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The FCEM Notebook

The FCEM Notebook pdf – Revision notes and clinical resource for emergency physicians – 2015

The FCEM Notebook pdf


The FCEM Notebook pdf

The FCEM Notebook pdf free download

The FCEM Notebook ebook

Table of Contents:

CARDIOLOGY

Give the ECG features of VT 3

What are the associated stigmata of infective endocarditis? 4

How is the QT interval calculated? 5

List the causes of a long QT 5

List the causes of ST elevation 6

List the causes of a low-voltage ECG 7

List eight causes of sinus bradycardia 8

A well patient with no arrhythmias is experiencing multiple ICD

shocks. What is your management? 9

What does a ‘bleeping’ ICD indicate? 9

An ICD patient has received no device shocks but is in VT with

hypotension. What is your management? 9

What are the ECG findings in hypokalaemia? 11

Give six causes of hypokalaemia 11

What are the diagnostic features of Kawasaki disease? 12

DERMATOLOGY

What are the presenting features of HSP? 15

Which children require admission? 15

Describe the presenting features and the skin rash associated

with Lyme disease 17

How should a tick be removed? 17

What descriptors are used in dermatology? 19

Give five differential diagnoses of a bullous rash 19

Give the associated causes of Stevens Johnson 19

Give the causes of erythema nodosum 20

ENDOCRINOLOGY

What are biochemical findings in, and precipitants of, an acute

Addisonian crisis? 23

Give the causes of hypernatraemia, hyponatraemia,

hyperchloraemia and hypochloraemia 24

Give six possible differential diagnoses of hypoglycaemia in

an adult 25

What are the features of cerebral oedema with DKA in children? 26

ENVIRONMENTAL MEDICINE

Differentiate between the features of acute mountain sickness,

high altitude cerebral oedema and pulmonary oedema 29

What information is initially reported from a major

incident scene? 31

What are the clinical features of heat stroke? 32

What is the differential diagnosis of hyperpyrexia? 34

Define the ATMIST handover tool 35

GASTROENTEROLOGY

Give six medical causes of abdominal pain 39

What is the Alvarado score? 39

What are the biochemical findings associated with pyloric

stenosis? 40

List the causes of a metabolic alkalosis and the causes of a

respiratory alkalosis 41

What is the differential of jaundice in pregnancy? 42

Define the grades of encephalopathy 43

What are the causes of priapism and the treatment approach? 44

Give six causes of bowel obstruction in neonates 45

HAEMATOLOGY

What are the precipitants of an acute painful sickle crisis? 49

List the types of sickle cell crisis 49

Give the acute complications of a blood transfusion 51

Give the differential diagnoses of fever with petechiae in a

four-year-old 53

INFECTIOUS DISEASES

When is antibiotic prophylaxis indicated following

meningococcal meningitis contact? 57

Describe your approach to the management following a

needlestick injury from a discarded needle in a public toilet 58

Differentiate between SIRS and septic shock 59

Give the EGDT principles 59

State the discharge advice for a well two‑year-old presenting

with a fever and presumptive diagnosis of a viral URTI 61

MEDICOLEGAL

When should the coroner be informed following the death

of a patient? 65

What are never events? 66

What is your understanding of controlled drugs? 67

MUSCULOSKELETAL AND INJURY

What are the clinical findings in necrotizing fasciitis? 71

Describe the features of Kanavel sign and the significance

of this sign 73

Give the causes of a radial nerve palsy 73

What are the features of a tetanus-prone wound? 74

What is the UK tetanus immunization schedule? 74

Describe the clinical findings in tetanus 74

List the causes of compartment syndrome 76

Define the following eponyms 77

What are the findings in the following eponymous fractures? 79

What is the Parkland formula? 81

When are ankle/foot X-rays indicated following trauma? 82

Describe the key features to identify on a child’s elbow

radiograph 83

Give the complications and contraindications of intra-osseous

needle insertion 84

What are the presenting features of toxic shock syndrome in

children following a burn, and what is the initial management

approach? 85

NEUROLOGY

What are the presenting features of botulism? 89

List 10 stroke mimics 90

What are the clinical findings in cerebellar lesions? 91

Give five causes of cerebellar syndrome 91

Give the presenting features of Guillain–Barré syndrome 92

What can precipitate acute worsening of symptoms in

myasthenia gravis? 94

What is the treatment approach for a fitting child? 95

Give the features in history and examination which would

be important to elicit in a six-year-old presenting following

a first fit 96

OBSTETRICS AND GYNAECOLOGY

What is your initial approach on identification of umbilical

cord prolapse? 99

Describe the APGAR score 99

Describe the clinical features of pre-eclampsia and the

management of an eclamptic seizure 100

What is your approach on identifying shoulder dystocia? 102

List the causes of post-partum haemorrhage 102

OPHTHALMOLOGY

What are the findings in retrobulbar haemorrhage? 105

List the differential diagnosis of papilloedema 106

List the causes of, and clinical findings in, central retinal artery

occlusion 107

What are the fundoscopy findings in central retinal

vein occlusion? 108

Which conditions are associated with central retinal

vein occlusion? 108

What is Seidel’s test? 109

A patient presents with painful eyes following a day walking

in snow. What is the likely diagnosis? 110

PSYCHIATRY

Give organic causes of psychosis 113

How should capacity be assessed? 114

Give the differences between Sections 2, 3, 5(2) and 136 of

the Mental Health Act 115

RESPIRATORY

Describe the clinical features seen with SVCO (superior vena

cava obstruction) 119

Give six causes of pneumomediastinum 120

How can a difficult airway be predicted? 121

Give the causes of the following capnography traces in an

intubated patient: sudden loss of trace, gradually increasing

trace, slanted expiratory trace, gradually falling size 122

What are the echocardiography findings in a significant PE? 124

Give the causes of cavitating lung lesions 125

How can the severity of pneumonia be assessed in adults? 126

What is the differential diagnosis of new onset stridor in a

three-year-old? 127

Suggest features to differentiate between causes of stridor 127

Describe the UK childhood immunization schedule 127

How should a child with croup be initially assessed in the ED? 128

SAFEGUARDING

Which features of a bruise in a child would be concerning? 131

Describe concerning burns 131

Who has parental responsibility? 132

What are the Caldicott principles? 133

SPINAL

What are the symptoms, precipitants and treatment approach

in autonomic dysreflexia? 137

What are the concerning features in a patient with back pain? 138

What are the clinical findings in anterior cord, Brown-Sequard,

central cord and cauda equine syndromes? 139

TOXICOLOGY

What are the contraindications for the use of activated charcoal? 143

What are the indications for multidose activated charcoal? 143

Give the approach to managing an accidental injection of

EpiPen® into a thumb 144

What are the features of Wernicke encephalopathy? 145

Give the clinical findings and causes of methaemoglobinaemia 146

What are clinical features in organophosphate poisoning? 147

How can the anion gap be applied? 148

How is the osmolar gap calculated? 149

What are the features associated with a smoke inhalation injury? 150

What are the indications for starting renal replacement therapy? 151

How much 1% lignocaine can be used for a seven-year-old? 152

What are the features of local anaesthetic toxicity? 152

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