Progress 9 (Page 119-136)

mbch4kz2's version from 2016-05-08 21:00


Question Answer
What is normal pH?7.35-7.45
What is normal pO2?10-14kPa
What is normal pCO2?4.5-6kPa
What is normal base excess?-2 to 2mmol/l
what is normal HCO3?22-26mmol/L
Name 4 causes of respiratory alkalosis1. Anxiety leading to hyperventilation 2. PE 3. Salicylate poisoning (mixed respiratory alkalosis and metabolic acidosis) 4. CNS disorders (stroke, subarachnoid haemorrhage, encephalitis) 5. Altitude 6. Pregnancy
What specific test would you do for congestive heart failure?B-type natriuretic peptide
What is the treatment pathway for acute severe asthma?1. 100% O2 2. Nebulised salbutamol (5mg) 3. Ipratropium bromide (500ug) 4. IV hydrocortisone (200mg) 5. If no improvement then IV Mg sulphate (1.2-2g) over 20mins 6. If IV Mg sulphate does not work then consider IV salbutamol
What is the treatment for haemophilus influenza infection?Amoxicillin
What is the treatment for acute exacerbations of COPD?1. Increase frequency of bronchodilator use and consider use of nebuliser 2. Give predniscolone 30mg daily for 7-14 days 3. Antibiotic treatment
What is the process of percutaneous coronary intervention?Cardiologist feeds a deflated balloon on a catheter from the inguinal femoral artery or radial artery until they reach the site of blockage- X-ray imaging used to guide catheters threading. A stint is often placed at the site of the blockage
What is polycythaemia rubra vera?A myeloproliferative disorder caused by clonal proliferation of a marrow stem cell, leading to an increase in red cell volume (often accompanied by overproduction of neutrophils and platelets)
What are the features of polycythaemia rubra vera?1. Hyperviscosity- spout bleeding from mucous membranes, visual disturbances and neurological signs 2. Pruritis (after hot bath) 3. Splenomegaly 4. Haemorrhage (secondary to abnormal platelet function) 5. Plethoric appearance (red face) 6. Hypertension
What is cystic fibrosis?An autosomal recessive disorder causing inreased viscosity in secretions (eg. lungs and pancreas). Due to a defect in the cystic fibrosis transmembrane conductance regulatory gene (CFTR) which codes a CAMP-regulated chloride channel.
What is patent ductus arteriosis?Connection between the descending aorta and pulmonary trunk. Acyanotic heart defect more common in premature babies and those born at high altitude
What are the features of a patent ductus arteriosis?1. Left subclavical thrill 2. Continuous machinery murmur 3. Large volume, bounding, collapsing pulse 4. Widespread pulse pressure 5. Heaving apex beat
How is patent ductus arteriosis managed?Indomethacin (NSAID) closes the connection in the majority of cases
What respiratory problems can be seen in patients with rheumatoid arthritis?Pulmonary fibrosis, pleural effusion, pulmonry nodules, bronchiolitis obliterans, complications of drug therapy (eg. methotrexate pneumonitis), pleurisy, Caplan's syndrome (massive fibrotic nodules with occupational coal dust exposure), infection (possible atypical) secondary to immunosuppression
What is target O2 sats for COPD patient at risk of hypercapnea88-92%
What is the immediate management of a COPD patient prior to the availability of blood gases28% O2 at 4L/min via a venturi mask- aim for O2 sats of 88-92% for patients with risk factors for hypercapnea but no prior history of respiratory acidosis- adjust target range to 94-98% if pCO2 is normal
What are shockable rhythms?Ventricular fibrillation and pulseless ventricular tachycardia

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