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Flashcards in Key Deck (40):
1

Normal pH value in ABGs?

7.35-7.45

2

Normal PaCO2 value?

4.6-6

3

Normal PaO2 value?

11-13

4

Normal HCO3- value?

22-26

5

Normal BE value and meaning?

-2 to +2
(more positive means higher HCO3- in system)

6

4AT model?

Alert 4 (if clearly abnormal)
AMT4: Age, dofb, location, year (1 if 1 mistake, 2 if 2 or more mistakes)
Attention: (1 if <7 months, 2 if unable)
Acute: (4 if yes)

7

Results of 4AT?

>4 delirium likely
1-3 cognitive impairment
0 delirium still possible

8

Obstructive FEV1:FVC ratio?

<0.7

9

Restrictive FEV1:FVC ratio and why?

>0.8 FEV1 reduces at a lower rate than FVC

10

CURB 65?

Confusion
Urea >7
RR >30
BP <90, <60
65

11

CURB 65 results and abx?

0-2 mild/mod: amoxicillin 1g TDS for 5 days
3-5 severe: IV co-amox 1.2g TDS and PO doxy 100mg BD

12

What does 0.9% NaCl contain and what kind of solution is it?

154mmol/l Na and Cl
Isotonic crystalloid

13

What does Hartmanns contain and what kind of solution is it?

Na 131, K 5, Ca 2, Cl 111, HCO3- 29
Isotonic, crystalloid

14

What does 5% dextrose contain and what kind of solution is it?

50g glucose
Isotonic until glucose metabolised then hypotonic

15

Why do colloids expand only the intravascular volume and give an example?

The cannot pass through the semipermeable membrane (e.g isoplex)

16

How to put up a fluid bag?

Confirm identity
Check bag
Close valve on giving set and attach to bag
Open valve to flush tube
Close valve and squeeze reservoir till half full
Check for bubbles in tube
Attach to cannula and set flow rate

17

What flow rate if delivering 500mls fluid 4hrly?

125mls/hr

18

What flow rate if delivering 1unit of blood 2hrly?

(450mls)
225mls/hr

19

Resus fluids?

500ml IV stat
If elderly or cardiac failure consider 250ml IV stat to avoid fluid overload

20

What rate can K be given at?

max 10 mmol/hr

21

What is a good maintenance fluid regime?

1L: 1 salty (NaCl), 2 sweet (5% dextrose) + 20mmol KCl per bag (over 8hrs 125mls/hr)

22

Antihistamine in anaphylaxis?

Chloramphenamine 10mg IV

23

Nebuliser application?

Fill nebuliser chamber with dose (can draw up with syringe and needle) close chamber and attach to mask
Place on patient before plugging to oxygen
6l/min

24

Review consultation?

Content
Problems
Management
Monitoring
Complications

25

Dopamine anatgonist anti emetic?

Metoclopramide 10mg IV over 3 mins

26

Antihistamine anti emetic?

Cyclizine 50mg IV TDS

27

Serotonin (5HT3) antagonist anti emetic?

Odansatron

28

What are the main oxygen delivery devices the flow rates and FiO2?

Nasal cannula: 1-6L/min 24-48%
Simple face mask: 10-22L/min 40-60%
Venturi mask: 2-15L/min 24-60%
Non rebreather (has a one way valve to prevent inspiration of room air) 15L/min (80%)

29

What are the major benefits of venturi mask and the different colour attachments?

Best for controlled oxygen delivery
Blue: 2L (24%)
White: 4L (28%)
Yellow: 8L (35%)
Red: 10L (40%)
Green: 15L (60%)

30

What is FiO2 of normal air?

Approx 20%

31

SIRS criteria?

RR >20, HR >90, temp >38, <36
Altered mental state, known or suspected neutropenia, WCC <4 >12

32

Neuro power scoring system?

0 paralysis
1 some muscle contraction
2 movement without gravity
3 movement against gravity
4 movement with some resistance
5 normal against resistance

33

Aortic stenosis

Systolic
Cresendo decresendo
Slow rising pulse
Radiates to carotid (listen with bell)
Best heard over RSE/aortic area

34

Aortic regurge

Diastolic
Decresendo
Best heard at erbs point (3ICS LSE)
Accentuated by leaning foreward with diaphragm over erbs point
Collapsing/waterhammer pulse
Widened pulse pressure

35

Mitral stenosis

Diastolic rumble
Accentuate by rolling over onto LHS with bell over 5th ICS MCL
Best heard at apex

36

Mitral regurge

Pan systolic
Radiates to axilla
Loudest at apex

37

What is drip and suck?

NBM, NG tube decompression, fluids and balance, catheter

38

Investigations in suspected abdominal obstruction?

Abdo exam, PR (blood), AXR, erect CXR, bloods

39

Differentiating between small and large bowel obstruction?

SI: >3cm, central, valvulae contuents
LI: >6cm or 9cm at coaecum, peripheral, haustra

40

Management of bowel obstruction?

If no signs ischaemia or perforation (pain worse on movement, focal pain, pyrexia, free air under diaphragm) Drip and suck with pain relief if no improvement in 48hrs then surgery
If signs of ischaemia urgent surgery