A+E

Question 1

hypocalcaemia causes

Answer 1

• hypoparathyroidism
• steroids
• blood transfusion
• hypomagesemia

Question 2

S+S hypocalcaemia

Answer 2

• Convulsions
• Arrhythmia
• Tetany
• Numbness
• Trousseau and chvostek

Question 3

diagnosis hypocalcaemia

Answer 3

• Ca <2.2
• ECG = prolonged QT

Question 4

Mx hypocalaemia

Answer 4

• calcium gluconate 10% 10ml over 10 m

Question 5

hypercalcaemia causes

Answer 5

• primary and tertiary hyperpara
• multiple myeloma
• cancer
• sarcoidosis
• thiazide diuretics

Question 6

S+S hypercalcaemia

Answer 6

• stones
• bones
• groans
• moans
• muscle tone

Question 7

Dx hypercalcaemia

Answer 7

• ca >2.6
• short QT

Question 8

mx hypercalcaemia

Answer 8

• 0.9% NaCl 1L 4hrs

Question 9

hypokalaemia symptoms

Answer 9

• metabolic alkalosis
• arrhytmia
• muscle weakness
• reduced reflexes
• constipation

Question 10

Hypokalaemia dx

Answer 10

• <3.5
• ECG = no T, long PR, long QT

Question 11

mx hypokalaemia

Answer 11

• 0.3% KCl 1L 4hrs

Question 12

hyperkalaemia S+S

Answer 12

• metabolic acidosis
• Arrhtyhmia
• Muscle weakness
• Diarrhoea

Question 13

Dx hyperkalaemia

Answer 13

• > 5.3
• tall tented T waves

Question 14

Mx hyperkalaemia

Answer 14

calcium gluconate 10% 30ml 10m
- short term = insulin and glucose, salbutamol

Question 15

bradycardia with evidence of life threatening signs

Answer 15

• Atropine 500mcg IV
  If no response
• Atropine 500mcg IV up to 3mg
• Isoprenaline 5mcg min IV
• Adrenaline 2-10 mcg min IV
• transcutaneous pacing
• Transvenous pacing

Question 16

shockable rhythms are

Answer 16

• VF
• Pulseless VT

Question 17

Non shockable are

Answer 17

• PEA
• Asystole

Question 18

Mx if shockable

Answer 18

• 1shock
• CPR 2 mins
• adrenaline after shock 3 then repeat 3-5 mins
• amiodarone after shocks 3 and 5

Question 19

Mx if non shockable

Answer 19

• CPR 2 mins
• adrenaline and repeat every 3-5 minutes

Question 20

what to give in polymorphic VT/TDP

Answer 20

magnesium 2g over 10 mins

Question 21

tachycardia with broad QRS, regular rhythm

Answer 21

• amiodarone 300mg IV over 10-60m
• unneffective = DC shock up to 3 attempts

Question 22

tachycardia with narrow QRS regular rhythm

Answer 22

• vagal manouvres
• Adenosine = 6,12,18
• then verapamil or BB

Question 23

tachy and narrow qrs irregular

Answer 23

• BB
• digoxin or amiodarone