Title 30 Critical Care LMV 5.1.pdf ✅

1 | P a g e [ C r i t i c a l C a r e ] © Copyright www.plab1keys.com (Constantly updated for online subscribers) Copyrights @ Plab1Keys.com Critical Care Version 5.1 Corrected, Updated, Lighter PLAB 1 Keys is for PLAB-1 and UKMLA-AKT (Based on the New MLA Content-Map) With the Most Recent Recalls and the UK Guidelines ATTENTION: This file will be updated online on our website frequently! (example: Version 2.5 is more recent than Version 2.4, and so on) Plab1keys.com Strict Copyrights! No Sharing or Copying Allowed by any means Compensations and Penalties Worldwide System is Active
2 | P a g e [ C r i t i c a l C a r e ] © Copyright www.plab1keys.com (Constantly updated for online subscribers) Copyrights @ Plab1Keys.com Key 1 TCA (Tricyclic Antidepressant) Overdose (e.g. Amitriptyline) ◙ Excessive sedation, Dry mouth and skin. ◙ Sympathomimetic effect: tachycardia, Sweating, Dilated Pupils. ◙ ECG: Sinus tachycardia (Common), Prolongation of QRS, QT, PR Dilated pupils – Dry mouth – Dry flushed skin – Drowsiness – Hypotension – Urine retention – Tachycardia – Severe Sedation ◙ ECG monitoring is essential: Widened QRS, PR, QT and Broad complex tachycardia. ◙ As the patient is in severe metabolic Acidosis → give an IV bolus of 250 ml Normal Saline (0.9%). + Sodium Bicarbonate (50 mmol IV slowly) of 8.4% NaHCO3. ♠ N.B. aim for pH of 7.5-7.55! ♠ Sodium bicarbonate will correct ECG changes and cardiac rhythm. ♠ Do not forget that in a patient with amitriptyline (TCA) overdose, if he is acidotic, 2 steps to be done:
3 | P a g e [ C r i t i c a l C a r e ] © Copyright www.plab1keys.com (Constantly updated for online subscribers) Copyrights @ Plab1Keys.com 1) ECG monitoring. 2) IV fluids including Sodium Bicarbonate (HCO3). In a previous exam, the candidates were asked about the dose of the Sodium Bicarbonate, the answer was: → IV fluids + Sodium Bicarbonate 50 ml of 8.4% IV. Key 2 Refeeding Syndrome A 22 YO ♀ with a BMI of 12 kg/m2 was admitted to the medical ward for feeding through a nasogastric tube. What electrolyte abnormality is expected? → Hypophosphatemia (↓ Phosphate)
4 | P a g e [ C r i t i c a l C a r e ] © Copyright www.plab1keys.com (Constantly updated for online subscribers) Copyrights @ Plab1Keys.com