ED

Question 1

Neck xrays
What are the 4 lines to follow
How big should the retropharyngeal space be

Answer 1

Ant and post vertebral, spinolaminal and spinous process tips
< half a vert body at c2
< full at c6

Question 2

Is c2/3 subluxation normal in children

Answer 2

Yes!

Question 3

What is a c2 pedicel fracture otherwise called

How is it seen

Answer 3

Hangman fracture

Open mouth views

Question 4

What happens in a Jefferson fracture

Answer 4

Burst fracture of c1

Question 5

Do wedge fractures risk the spinal cord?

Answer 5

No!

Question 6

What is the treatment for a scaphoid fracture

What are the 2 possible bad outcomes

Answer 6

Short arm cast with thumb extension

AVN or non union

Question 7

How are epicondyle avulsion fractures seen

What is the mnemonic

Answer 7

Abnormal ossification centres

CRITOE

Question 8

What upper arm fracture can damage the median nerve

Answer 8

Supracoldylar

Question 9

What is seen on a monteggias fracture

Which line is lost?

Answer 9

Displacement of the radial head and ulnar fracture-

Lose radiocapitellar lines

Question 10

What does a posterior fat pad indicate

Answer 10

Supracondylar fracture

Question 11

What age does a sufe occur
If not obesity what rarely can cause it
How is it best seen on X-ray

Answer 11

12 years
Hypothyroidism or growth hormone deficiency
Loss of klein line

Question 12

How does perches disease look differently to sufe on X-rays

What usually causes it

Answer 12

Klein line is normal, femoral head is irregular

Idiopathic

Question 13

Where are they tender
Osgood schlater disease
Sinding larding johansen

Answer 13

Tibial tuberosity

Higher- inf patellar pole

Question 14

Which toxins should not be given activated charcoal

Answer 14

P- pesticides and petroleum 
H- hydrocarbons and heavy metal 
A- acids alcohol and alkali
I- iron 
L- lithium 
S- solvents

Question 15

What should not be used in seizures with toxic ingestion

Answer 15

Phenytoin

Question 16

What can hyperthermia predict in toxic ingestion

What should be done for a temp >39 degrees

Answer 16

Multi organ failure

Neuromuscular paralysis and intubation

Question 17

Name the antidote
TCA 
Organophosphate 
Lead 
Iron

Answer 17

Sodium bicarb
Atropine
Dimercalprol
Deferoxamine

Question 18

Name the antidote
Salicylates
Methanol 
Benzodiazepines 
Beta blockers 
Ca channel blockers

Answer 18

Na bicarb
Ethanol 
Flumazenil 
High dose insulin 
Ca infusion and “

Question 19

What overdose might you use multi dose charcoal for?

Answer 19

Carbamazepine

Question 20

What ingestion might you use urinary alkinisation for

Answer 20

Salicylates

Question 21

What are the features of an anticholinergic toxidrome

What meds can cause it

Answer 21

Agitated confused and picking at objects. Dry. Tachycardic. Big pupils. Reduced or absent bowel sounds. Urinary retention

Antihistamines and TCAs

Question 22

What are the symptoms of a cholinergic toxidrome
What meds can cause it
What is the specific treatment. How much do you give

Answer 22

Copious secretions, lots of urine. Vomiting and diarrhoea. Eventual resp depression. Pinpoint pupils
Organophosphates, mushrooms, nerve agents

Atropine until the secretions stop!

Question 23

What are symptoms of a sympathomimetic toxidrome?

What meds cause it?

Answer 23

Tachycardia and sweating. Big pupils. Raised temp

Ecstasy, MDMA. Ritalin

Question 24

What are symptoms of serotin syndrome
What usually causes it
Give examples of meds

Answer 24

Clonus, agitation, big pupils and sweating
Swapping meds or multiple meds
SSRIs with fentanyl or tramadol

Question 25

How is neuroleptic malignant syndrome different to serotonin syndrome

Answer 25

Slower onset No pupil change More rigid with no clonus normally

Question 26

What three views are needed in a c spine series

Answer 26

AP and lateral neck views | PEG view

Question 27

Where are c spine injuries likely to be in Infants Older children

Answer 27

C1-3 | C3-7

Question 28

What agents should be used for rapid sequence induction in trauma

Answer 28

Ketamine and rocuronium

Question 29

Trauma What additional products are given to replace Low fibrinogen Prolonged APTT

Answer 29

Cryoprecipitate | FFP

Question 30

What is a common injury in the abdomen seen with handlebars

Answer 30

Duodenal perforation

Question 31

How much haematuria warrants a CT abdomen

Answer 31

>30

Question 32

What is a likely organism seen in fight bites | Which is a good antibiotic to use

Answer 32

Eikinella | Augmentin

Question 33

Burns How long should they be cooled for What is different about the rule of 9s In babies What is the ideal temp of water

Answer 33

20 mins Babies heads are 18% not 9 18 degrees

Question 34

When is the biggest risk of bleeding from Eschar formation

Answer 34

2-3 weeks

Question 35

What is the biggest side effect of ketamine | Does proposal provide analgesia

Answer 35

Laryngospasm | No!

Question 36

What 4 scenarios make a foreign body unable to be conservatively managed

Answer 36

Batteries Magnets >$2 coin (>25mm) Longer than 5cms

Question 37

What dose of adrenaline is given in cardiac arrest | What energy is given in J for defibrillation

Answer 37

10microgram/kg of 1:10000 | 4J/kg

Question 38

What strengh of adrenaline is given in anaphylaxis in community In hospial? Dose? What strength of adrenaline is used in resus? What dose

Answer 38

1: 1000 0. 1ml/kg 1:10000 or 0.01ml/kg of 1:1000 (always 5 zeros!!) 10 micro grams per kg of 1:10000

Question 39

What is the algorithm for vt with pulse and no shock “With shock What can amiodarone cause If there is torsades what should be given

Answer 39

Amiodarone infusion then synchronised shocks Shock 1j/kg then 2j/kg and amiodarone infusion Hypotension Magnesium sulfate

Question 40

``` Catecholaminergic polymorphic VT What causes it What is seen on ecg What happens with adrenaline What is the treatment ```

Answer 40

AD channelopathy Frequent ventricular ectopics Polymorphic VT IV morphine

Question 41

What weight is a size 2 LMA useful for

Answer 41

<20kg

Question 42

How do you calculate estimated weight

Answer 42

(Age+4) x 2

Question 43

What age group should uncuffed ETTs be used | How are they measured

Answer 43

<8yrs | (Age/4) +4

Question 44

What physiologically happens In Paracetamol overdose | How does NAC help this

Answer 44

Depletes glutathione stores and builds up NAPQI | Replenishes your stores