Some kfp stuff


Some drug doses
Question | Answer |
---|---|
Pharmacotherapy for paracetamol overdose | Acetylcysteine 150 mg/kg IV infusion, over 15 to 60 minutes. Then 50 over 4 hrs, then 100 over 16 hours. |
Toxic dose of paracetamol | Acute dose: 10g or 200mg/kg. Supratherapeutic: >10g or 200mg/kg per 24 hrs, or 6g / 150mg/kg per 24h over 48h; or >4g/day or 100mg/kg/d; or >4g or 100mg/kg in someone with risk factors. |
Drugs for acute gout | Colchicine 1 mg orally initially, then 500 micrograms 1 hour later. Ibuprofen 400mg tds. Prednisone 30mg / day for 5 days. |
Dosages for smoking cessation | Nicotine 21mg/24hr transdermally, once daily for 24h. Varenicline 0.5mg/d for 3 days, then bd for 4 days, then 1mg bd for remainder of 12 weeks. |
Antidepressant with lowest risk of serotonin syndrome | Mirtazapine 15 to 30 mg orally, at night |
Mixed bag 1
Question | Answer |
---|---|
Margins for BCC | 3-4mm. Other options include radiotherapy (for frail), photodynamic therapy (nodular, superficial), cryotherapy (confirmed histo, well defined tumour, not head/neck), imiquamod (superficial). |
Fertility tests | FSH (day 3). Progesterone (7 weeks prior to menses). |
Interstitial lung disease, examples | 1. Idiopathic, eg idiopathic pulmonary fibrosis. 2. Multisystem dz, eg connective tissue dz, sarcoid, IBD. 3. Environmental, eg. hypersensitivity pneumonitis, pneumoconiosis, drug/radiation induced. 4. Other, eg. histiocytosis. |
Non-ACS causes of elevated troponins | 1. iatrogenic (cardiac contusion/surgery, ablation, pacemaker implantation) . 2. other heart disease (aortic dissection, aortic valve disease, hypertrophic cardiomyopathy, tachyarrhythmias, Takostubo, myocarditis) . 3. pulmonary (embolism, hypertension) . 4. neurological (stroke or SAH) . 5. other such as renal failure, rhabdo, severe illness (resp failure, sepsis), infiltrative disease (eg amyloidosis, haemochromatosis, sarcoidosis, and scleroderma) |
Components of planning for future medical events for elderly patients | 1. appoint medical EPOA, 2. create AHD, 3. create health summary, 4. establish MyHealth Record, 5. ACAT assessment. |
Surgical sieve | Metabolic, Autoimmune, Genetic, Infective, Cancer, Acquired (eg. COPD, asbestosis), Degenerative, Drugs, Insanity, Trauma, Idiopathic, Vascular, Endocrine |
Risk factors for BCC | 1. previous BCC/skin cancers; 2. skin damage (sun damage, repeated sunburn, prev cutaneous injury, prev thernal burn), 3. ionising radiation, 4. immunosuppression, 5. arsenic |
Emergencies!
Question | Answer |
---|---|
Meningitis | benzylpenicillin [60 mg/kg up to] 2.4 g IV or IM - max infusion rate 300mg/min. |
Epiglottitis | maintain airway, don't examine throat; urgent escorted transfer to hospital. close monitoring. empirical abx is ceftriaxone 50mg/kg up to 1g, daily for 5 days. |
Acute MI | Aspirin 300mg chewed or dissolved. GTN 400mcg spray subling every 5 minutes to max 1200mcg. Morphine 5-10mg every 5 minutes as required. O2 if required to maintain SpO2 94-96%. If reperfusion therapy for STEMI: reteplase 10u IV bolus, repeat once after 30 minutes |
Anaphylaxis | Remove allergen, call for help, and lie the patient flat. 0.01mL/kg of 1:1000 adrenaline (1mg per mL), up to maximum 0.5mL. Repeat every 5 minutes as needed. Monitor abc's; give high flow O2 and/or 20mL/kg normal saline bolus if required. |
Lumbar nerve roots
Question | Answer |
---|---|
Tests for L3 compromise | Femoral stretch test. Extension of knee. Sensation: anterior thigh. Knee jerk (L3/L4). |
Tests for L4 compromise | Resisted inversion of foot [resisted eversion is S1]. Sensation: inner border of foot to great toe. Knee jerk (L3/L4). |
Tests for L5 compromise | Great toe/foot dorsiflexion (heel walking) [toe walking is S1]. Sensation: middle 3 toes. |
Test for S1 compromise | Walking on toes [heel walking is L5], resisted eversion [resisted inversion is L4]. Sensation: little toe, most of sole. Reflex: ankle jerk. |
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