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Flashcards in Emergencies Deck (23)
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1
Q

How does spinal cord compression present?

A

Most people present with back pain,,particularly radical are (band like)

2
Q

What is the character of the pain in SCC?

A

Worse on coughing and straining. Burning pain in a band like distribution.

3
Q

Investigation of spinal cord compression?

A

MRI spine.

4
Q

Management of SCC>

A

16mg IV dexamethason followed by 8mg oral BD.

5
Q

What is the mainstay of treatment of spinal cord compression?

A

Radiotherapy (20Gy/5#)

6
Q

What are the symptoms of superiorvena cava obstruction?

A

Welling of face, neck or both arms.

Distend veins.
Shortness of breath.

Headache

Lethargy.

7
Q

Options for Vena cava obstruction if clot causing it?

A

Thrombolyis with alteplase or anticoagulastion with LMWH / warfarin.

8
Q

Best treatment option for vena cava obstruction?

A

Stent (95% response rate)

Relieves symptoms but does not treat the cause.

9
Q

How is SVCO best diagnosed?

A

CXR
Venogram (clots)
CT chest

10
Q

1st line management of someone with malignant hypercalcaemia?

A

IV fluids.

11
Q

Symptoms of hypercalcaemia in cancer patient?

A

Nauseated anorexia.
Thirsty
Polyuria + polydipsia.
Confused

12
Q

Most important blood test after calcium for hypercalcaemia?

A

U+Es to look for dehydration.

13
Q

Management apart from fluids for hypercalcaemia?

A

Bisphosphonates

- IV pamidronate over 2 hours.

14
Q

Becks triad of pericardial tamponade/

A

JVP distension.
Pulsus paradoixcus
Muffled heart sounds.

15
Q

INbvestigation for pericardial tamponade?

A

CXR
ECG (low complex size)
Echo (rim of fluid)
Cytology of fluid.

16
Q

Treatment of pericardial tamponade?

A

Pericardiocentesis.

17
Q

Does diastolic or systolic heart failure cause pericardial tamponade?

A

Diastolic.

18
Q

How is neutropenic sepsis defined?

A

Sepsis + neutrophil count <0.5

19
Q

Neutropenic sepsis criteria in someone who has had chemo in last 21 days /

A

Neutrophils count < 1.0

20
Q

Note:

A

If chemo within the last 3 weeks and temp > 37.5 or clinically septic give ABx within 1 hour

21
Q

Neutropenic sepsis and NEWS score < 6 management?

A

Piperacillin and tazo bactam (no gent)

22
Q

Neutropenic sepsis and NEWS > 7

A

Piperacillin, tazobactam and gentamicin.

23
Q

Management of PE in cancer patient?

A

LMWH for 6 months.