Images and instruments

Question 1

Treatment of extradural and subdural haematoma

Answer 1

A-E
Supportive if small, craniotomy or burr hole if large

Question 2

Treatment of subarachnoid haemorrhage

Answer 2

A-E
Supportive
Nimodipine (CCB to prevent vasospasm)

Question 3

Cause of subarachnoid haemorrhage

Answer 3

Berry aneurysm
AV malformation

Question 4

What are monocryl and vicryl sutures?

Answer 4

Absorbable sutures

Monocryl - monofilament, stable knot
Vicryl - polyfilament, less throws but fraying

Question 5

Blood bottle colours, what they contain, indications

Answer 5

Purple (EDTA) - haematology
Pink (EDTA) - G&S, crossmatch
Blue (sodium citrate) - coagulation
Yellow (silica and serum separating gel) - immuno, micro, endo, U&E
Grey (sodium fluoride and potassium oxalate) - glucose and lactate
Red (silica) - toxicology, drugs, antibodies
Dark green (sodium heparin) - ammonia, renin, aldoesterone, insulin
Light green (lithium heparin) - biochemistry
Rust top - viral immunology

Question 6

Which blood culture top is aerobic?

Answer 6

Blue

Question 7

When are catgut sutures still used?

Answer 7

Stomas and circumcisions

Question 8

What can a catheter bag be joined to?

Answer 8

Urethral or suprapubic catheter

Question 9

Indications for central line insertion pack

Answer 9

TPN
Fluid resus
Infusion of irritant drugs
Blood tests
Central venous pressure

Question 10

Where are central lines inserted?

Answer 10

Subclavian or internal jugular vein via USS

Question 11

What is the curved big retractor called?

Answer 11

Devers retractor

Question 12

When is an endotracheal tube used?

Answer 12

Trauma
Surgery with GA
GCS <8

Question 13

Which bristol stool chart numbers warrant stool samples?

Answer 13

5, 6, 7

Question 14

How long for rotavirus, norovirus, C. diff ribotyping, parasites, and helicobacter antigen testing results to come back?

Answer 14

Rotavirus, norovirus - same day
C. diff ribotyping - 2 weeks
Parasites - 4 days
Helicobacter antigen - 1 week

Question 15

What does Hartmann/plasmalyte contain?

Answer 15

NaCl
Bicarbonate
Lactate

(crystalloid solution - fluid of choice initially in trauma)

Question 16

What is a long term central venous line called (single long line)?

Answer 16

Hickman line

TPN
Long-term IV abx and chemo

Question 17

Yellow topped pot

Answer 17

Histology specimen pot - biopsies set in formalin

Question 18

When are interlocking screws removed from a femoral nail?

Answer 18

12/18 months

Question 19

What is instillagel?

Answer 19

Lubricant and anaesthetic gel for catheterisation

Question 20

Name of curved and straight laryngoscope blades?

Answer 20

Curved - Macintosh
Straight - Miller

Question 21

When is mannitol used?

Answer 21

Raised intracranial pressure
Drive urine output in obstructive jaundice to prevent hepatorenal syndrome

Question 22

What is the tool used for coagulation and dissection of tissue called?

Answer 22

Monopolar diathermy handle

Question 23

What is used to test pinprick sensation?

Answer 23

Neurotip

Question 24

What is an ethilon suture and when is it used (3)?

Answer 24

Nylon monofilament - non-absorbable
Required 9 throws

Percutaneous wound closure
Bowel anastomosis (prolene)
Vascular anastomosis (prolene)

Prolene different to ethilon (nylon)

Question 25

Flow rate range of non-rebreather mask

Answer 25

10-15L/min

Question 26

What does a PICC line look like, what is it, and what is it used for?

Answer 26

Line with 2 separations (pink and yellow), and one more coming off of one of the separations Peripheral and central venous access TPN Chemotherapy Blood sampling

Question 27

Name of chest drain insertion pack

Answer 27

Seldinger Willl have pointy things, scalpel, tubes, syringe

Question 28

Types of spinal needles

Answer 28

Traumatic needles (normal bevel at the end) - associated with post-LP headaches Atraumatic - choice for LP, blunt dissection rather than cutting

Question 29

What is the mask with the bag called and how much oxygen can it deliver?

Answer 29

Self-inflatable bag-valve-mask Can deliver high levels at low flow rates Up to 100% over 10L/min

Question 30

When is self retaining retractor used?

Answer 30

Hernia repair Appendicectomy

Question 31

What is the scary looking metal syringe called and used for?

Answer 31

Shouldered syringe Injection of haemorrhoides with 5% phenol in almond oil Proctoscope + done above dentate line (insensitive)

Question 32

What is the clear catheter called and used for?

Answer 32

Silastic urinary catheter Silicone - better for long term (3 months)

Question 33

What's the proper name for a neck brace, how is it sized, and what else is used for immobilisation?

Answer 33

Stiff neck cervical collar 2 sand bags and tape (triple immobilisation) Sized with number of fingers from clavicle to angle of mandible, compared to measuring peg

Question 34

Line with 5 different lengthed splits (blue, yellow, red)

Answer 34

Swan Ganz catheter Inserted into central vein Measure pulmonary artery wedge pressure and cardiac output

Question 35

When are synthetic absorbable sutures used?

Answer 35

Bowel anastomosis Tying off vessels

Question 36

Benefits of tracheostomy

Answer 36

Decreased dead space More effective suctioning Less damage to vocal cords

Question 37

Name of needle for histological specimens from lesions

Answer 37

Trucut needle

Question 38

What is an opaque catheter made of and how long is it used for?

Answer 38

Latex Up to 28 days

Question 39

When is a three-way catheter used?

Answer 39

Haematuria for washout and irrigation of clots

Question 40

When should a urine dip be sent for MCS and PCR?

Answer 40

Positive nitrites and leukocytes - MCS Positive blood and protein - PCR

Question 41

When is a urometer drainage bag used?

Answer 41

During surgery Post-op Monitor fluid status

Question 42

Which colours of venturi mask are for 24% and 28%?

Answer 42

Blue - 24% White - 28% (BWYRG)