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IMT Knowledge Flashcards

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1
Q

What is the time limit guideline for PCI in STEMI?

A

2 hours of ECG diagnosis (pre-hsopital) or 1 hour (hospital diagnosis)

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2
Q

What is the time limit for thrombolysis in STEMI?

A

12 hours

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3
Q

Which patients with NSTEMI may be considered for immediate PCI?

A

CV unstable

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4
Q

Patients with NSTEMI and high GRACE score should be considered for…

A

PCI within 72 hours

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5
Q

Give ECG findings which may suggest NSTEMI

A

TWI, ST depression, Q waves

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6
Q

Which coronary artery is usually implicated in anterolateral MI?

A

LCA

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7
Q

Which coronary artery is usually implicated in lateral MI?

A

Circumflex

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8
Q

Which coronary artery is usually implicated in anterior MI?

A

LAD

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9
Q

Which coronary artery is usually implicated in inferior MI?

A

RCA

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10
Q

How is fast AF treated?

A

Rate control (beta-blocker +/- amiodarone) and anticoagulation

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11
Q

How is stable SVT usually treated?

A

Adenosine 6mg IV, can give 12 - 18mg if unsuccessful, may require cardioversion

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12
Q

What is the treatment for stable VT?

A

Amiodarone 300mg

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13
Q

What are the mainstays of management for exacerbation of COPD?

A

Ipratropium
Salbutamol
Oxygen
Antibiotics (if infective)
Prednisolone

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14
Q

What are the main treatments for exacerbation of asthma?

A

Oxygen
Salbutamol
Hydrocortisone
Ipratropium
Theophylline
Magnesium
Anaesthetis

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15
Q

Which features suggest a severe asthma exacerbation?

A

Unable to complete sentences
Increased WOB
Peak flow < 50%
Sats < 92%
Raised ++ HR/RR for age

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16
Q

Which features suggest a life-threatening asthma exacerbation?

A

Peak flow < 33%
Exhaustion
Hypotension
Silent chest
Cyanosis
Confusion

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17
Q

Which sign on an ABG is concerning in acute asthma?

A

Rising pCO2

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18
Q

Which finding may be found on ABG in a patient with PE?

A

Respiratory alkalosis

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19
Q

How are patients with a stable PE treated?

A

anticoagulate with DOAC or LMWH

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20
Q

How are patients with an unstable PE treated?

A

continuous infusion unfractionated heparin +/- thrombolysis

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21
Q

What are the mainstays of DKA treatment?

A

Fluid resuscitation, insulin and electrolyte replacement (esp K)

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22
Q

Give examples of stroke mimics.

A

Hypoglycaemia
Seizures
FND
SOL
Electrolyte imbalance

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23
Q

What are the main treatment options for stroke caused by an infarct?

A

Thrombolysis and Thrombectomy

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24
Q

What scoring system can be used for stroke?

A

NIHSS

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25
What is the usual timeframe for thrombolysis?
4.5h
26
What is the usual timeframe for thrombectomy?
Usually 6h but can be performed up to 24h
27
Which protocol may need to be activated in UGIB?
Major Haemorrhage
28
Which treatments may be considered for variceal bleeding?
Terlipressin pAbx Definitive - ligation, banding
29
What is involved in the 'sepsis six'?
Give 3 - antibiotics, fluids, oxygen Take 3 - cultures, urine output, lactate
30
What is the treatment for anaphylaxis?
IM adrenaline 500mcg (1ml 1 in 1000)
31
Which ECG changes may suggest hyperkalaemia?
Tented T waves, prolonged PR interval, prolonged QRS
32
What is the treatment for hyperkalaemia?
Calcium gluconate 10% 10mls to stabilise myocardium Insulin/dextrose infusion Sometimes nebulised salb recommended
33
Give some common causes of delirium.
PINCHME Pain Infection Nutrition Constipation Hydration Medication Environment
34
What is meant by status epilepticus?
Seizure > 5 mins or not recovering between multiple seizures
35
What initial treatments and doses could be given in status epilepticus?
10mg buccal midazolam or PR diazepam
36
What is the most important part of your assessment in status epilepticus?
Airway
37
What is the treatment for status epilepticus?
benzo such as midazolam, repeated after 5 mins if no response 2nd/3rd line include levetiracetam, phenytoin etc May require RSI and intubation
38
Which symptoms may be present in adrenal insufficiency?
Dizziness, vomiting, reduced GCS
39
Give common triggers for adrenal insufficiency.
Infection, surgery, exogenous steroid withdrawal
40
What is the biochemical pattern seen in adrenal crisis?
Hyponatraemia, hyperkalaemia, hypoglycaemia
41
Hypoadrenalism leads to deficiency of...
Mineralocorticoids and glucocorticoids
42
Rapid correction of sodium can lead to...
central pontine myelinolysis
43
Give differential diagnoses for chest pain.
ACS, PE, Pneumothorax, dissection, boerhavve's
44
Give examples of features which may suggest high risk in NSTEMI.
Poor LV function Previous CABG Other co-morbidities Raised trop Arrythmia
45
What is the usual treatment for DVT?
DOAC
46
Give potential causes for 'unprovoked' DVT.
Malignancy Clotting issues inc thrombophilia
47
How was IMT as a training programme conceived?
Transitioned from CMT in 2019 after 'Shape of Training' review
48
How does IMT differ from previous CMT?
Addition of IMT3, allows for a 'bridge' between SHO and Reg level, usually working as a junior reg with support
49
What are the three main aspects to the IMT curriculum?
Capabilities in Practice (CiPs), clinical knowledge, and procedures
50
What are the indications for emergency dialysis?
Refractory hyperkalaemia Metabolic acidosis Fluid overload unresponsive to treatment Symptoms of uraemia
51
Which classification score is used for stroke?
Oxford-Bamford
52
What is meant by a Total Anterior Circulation Stroke (TACS)?
3/3 features of weakness, hemianopia, cognitive
53
What is meant by TACS?
2/3 features of weakness, hemianopia, cognitive OR cognitive alone
54
What is meant by lacunar stroke?
pure motor/sensory without higher cognitive dysfunction This remains important in prognosticatio
55
What is the treatment for addisonian crisis?
100mg methylpred
56
What is the mechanism for adrenal crisis when steroids omitted?
Due to exogenous steroids, HPA axis becomes down-regulated meaning insufficient endogenous steroid production
57
Which criteria can be used to differentiate exudative and transudative pleural effusion?
Light's criteria
58
Which factors are involved in Light's criteria?
Serum/pleural LDH and serum/pleural protein
59
What is the pathophysiology of an exudative effusion?
Leakage of protein out of pleural space
60
What is the pathophysiology of a transudative effusion?
Fluid leaking INTO pleural space
61
What is the most common cause of a unilateral pleural effusion?
Malignancy
62
Give causes of exudative pleural effusion.
Malignancy Pneumonia RA TB
63
Give causes of transudative pleural effusion.
Heart failure Hypoalbuminaemia Hypothyroidism Meig's syndrome

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