PHTLS EXAM PREPARATIONS AND SOLUTIONS

PRAEVIA: (placenta is near or covers the cervical opening) colour - bright red loss - visible uterus - soft pain - nil level of shock - proportionate to visible blood loss clotting - usually clotting normally presenting part -high/displaced - The greatest risk of placenta previa is bleeding (or hemorrhage). Bleeding often occurs as the lower part of the uterus thins during the third trimester of pregnancy in preparation for labor. This causes the area of the placenta over the cervix to bleed. The more of the placenta that covers the cervical os (the opening of the cervix), the greater the risk for bleeding. Other risks include the following what are the 4 T's of post partum haemorrhage -Answer- Tone Trauma Tissue (retained) Thrombin (coagulation problems) what is defined as PPH and Severe PPH? -Answer- PPH = 500mls blood loss severe = 1000mls blood loss define seizures -Answer- "abnormal paroxysmal discharge of cerebral neurons" manifests clinically as changes in motor, sensory, behavioural or autonomic function asthma -Answer- PATHO: - submucosal inflammation/oedema to lower airway walls - hyper-reactive lower airways (contract in response to a trigger (intrinsic/extrinsic) - increased mucus production - inflam + spasm + mucus = air entry & exp wheeze SIGNS/SYMPTOMS: wheeze/silent, +effort/accessory muscles, recessions, tachycardia, diaphoresis, pale/cyanosis, anxiety MANAGEMENT: oxygen if tolerated, positioning, reassurance salbutamol, atovent, adrenaline, monitor ECG what is status epilipticus? -Answer- at least 30 minutes of persistent seizure activity OR a series of persistent seizures without return to full consciousness between siezures