Emergency

Question 1

Pt with history of excessive drinking+ hematemisis……. His vitals a nd Hb are normal
What’s the next step?

Answer 1

Discharge and advice

Question 2

Paracetamol poisoning

Answer 2

1-If within 1 hour…… > activated charcoal
2-If more than 8 hrs or 24 tab or above level or uncertain time or jaundice liver tender or unconcious …… > N acetylcystein infusion over 21 hrs
3- If > one houre but less than 4 hrs( 3 hrs post ingestion) ……..> check paracetamol level at 4 hrs
4-

Question 3

Opioid overdose

Answer 3

Naloxon

Question 4

Opioid deaddiction

Answer 4

Methadone

Question 5

BZD overdose

Answer 5

Flumazinel

Question 6

Shock, hypotension not improvend by IV fluid is….

Answer 6

Septic shock

Question 7

Criteria of SIRS

Answer 7

WBSs... More than 12 or less than 4
Temp.. More than 38.3 or less than 36
HR >90
RR >20
Glucose >7.7 mmol/L

Question 8

Red flags of sepsis

Answer 8

Systol <90
HR >130
RR>25
Lactat>2 mmol
Urine output <0.5 ml/ kg/hr for >2hrs
O2 saturation < 91 %
Unresponsive to voice

Question 9

Sepsis 6

Answer 9

Take 3, give 3
Take..
1-Blood culture
2-. CBC, urea, electrolyte, clotting, lactate
3- monitor urine output

Give
1- high flow o2
2- IV fluid challenge
3-IV antibiotics

Question 10

What’s SOFA score?

Answer 10

Used to identify organ dysfunction… If >2
RR >22
Systol <100
Altered mentation

Question 11

IN case of Burn . IV fluid calculated from the time of……….

Answer 11

time of burn not presentation
parkland formula = % * kg* 4ml
half in 1st 8 hrs
other half in next 16 hrs

Question 12

upper GIT bleeding
1- initial managemt
2- appropriate next step

Answer 12

1- IV fluid
2- FFP
urgent endoscopy

Question 13

TTT of urticaria

Answer 13

oral histamine

if anaphylaxis ………… > IM adrenaline

Question 14

drugs cause metabolic acidosis

Answer 14

MAAIID
Metformine
alcohol
aspirin
iron
INH
Digoxin

Question 15

Hypothermia, Hypotension, tachycardia, dry mouth, Dilated pupil,
ECG… Wide QRS, PR, QT

Drug toxicity??

Answer 15

Amitriptyline toxicity

Question 16

Dilated pupil, hypotension, tachycardia, nystagmus

Answer 16

Carbamazipine

Question 17

BDZ side effect (lorazepam)

Answer 17

CRASH
Cognitive problem
Resp. Depression
Anteretrograde Amnesia
Sedation
Hypotension

Question 18

Initial step if GCS < 8

Answer 18

Less than 8…… Intub8 :D

Question 19

Superficial burn (no blisters) Tx

Answer 19

Wound dressing, bandage, discharge

Question 20

Partial (blisters + intact sensation),
 full thickness (black + lost sensation)  burn Tx

Initial step if smoke inhalation injury?

Answer 20

Refer to spcialised burn unit
steps :
1- IV fluid  IF >10% in children or >15 in adult 
2-Analgesia 
3- prevent hypothermia  

*if smoke inhalation injury……> ABC Call anethesist

Question 21

seizures > 30 min

initial step ?

Answer 21

establish a clear airway d.t increased risk of brain damage

Question 22

CO poisoning Tx in concious and unconcious pt.

Answer 22

If concious……….> tight fitting mask with O2

If unconcious…………> intubation. IPPV with 100% O2

Question 23

episods of facial and tongue swelling + family history+ abdominal pain ?
diagnosis?

Answer 23

C1 esterase inhibitor def.( hereditary angioedema)

Question 24

Increased body secretions ……….> runny nose. watery eye . sweating. diarrhea + muscle cramp =flu-like symptoms

agitation. insomnia
withdrawal of……….?

Answer 24

Heroin withdrawal

Question 25

panic attacks + other withdrawal symp.

Answer 25

Benzo withdrawal

Question 26

depression +other withdrawal symp.

Answer 26

cocain

Question 27

N/V +other withdrawal symp. | start 8 hrs after stopping abusing substance

Answer 27

Alcohol

Question 28

drug toxicity after 4 days cause ...........> imparid LFTs ( billirubin. ALT. AST. PTT) and KFTs

Answer 28

paracetamol

Question 29

truma + resp.distress + painful abdomen and chest + curled NG tube in CXR Diagnosis? best Ix?

Answer 29

Diaphragmatic rupture | CT is the best Ix

Question 30

rescued from burn + has soot+ difficult breathing | Tx ?

Answer 30

Intubtion

Question 31

pt with history of RA complain of rigid tender abdomen + pain referred to rt shoulder diagnosis? Ix?

Answer 31

perforated peptic ulcer | Ix........> Erect CXR.......>show air under diaphragm

Question 32

stages of hemorrhagic shock?

Answer 32

1- HR normal.................... blood loss 10-15% 2-HR> 100...............................................15-30% 3-HR >120...............................................30-40% 4-HR >140..............................................>40% rule of 4.......> stage 4 .HR>140. blood loss >40%

Question 33

Paracetamol liver failure ( criteria for liver transplantation)

Answer 33

pH less than 7.3 PTT>100 creat>300 grade 3 or 4 enchephalopathy

Question 34

road traffic...........> brusis in chest and upper quadrant + abdominal distention +shock

Answer 34

splenic injury