Qesmed Bank Review Flashcards
Stages of Hypovolemic Shock
1 - Anxiety
2 - Agitation & tachy
3 - Shock, Confusion, Tachycard., Hypotensie, Tachyopneic, Reduced Pulse pressure
4 - Unconscious. HR 140+, and Extremely Hypotensive. Little to no output
A 27-year old female presents with right upper quadrant (RUQ) pain and fever. Her last menstrual period was 2 weeks ago, and she was last sexually active 10 weeks ago. They did not use a condom, but she is on the oral contraceptive pill. Her past medical history includes an appendectomy only. She is febrile but other observations are stable. On abdominal examination she is tender in the right upper quadrant. Bimanual vaginal exam reveals cervical excitation. Urine dip shows leucocytes but is negative on a pregnancy test. Bloods show a leucocytosis but are otherwise entirely normal. What is the most likely diagnosis
itz-Hugh Curtis syndrome is when pelvic inflammatory disease (PID) causes perihepatic inflammation, leading to RUQ pain and/or referred shoulder tip pain. Chlamydia is the most common culprit.
PID is indicated here by the presence of cervical excitation.
High vaginal swabs can confirm the diagnosis.
Perihepatic fine adhesions may develop as a later complication.
> doxycycline or azithromycin
A 17-year-old girl is admitted to hospital with a low BMI secondary to anorexia nervosa. While food and fluid are slowly reintroduced, she requires frequent monitoring of her serum electrolyte levels to guard against the development of refeeding syndrome.
Which ECG change may be seen in refeeding syndrome?
In refeeding syndrome, patients are at risk of low phosphate, magnesium and potassium levels, as well as hyperglycaemia. Prominent U waves are a feature of hypokalaemia and may therefore be seen in refeeding syndrome
