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What is a hairline fracture characterized by?

Low-moderate force
Repetitive stress or minor trauma
Bone cortex cracks but overall shape stays aligned

Hairline fractures are often seen in athletes or individuals with repetitive activities.

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What causes an oblique fracture?

Angled force + compression
Often combined with rotation/twisting forces
Causes the bone to shear at an angle

Oblique fractures can occur in various activities, especially in sports.

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What is a linear fracture and where is it commonly found?

Force applied in line with bone (compression)
Common in skull and long bones from direct impact

Linear fractures are typically the result of a direct blow.

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What defines a comminuted fracture?

Bone breaks in 3 or more pieces
High energy trauma
Crush injuries, MVC

Key concerns include bleeding, more swelling, and higher risk of compartment syndrome.

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What is a spiral fracture caused by?

Torsion/twisting
Classic with foot planted + body rotating
Common in sports injuries, especially in children

Spiral fractures often indicate a significant force applied to the bone.

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What is a greenstick fracture?

Occurs in children
Bone is more flexible
Force bends the bone

Greenstick fractures are incomplete fractures where the bone bends and cracks on one side.

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What are the main functions of the spleen?

Filters blood
Immune function
Stores blood components
Holds a reserve of platelets

The spleen is highly vascular and plays a crucial role in the immune response.

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What does the liver do?

Makes bile
Detoxifies/processes chemicals
Metabolizes nutrients
Stores glucose as glycogen
Releases glucose when needed
Handles fat + protein processing
Produces albumin and clotting factors
Stores vitamins

Bile helps digest fats and is stored in the gall bladder.

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What are the two functions of the pancreas?

Endocrine: hormone for blood sugar (glucagon)
Exocrine: digestive enzymes

The pancreas plays a critical role in both digestion and blood sugar regulation.

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What is alteplase used for?

Breaks down blood clots
Converts plasminogen -> plasmin
Plasmin digests fibrin, which holds clots together

Alteplase is commonly used in cases of acute ischemic stroke.

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What is Form 1 in the Mental Health Act?

Physician’s application for psychiatric assessment
Effective for 7 days
Assessment hold, not forced treatment

Treatment may be reused if the patient is capable.

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What does Form 2 in the Mental Health Act entail?

Justice of peace order
Orders police to take a person to hospital for assessment

This form is used when immediate assessment is necessary.

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What does Form 3 signify in the Mental Health Act?

Person becomes an involuntary patient
Can be kept in hospital for psychiatric care under the act

This form is used when a person poses a risk to themselves or others.

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What is the Sgarbossa criteria used for?

Diagnose acute MI/coronary occlusion
When ECG is hard to read for STEMI

Particularly useful in patients with left bundle branch block or ventricular paced rhythm.

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What are the main signs/symptoms of mild hypothermia (35-32°C)?

Shivering
Cold, pale skin
Tachycardia
Hypertension (early)
Slurred speech
Confusion

These symptoms occur as the body attempts to generate heat.

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What characterizes moderate hypothermia?

Shivering decreases or stops
Bradycardia
Bradypnea
Hypotension
Decreased LOC
Dilated pupils/sluggish
Weak pulse

Metabolism slows, and the body can no longer sustain shivering.

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What is carbon monoxide and its effects?

Toxic gas
Binds to hemoglobin with stronger affinity than oxygen
Causes headache, dizziness, weakness, fatigue
Can lead to confusion, altered mental status, syncope, seizures, or coma

Carbon monoxide poisoning can be life-threatening due to reduced oxygen delivery.

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What happens in carbon dioxide retention?

Normal waste gas from metabolism
Problems occur when you can’t ventilate it out
Symptoms include headache, flushed/warm skin, confusion, decreased RR

Conditions like COPD exacerbation and severe asthma can lead to carbon dioxide retention.

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Why do we give high concentration oxygen to patients suspected of carbon dioxide poisoning?

To saturate blood with free oxygen to compensate for hypoxia

This helps improve oxygen delivery to tissues.

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What are the three fetal shunts?

Ductus venosus
Foramen ovale
Ductus arteriosus

These shunts allow oxygen-rich blood from the placenta to bypass the non-functioning fetal lungs.

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What happens to the ductus venosus after birth?

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Closes and becomes ligamentum venosum

This occurs when the umbilical cord is clamped and placental circulation stops.

What occurs to the foramen ovale after birth?

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Closes and becomes fossa ovalis

This happens as left atrial pressure increases when the baby breathes.

What happens to the ductus arteriosus after birth?

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Closes and becomes ligamentum arteriosum

This occurs when oxygen levels rise and prostaglandins fall.

What is a bleb and its significance?

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Most common in spontaneous pneumothorax
Tall, thin, young people at risk
Can rupture due to coughing, stretching, or pressure changes

When a bleb ruptures, air leaks out of the lung, causing pneumothorax.

What does **Grey's Turner sign** indicate?

