ABCDE - Specific

Question 1

What should be added to the second bag of fluids in DKA in most cases?

Answer 1

40mmol KCl

Question 2

What four drugs should you give to a patient with ACS? How would you give each one?

Answer 2

Morphine (IV), GTN (sublingual), aspirin and ticagrelor (oral)

Question 3

You shouldn’t give IV furosemide to patients with pulmonary oedema who have what clinical sign? What should you do instead?

Answer 3

Hypotension - contact the critical care team

Question 4

What dose of nebulised ipratropium bromide should be given in acute asthma/COPD?

Answer 4

500mcg

Question 5

What should be done when blood glucose falls below 15mmol/l in DKA?

Answer 5

Start an infusion of 5% dextrose in 0.9% saline

Question 6

What products will you be given upon activation of the major haemorrhage protocol?

Answer 6

4 x units of RBCs and 4 x units of FFP

Question 7

What dose of IV lorazepam should be given for a seizure?

Answer 7

4mg

Question 8

Assuming the patient has had no other benzodiazepines, how soon can a dose be repeated in a seizing patient?

Answer 8

After 5 minutes

Question 9

What three drugs should you give to a patient with anaphylaxis? How would you give each one?

Answer 9

Adrenaline (IM), hydrocortisone (IV) and chlorphenamine (IV)

Question 10

What dose of oral aspirin should be given in ACS?

Answer 10

300mg

Question 11

How often can the dose of adrenaline be repeated in anaphylaxis?

Answer 11

Every 5 minutes

Question 12

How often can nebulised salbutamol be repeated?

Answer 12

Every 15 - 30 minutes

Question 13

What dose of oral ticagrelor should be given in ACS?

Answer 13

180mg

Question 14

Patients with clinical evidence of a STEMI require what further intervention?

Answer 14

Primary PCI

Question 15

What medications are given to drive potassium into cells in hyperkalaemia?

Answer 15

10 units Actrapid in 50ml 50% dextrose

Question 16

What further intervention can be considered for patients with acute COPD who are not improving and have evidence of type 2 respiratory failure?

Answer 16

Non-invasive ventilation

Question 17

What dose of IV amiodarone should be given in cardiac arrest?

Answer 17

300mg

Question 18

What dose of IV metronidazole should be given to septic patients?

Answer 18

500mg (tds)

Question 19

What investigation can be used to give you a rapid lactate measurement in septic patients?

Answer 19

ABG/VBG

Question 20

What is the immediate emergency treatment for a tension pneumothorax?

Answer 20

Needle decompression into the 2nd intercostal space, mid-clavicular line (on the affected side)

Question 21

How often can a dose of sublingual GTN be repeated in ACS?

Answer 21

Every 5 minutes, up to 3 times

Question 22

If a patient with DKA has a systolic BP > 90mmHg, what fluids should be given?

Answer 22

1L of 0.9% saline over 1 hour

Question 23

When should IV amiodarone be given in cardiac arrest?

Answer 23

After 3 shocks

Question 24

If there is no response to benzodiazepines in a seizing patient, what drug should be tried next?

Answer 24

IV infusion of phenytoin

Question 25

What dose of chlorphenamine should be given in anaphylaxis?

Answer 25

10mg

Question 26

What are some additional interventions if a COPD exacerbation is suspected to be infective?

Answer 26

Take blood and sputum cultures, give antibiotics

Question 27

What antibiotics should be given to patients with sepsis of unknown origin who are penicillin allergic?

Answer 27

IV vancomycin, metronidazole and gentamicin

Question 28

What dose of oral prednisolone should be given in acute COPD?

Answer 28

30mg

Question 29

What medication should be given to patients in acute pulmonary oedema?

Answer 29

IV furosemide 40mg

Question 30

What are the two treatment options for severe hypoglycaemia?

Answer 30

150ml 10% glucose over 10-15 minutes OR 1mg glucagon IM

Question 31

What is included in the sepsis 6 bundle?

