxin

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19
Q

Cholinergic syndrome is caused by…

A

Excess stimulation of ACh receptors

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20
Q

Give a possible cause of cholinergic syndrome.

A

Organophosphates

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21
Q

Give symptoms of cholinergic syndrome.

A

Pinpoint pupils, increased bowel sounds and urine output

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22
Q

Give symptoms of anticholinergic syndrome.

A

Tachycardia, Hypertension, Hyperthermia, dilated, dehydrated (urinary retention)

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23
Q

What is the mechanism of anticholinergic syndrome?

A

competitive antagonism of ACh receptors - reduces parasympathetic drive

24
Q

Give causative drugs of anticholinergic syndrome.

A

Anti-histamines, TCAs, anti-parkinson drugs

25
Q

Give symptoms of sympathomimetic syndrome.

A

Tachycardia, Hypertension, dilated pupils, agitated

26
Q

What is the mechanism of sympathomimetic syndrome?

A

Inhibition of NE and Dopamine re-uptake

27
Q

Give causes of sympathomimetic syndrome.

A

Cocaine, Mephedrone, SSRIs

28
Q

Give symptoms of sedative-hypnotic syndrome.

A

Bradycardia, hypotension, hypothermia

29
Q

Give symptoms of sedative-hypnotic syndrome.

A

Bradycardia, hypotension, hypothermia

30
Q

What is the mechanism of sedative-hypnotic syndrome?

A

Caused by CNS depression (usually through GABA stimulation)

31
Q

Give causes of sedative-hypnotic syndrome.

A

BZDs, anti-histamines

32
Q

TCA overdose is associated with which toxidrome?

A

Anticholinergic

33
Q

Give ECG changes classic of TCA overdose.

A

Sinus tachycardia, RBBB, broad QRS

34
Q

What is the reversal agent for Amitriptylline?

A

Sodium bicarbonate

35
Q

How long after a paracetamol overdose should levels be measured?

A

4-6 hours

36
Q

What is the reversal agent for paracetamol?

A

N-acetylcysteine

37
Q

What is the reversal agent for Lidocaine?

A

Intralipid

38
Q

What is the reversal agent for beta-blockers?

A

Glucagon

39
Q

Give some symptoms of aspirin overdose.

A

Tinnitus, metabolic acidosis

40
Q

What is the reversal agent for ethylene glycol?

A

ethanol or Fomepizole

41
Q

The deadly nightshade mushroom causes which toxidrome?

A

Cholinergic

42
Q

What is the reversal agent for cyanide?

A

Hydroxycobalamin

43
Q

What is the reversal agent for iron salts?

A

Desferrioxamine

44
Q

How is coronary vasospasm after cocaine ingestion treated?

A

GTN, BZDs, may need PCI if ongoing chest pain

45
Q

Which ECG changes are consistent with hypokalaemia?

A

T wave inversion, ST depression, U waves

46
Q

Which ECG changes are consistent with Hyperkalaemia?

A

Peaked T waves, PR prolongation, Wide QRS

47
Q

Give a serious side effect of ACEIs.

A

Angio-oedema

48
Q

Is profound resp acidosis with or without compensation more worrying in acute asthma?

A

Without comp more worrying - patient is tiring

49
Q

What are the criteria for liver transplantation after paracetamol overdose?

A

pH < 7.3 24 hours after ingestion
PT > 100
Creatinine > 300
Encephalopathic

50
Q

Give a common side effect of N-acetylcysteine.

A

Anaphylactoid reaction

51
Q

How should you manage a massive haemorrhage?

A 
ABCDE
Call 2222 stating 'massive haemorrhage'
Alert senior
Send urgent blood samples
Will be sent 4 RBC and 4 FFP - transfuse as appropriate
52
Q

Shock with increased RR, low HR and BP suggests…

A

Neurogenic shock

53
Q

Give signs of progressive shock,

A 
Hypotension
Acidosis
Oedema
Cool & clammy skin
Reduced LOC
54
Q

Give causes of cardiogenic shock.

A

Valvular heart disease
MI
Cardiac arrhythmias
Cardiomyopathy

55
Q

Give causes of obstructive shock.

A

Cardiac tamponade
PE
Tension pneumothorax

56
Q

Shock with bradycardia, warm/flushed peripheries suggests…

A

Neurogenic shock

57
Q

What is the treatment for anaphylaxis?

A

500 micrograms adrenaline IM (0.5ml of 1:1000 solution)

Acute Care (Y4) (3 decks)

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