acute

• What is the definition of infection?

  Invasion and multiplication of organisms
• How is sepsis defined?

  Life-threatening organ dysfunction due to infection
• What characterizes septic shock?

  Sepsis with persisting hypotension requiring vasopressors
• What is the most common cause of sepsis?

  Pneumonia
• What are some risk factors for sepsis?

  Age <1 or >75, frailty, trauma
• What does a NEWS2 score greater than 5 indicate?

  Increased likelihood of sepsis
• What is a red flag symptom of sepsis?

  New confusion or altered mental state
• What does a lactate level greater than 2mmol/L indicate?

  Possible sepsis or tissue hypoperfusion
• What is the significance of a heart rate greater than 130 bpm in sepsis?

  It is a red flag symptom
• What is the purpose of basic blood investigations in sepsis?

  To assess organ function and infection
• What are the components of the sepsis 6 management protocol?

  1. Maintain oxygen saturation >94%
  2. Administer IV antibiotics within the first hour
  3. Provide IV fluids even if BP is stable
  4. Take cultures before starting antibiotics
  5. Measure lactate levels
  6. Monitor urine output
• When should patients with lactate >4 be referred?

  To critical care
• What is antimicrobial stewardship?

  Optimal selection and duration of antimicrobial treatment
• What defines major haemorrhage?

  Life-threatening bleeding requiring massive transfusion
• What is the definition of shock?

  Circulatory failure with inadequate organ perfusion
• How is haemorrhagic shock classified?

  By volume of blood loss
• What are the classifications of haemorrhagic shock based on blood loss?

  1. Class 1: <750ml or <15%
  2. Class 2: 750-1500ml or 15-30%
  3. Class 3: 1500-2000ml or 30-40%
  4. Class 4: >2000ml or >40%
• What does SCALPeR stand for in causes of haemorrhage?

  Scalp, Chest, Abdomen, Long bones, Pelvis, Retroperitoneum
• What are the initial measures in catastrophic haemorrhage management?

  • Direct pressure and haemostatic dressings
  • Application of tourniquets
  • Use of Cellox
  • Splinting or binding fractures
  • Suturing or tying off blood vessels
• What is the blood product ratio in major haemorrhage management?

  1:1 blood to FFP
• What is the lethal triad in major trauma?

  Hypothermia, coagulopathy, acidosis
• What temperature indicates hypothermia in trauma patients?

  Temperature <36 degrees
• How does acidosis affect clotting?

  It contributes to coagulopathy
• What is the purpose of damage control resuscitation?

  To prevent the lethal triad from manifesting
• What are the measures to prevent the lethal triad?

  • Stop or reduce active haemorrhages
  • Apply blankets and warmed fluids
  • Minimize exposure
  • Aggressive resuscitation with blood products
• What is anaphylaxis?

  Life-threatening type 1 hypersensitivity reaction
• What are the risk factors for anaphylaxis?

  Allergic rhinitis, asthma, eczema
• What are common precipitants of anaphylaxis?

  Foods, drugs, insect stings, latex
• What are the phases of anaphylaxis pathophysiology?

  1. Sensitisation phase: IgE production
  2. Effector phase: re-exposure causes mast cell degranulation
• What are the criteria for diagnosing anaphylaxis?

  Sudden onset, life-threatening ABC problems, skin changes
• What is the first-line treatment for anaphylaxis?

  0.5ml/mg 1:1000 Adrenaline IM
• What are the steps in acute management of anaphylaxis?

  • A to E assessment
  • Administer adrenaline
  • Remove allergen
  • Maintain airway and give O2
  • IV access and fluid challenge
• What are rapidly reversible causes of altered consciousness?

  Hypoglycaemia, dehydration, heat stroke
• What are the categories of causes for altered consciousness?

  • Cardiorespiratory
  • Infectious
  • Metabolic
  • Toxic
  • Mental health
  • Other causes
• What is the most common cause of acute liver failure in the UK?

  Paracetamol overdose
• How is paracetamol metabolised in the liver?

  Primarily to non-toxic metabolites
• What happens in paracetamol overdose?

  Metabolism pathways become overwhelmed
• What is NAPQI in paracetamol metabolism?

  Toxic metabolite formed in overdose
• What happens when glutathione is depleted in paracetamol overdose?

  NAPQI binds to hepatocellular proteins
• What is the command response level for a score of 6?

  Obeys commands