Answer 31

Take blood cultures, serial lactate measurements and urine output; give oxygen, IV fluids and IV antibiotics

Question 32

What dose of IV morphine is a reasonable starting point for patients with ACS?

Answer 32

5mg (may consider giving less for frail patients)

Question 33

What dose of sublingual GTN should be given in ACS?

Answer 33

400mcg

Question 34

What additional medication may be given in trauma patients where the major haemorrhage protocol has been activated?

Answer 34

1g tranexamic acid IV

Question 35

What antibiotics should be given to patients with sepsis of unknown origin?

Answer 35

IV amoxicillin, metronidazole and gentamicin

Question 36

What dose of nebulised salbutamol should be given in acute asthma/COPD?

Answer 36

5mg

Question 37

Giving GTN for ACS is contraindicated in patients with which clinical sign?

Answer 37

Hypotension

Question 38

In trauma situations, in what ratio should RBCs and FFP be given in the major haemorrhage protocol?

Answer 38

1: 1

Question 39

What is the management for a patient with a massive PE (i.e. PE with haemodynamic instability)?

Answer 39

Thrombolysis with IV alteplase

Question 40

When should IV adrenaline be given in cardiac arrest?

Answer 40

Every 3-5 minutes

Question 41

What dose of naloxone should be given in opioid overdose?

Answer 41

400mcg IV

Question 42

What is the management for a patient with a PE without haemodynamic instability?

Answer 42

Oral rivaroxaban 15mg

Question 43

What dose of oral prednisolone should be given in acute asthma?

Answer 43

40-50mg

Question 44

What dose of IV hydrocortisone should be given in acute asthma?

Answer 44

100mg

Question 45

In non-trauma situations, in what ratio should RBCs and FFP be given in the major haemorrhage protocol?

Answer 45

2: 1

Question 46

What antibiotic should be given for an infective COPD exacerbation?

Answer 46

Oral amoxicillin 500mg

Question 47

What dose of IV adrenaline should be given in cardiac arrest?

Answer 47

1mg of 1: 10,000

Question 48

What dose of IV amoxicillin should be given to septic patients?

Answer 48

1g (tds)

Question 49

What dose of adrenaline should be given in anaphylaxis?

Answer 49

0.5mls 1: 1000 (500mcg)

Question 50

What dose of PR diazepam should be given for a seizure?

Answer 50

10mg

Question 51

What dose of hydrocortisone should be given in anaphylaxis?

Answer 51

200mg

Question 52

How should patients with DKA be given insulin?

Answer 52

Fixed rate infusion - 0.1 units/kg/hour

Question 53

What three drugs should you give to a patient with acute asthma? How would you give each one?

Answer 53

Salbutamol (neb), ipratropium bromide (neb) and prednisolone (oral)/hydrocortisone (IV)

Question 54

What dose of buccal midazolam should be given for a seizure?

Answer 54

10mg

Question 55

How may benzodiazepines be given in the treatment of seizures?

Answer 55

IV lorazepam, buccal midazolam or PR diazepam

Question 56

What insulin should be given in DKA?

Answer 56

50 units Actrapid in 50mls 0.9% saline

Question 57

How should patients with HHS be rehydrated?

Answer 57

0.9% saline infusion over 48 hours

Question 58

After initiating cardiac monitoring, what drug is given to stabilise the cardiac membrane in hyperkalaemia?

Answer 58

10mls 10% calcium gluconate

Question 59

What are the most important investigations to do in an individual with DKA?

Answer 59

ABG and ECG

Question 60

After treatment for DKA, when should individuals be switched from a fixed rate infusion to a sliding scale?

Answer 60

When blood glucose is \< 11mmol/L

Question 61

What should be done with regards to an individual's normal insulin regime when being treated for DKA?

Answer 61

Continue long acting insulin, stop short acting insulin