* Bruising around flanks * Indicates bleeding deep inside the abdomen (retroperitoneal space) ## Footnote Conditions causing it include acute hemorrhagic pancreatitis and severe blunt abdominal injury.

What are the signs and symptoms of **SVT**?

* Loss of atrial kick * Preload drops * Coronary perfusion drops * Breathlessness when heart racing ## Footnote These symptoms occur due to inadequate filling time and reduced cardiac output.

How does reduced coronary artery circulation affect the **LV**?

* LV muscle becomes ischemic (O2 starved) * Less ATP = weaker contraction * SV drops, CO drops unless HR increases enough to compensate ## Footnote Ischemia worsens with higher afterload, leading to LV hypertrophy.

What happens to the **ventricles** when the myocardium is exhausted its ability to respond to each pulse?

They can’t fill properly ## Footnote The rate is so fast that it leads to decreased preload and stroke volume.

When the myocardium becomes ischemic, what happens to **ATP production**?

It drops ## Footnote This leads to weaker contractions and worse calcium handling.

What are the **consequences** of excessive ketones in the bloodstream?

* Excessive H⁺ * Loss of base * Metabolic acidosis ## Footnote Insulin deficiency leads to increased lipolysis and ketone production.

What are the **signs** of tension pneumothorax?

* Distended neck veins * Tachycardia * Shortness of breath * Mediastinal shift ## Footnote High pressure in the venous system occurs because blood can’t return to the heart.

What is the **direct cause** of metabolic acidosis in hyperglycemia?

Excessive ketones in the blood ## Footnote This is caused by insulin deficiency leading to increased hydrogen ion concentration.

What hormones released by the **placenta** during the 2nd and 3rd trimester increase insulin resistance?

* Progesterone * Estrogen * Cortisol * Placental growth hormone ## Footnote These hormones cause the mother to need to produce more insulin to maintain normal blood sugar levels.

What is the **effect** of cholinergic overdose?

* Salivation * Lacrimation * Urination * Defecation * GI cramping * Emesis ## Footnote This is caused by excess acetylcholine due to the inhibition of acetylcholinesterase.

What is **compartment syndrome**?

Increased pressure within a compartment restricting blood flow ## Footnote This can occur after bleeding or swelling from an injury.

What do **ACE inhibitors** do?

Prevent the production of angiotensin II ## Footnote They interfere with the renin-angiotensin-aldosterone system.

What is the **characteristic** of uterine ruptures?

Severe and steady tearing pain in the uterus ## Footnote This occurs usually in the 3rd trimester during labor.

What are the **classic signs** of aortic contraction?

* High BP in arms * Weak/absent femoral pulses * Cold feet/pale legs ## Footnote High pressure is found before the narrowing and low pressure after.

What happens to the **baby** when the mother's glucose is high due to gestational diabetes?

Baby's glucose is high ## Footnote The baby's pancreas responds by producing lots of insulin.

What is the **function** of the auditory ossicles?

Responsible for hearing ## Footnote They transmit sound vibrations from the air to the inner ear.

What does **dromotropic** refer to?

The effect on the speed of electrical signals in the heart ## Footnote This includes conduction from the atria to the ventricles via the AV node.

What is **tidal volume**?

The amount of air inhaled or exhaled in a single, normal breath ## Footnote Typically around 500 mL in adults.

What is the **effect** of serotonin syndrome on mental status?

* Agitation * Confusion * Restlessness * Delirium * Coma ## Footnote These symptoms arise from excessive serotonin in the body.

What are the **neuromuscular abnormalities** associated with serotonin syndrome?

* Tremor * Clonus * Hyperreflexia * Muscle rigidity * Akathisia ## Footnote These symptoms result from excessive serotonin affecting the nervous system.

What are the **serious complications** of serotonin syndrome?

* Rhabdomyolysis * Myoglobinuria * Renal failure * Respiratory failure * Seizures * Death ## Footnote These complications can arise from untreated serotonin syndrome.

What is the **role** of oncotic pressure?

Draws water from surrounding tissue back into the capillaries ## Footnote It opposes hydrostatic pressure and is crucial for maintaining blood volume.

What happens to the **skin** during shock?

* Coolness * Clamminess ## Footnote This occurs due to vasoconstriction and activation of the sympathetic nervous system.

What is the **outcome** of a spinal cord injury at C1-C5?

Loss of ability to breathe properly ## Footnote This can also lead to neurogenic shock due to loss of sympathetic tone.

What is the **consequence** of a myocardial infarction occluding the RCA?

Heart block ## Footnote This is not a late-stage symptom and can often resolve with treatment.

What is the **characteristic** of simple pneumothorax?

Decreased lung sounds on one side ## Footnote This occurs due to a collection of air in the pleural space.

What must drugs be to affect the **CNS**?

Lipid soluble ## Footnote Lipid soluble drugs can cross the blood-brain barrier, while water-soluble drugs cannot.

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