Guided Studies

Question 1

What does the ACE-III test?

Answer 1

Examines cognitive functions
Memory, attention, language, perception and problem solving

Question 2

What are the 2 forms of cognitive impairment?

Answer 2

Degenerative (worse over time)
and
Static (remains constant)

Question 3

What are some possible causes of cognitive impairment?

Answer 3

Medications
Alcohol and Drugs
Pain and Discomfort
Head injury
Learning disability
Psychiatric problems

Question 4

What are some progressive illnesses that affect cognition?

Answer 4

Alzheimer’s disease
Vascular dementia
Dementia w/ lewy body
Fronto temporal dementia

Question 5

What are the 5 subscales of the ACE-III exam?

Answer 5

Attention
Language
Fluency
Memory
Visuospatial

Question 6

How many points are there in an ACE-III and a mini ACE?

Answer 6

100
and
30

Question 7

When should the ACE-III be used?

Answer 7

Individuals over 50 y/o with suspected cognitive impairment

Question 8

What are the cut-off scores for the ACE-III exam and Mini ACE?

Answer 8

88-82 out of 100
and
25-21 out of 30

Question 9

What 6 physiological parameters form the basis for the NEWS2 scoring system?

Answer 9

Respiratory rate
Pulse rate
O2 Saturation
Systolic BP
Level of consciousness
Temperature

Question 10

What should you be thinking about when a patient has a NEWS2 score of 5 or above?

Answer 10

Consider Sepsis

Question 11

When would it be inappropriate to use NEWS2?

Answer 11

Pregnant women
Children
Spinal injury (tetraplegia)

Question 12

What is Microtia / Anotia?

Answer 12

Malformation of Pinna
Small or absent ear

Question 13

Treatment for Perichondritis?

Answer 13

Incision and drainage of pus
Antibiotics

Question 13

What are some symptoms of Perichondritis?

Answer 13

Red, swollen, tender ear
Pus + discharge
Fever

Question 14

What is a Pinna Haematoma?

Answer 14

Result of direct trauma
If left untreated may cause cauliflower ear due to fibrotic tissue

Question 15

Treatment for Pinna Haematoma?

Answer 15

Drained via incision and compression dressing

Question 15

What is Otitis Externa?

Answer 15

Bacterial infection of External Auditory Canal
May be swollen, exquisitely tender and filled with debris

Question 16

Treatment for Otitis Externa?

Answer 16

Steroids
and
Antibiotics

Question 17

What is Cerumen Impaction?

Answer 17

Build up and compacting of ear wax

Question 18

What does Otitis Media often proceed?

Answer 18

Upper respiratory tract infection

Question 19

What may be a severe symptom of Suppurative Otitis Media?

Answer 19

Perforation of tympanic membrane

Question 20

What 3 structures would need to be anaesthetised durring shoulder surgery?

Answer 20

Articular Capsule
Articular Surface
Skin

Question 21

What dermatomes would need to be anaesthetised for shoulder surgery?

Answer 21

C4 & 5

Question 22

What is Hilton’s Law?

Answer 22

The nerves that supply the muscles of a joint, also supply that joint itself

Question 23

What nerves would you aim to anaesthetise in order to perform shoulder surgery?

Answer 23

The **C5 and C6 roots** or **Superior Trunk** of brachial plexus

Question 24

What is an **Interscalene block**, and why would it be performed?

Answer 24

Anaesthetising the **sup. roots** and **sup. trunk** of the brachial plexus as they pass between **ant.** and **mid. scalene** **Anesthetises the shoulder for surgery**

Question 25

What **nerve functions** would you want to check to make sure that an Interscalene block has been effective?

Answer 25

Question 26

What structures may be **damaged** during an Interscalene block?

Answer 26

Sympathetic chain Phrenic nerve Apex of lung

Question 27

What are the **2 main ligaments** that hold the malleus, incus and stapes in place?

Answer 27

**Ant. Malleal lig.** and **Post. Incudal lig.**

Question 28

What is the purpose of the **round window** in the labyrinth?

Answer 28

Membranous structure that can deform to allow movement of perilymph in the labyrinth. Without this the perilymph couldn't move and we couldn't hear Located at the very end of the Cochlea

Question 29

What membrane seperates **Scala Vestibuli** from **Scala Media**?

Answer 29

**Reissner's** membrane

Question 30

What membrane seperates **Scala Tympani** from **Scala Media**?

Answer 30

**Basilar** membrane

Question 31

What **specific** structure are the hair cells within?

Answer 31

**Organ of Corti** (within basilar membrane)

Question 32

Lower frequencies vibrate the basilar membrane closer to the apex of the cochlear, whereas higher frequencies produce vibrations closer to the base. What is this known as?

Answer 32

**Tonotopic organisation**

Question 33

Name some **first line** opioids

Answer 33

- Codeine - Morphine - Diamorphine

Question 34

Name some **second line** opioids

Answer 34

- Oxycodone - Fentanyl

Question 35

Name some **third and fourth line** opioids

Answer 35

- Methadone - Buccal / SL fentanyl

Question 36

What is the standard dose of a strong opioid for **breakthrough pain**?

Answer 36

**one-sixth to one-tenth** of the regular 24h dose Repeated every 2 - 4 hours as required