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Phase 3B Anaesthetics/ITU COPY > Hospital @ Night > Flashcards

Flashcards in Hospital @ Night Deck (8)
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1

What might lead to communication difficulties with a patient?

Hearing aids, dementia, language barrier, unconsciousness, oxygen/ventilation, speech or language difficulties

2

Scars.
a) Mercedes Benz
b) Median sternotomy - look where else?
c)

a) Liver transplant
b) CABG, open valve/aneurysm repair (also look in calves for saphenous vein harvest)

3

Murmurs.
a) Before approaching patient, think...?
b) Intensifying sound
c) Differentiating between AS/MR murmur

a) What am I expecting (always expect to hear a murmur), e.g. elderly - AS, MI - MR, endocarditis/Marfan's - AR/MR
b) RILE: Right-sided (inspiration), Left-sided (expiration). Also getting them to stop breathing helps to hear it.
c) Radiation (carotids vs axilla), area, 2nd heart sound often quiet/inaudible with pansystolic but not with ejection systolic

4

Hernias.
a) Direct vs. indirect inguinal
b) Types
c) Tests to perform

a) Direct (through weakened abdominal wall), indirect (through inguinal canal, usually into groin)
b) Incisional, inguinal, femoral
c) Cough/sit up, reducible?

5

Rheumatoid hands.
a) If fixed flexion - also look for...?

a) Dupuytren's and palmar erythema - alcoholic liver diseases

6

Bruising/ecchymosis.
a) Periumbilical

a) Possible due to SC heparin

7

Stomas.
a) Ileostomy vs colostomy
b) Assess what?

a) Site (RIF vs LIF), opening (spouted vs flushed), consistency of fluid
b) Health of spout, consistency and volume of fluid, surrounding skin

8

Imaging.
a) Brain MRI landmarks
b) If several brain lesions
c) CXR - spiculated mass?

a) Midbrain (Mickey Mouse), Pons (handbag - worn by ponces)
b) Think mets - look for primary
c) Malignancy