Presentations

Question 1

What is the management of paracetamol overdose?

Answer 1

• Activated charcol if <1 hour ago
• N-acetylcysteine
• liver transplant

Question 2

What is the management of an opioid overdose?

Answer 2

Naloxone

Question 3

What is the managment of a tricyclic antidepressant overdose?

Answer 3

• IV bicarbonate

Question 4

What is the managment of a lithium overdose?

Answer 4

• normal saline fluid resus
• haemodialysis if severe

Question 5

What is the management of a warfarin overdose?

Answer 5

• vitamin K
• prothrombin complex

Question 6

What is the management of a heparin overdose?

Answer 6

Protamine sulphate

Question 7

What is the management of lead toxicity?

Answer 7

• Dimercaprol
• calcium edetate

Question 8

What is the management of carbon monoxide poisoning?

Answer 8

• 100% oxygen
• hyperbaric oxygen

Question 9

What are the features of a salicylate overdose?

Answer 9

• hyperventilation
• tinnitus
• lethargy
• sweating, pyrexia
• nausea/vomiting
• hyper and hypo glycaemia
• seizure
• coma

Question 10

What is the presentation of anaphylaxis?

Answer 10

• swelling of the throat and tongue causing hoarse voice and stridor
• respiratory wheeze
• dyspnoea
• hypotension
• tachycardia
• pruritis, widespread erythematous or urticarial rash

Question 11

MAnagement of anaphylaxis in under 6 months

Answer 11

Adrenaline 100-150 micrograms (1 in 1000)

Question 12

Management of anaphylaxis in 6 month to 6 year olds

Answer 12

150 micrograms (0.15ml of 1 in 1000)

Question 13

Management of anaphylaxis in 6-12 year olds

Answer 13

300 micrograms (0.3ml 1 in 1000)

Question 14

Management of anaphylaxis in >12

Answer 14

500 micrograms (0.5ml 1in 1000)

Question 15

Where is the best site for IM adrenaline injection?

Answer 15

Anterolateral aspect of the middle third of the thigh

Question 16

What is refractory anaphylaxis?

Answer 16

• respiratory and/or cardiovascular problems persist despite 2 doses of IM adrenaline

Question 17

What are the causes of syncope?

Answer 17

Reflex:
- vasovagal: emotion, pain, stress
- situational
- carotid sinus syncope

Orthostatic
- Primary: parkinsons, lewy body dementia
- Secondary: diabetic neuropathy, amyloidosis, uraemia
- drug induced
- volume depletion: diarrhoea, haemorrhage

Cardiac:
- arrhythmia
- structural
- PE

Question 18

What are the primary autonomic failure causes of syncope?

Answer 18

• Parkinsons
• Lewy body dementia

Question 19

What are the secondary autonomic failure causes of syncope?

Answer 19

• diabetic neuropathy
• amyloidosis
• uraemia

Question 20

What are the drug induced causes of syncope?

Answer 20

• diuretics
• alcohol
• vasodilators

Question 21

What is the evaluation of syncope?

Answer 21

• Cardiovascular examination
• postural BP reading
• ECG
• carotid sinus massage
• tilt table test
• 24 hour ECG

Question 22

Post fall

Answer 22

• history
• collateral history
• underlying cause: postural hypo, med review, infection

Question 23

Define a fall

Answer 23

Sudden, unintentional change in position from a higher surface to a lower surface coming to rest on the floor, an object, or the ground.

Question 24

Define a fall with harm

Answer 24

Any fall needing radiological intervention or resulting in harm

Question 25

What are the types of continence?

Answer 25

Stress or urge

Question 26

What is stress incontinence?

Answer 26

Cough/sneeze/laugh/increased pressure, are not able to control the bladder, weak pelvic floor and sphincter muscles

Question 27

What is urge incontinence?

Answer 27

Feel the need to go to the toilet but cannot make it on time. over activity of the detrusor muscle

Question 28

What are the risk factors for incontinence?

Answer 28

- age - bmi - cognitiive impairment - neurological impairement - pregnancy - pelvic floor prolapse - post-menopausal

Question 29

How to you assess continency?

Answer 29

- bi manual exam - urine dipstick - no acute cause - bladder scan: post void residual volume - urodynamic test - catheter

Question 30

What is the management of stress continency

Answer 30

- Avoid triggers - weight loss - reduced fluid intake - supervised pelvic floor exercise

Question 31

What is the management of urge continence?

Answer 31

- anticholinergics - oxybutynin - bladder retraining

Question 32

What is the treatment of alzheimers

Answer 32

Donepezil

Question 33

What is delerium?

Answer 33

An acute transient state of confusion

Question 34

Anticipatory care plan

Answer 34

Dynamic record developed over time through evolving conversations, collaborative actions and shared decision making. - level of intervention preferred - resus status - preferred place of care - post death wishes

Question 35

Just in case meds

Answer 35

- pain relief morphine - breathlessness and agitation medazolam - anti emetic: based on cause (brain mets: dex cyclozine) - hyoscine bromide for secretion

Question 36

What are the types of pain?

Answer 36

- nociecptive: injury, pressure, inflammation * somatic: skin muscle tendon bone * Visceral: pain arising from infiltration or compression of the viscera (liver capsule pain) - Neuropathic pain: damage to the central or peripheral nervous system

Question 37

Symptoms of dying phase

Answer 37

- reduced GCS - low mood - withdrawn - profound weakness - poor appetite - difficulty swallowing - temperature change at extremities - terminal restlessness

Question 38

What is palliative care

Answer 38

An approach that improves the quality of life of patients and families facing problems associated with life threatening illness through prevention and relief of suffering

Question 39

chemo

Answer 39

Ondansetron

Question 40

Brain mets

Answer 40

cyclozine or dex

Question 41

Hypercalcaemia

Answer 41

Halliperidol

Question 42

Constipation related nausea

Answer 42

metoclopramide

Question 43

What makes you feel sick

Answer 43

- vestibulocochlear - chemotactic: chemical or biochemical - gut - limbic

Question 44

Anterior artery stroke

Answer 44

lower more than upper

Question 45

Middle artery stroke

Answer 45

upper more than lower

Question 46

Anterior inferior cerebellar stroke

Answer 46

ipsillateral facial paralysis and deafness

Question 47

Nephrotic sydrome complications

Answer 47

- infection: immunoglobulin - VTE: antithrombin III, - hyperlipidaemia - CKD - hypocalcaemia