Trauma/Emergency

Question 1

Cushing’s triad?

Answer 1

Bradycardia, HTN, Wide pulse pressure

Question 2

Dose of adrenaline in anaphylaxis?

Answer 2

0.5mg 1:1000 IM

Question 3

Dose of adrenaline in cardiac arrest?

Answer 3

1mg - 10ml 1:10000 IV
1ml 1:1000

Question 4

In a non-urgent scenario how quickly should 1 unit of RBCs be transfused?

Answer 4

90 -120 minutes

Question 5

4 criteria for brainstem testing?

Answer 5

1. Deep coma of unknown cause
2. Reversible causes excluded
3. No sedation
4. Normal electrolytes

Question 6

6 tests to confirm brainstem death?

Answer 6

Pupillary light reflex
Corneal reflex
Ocular vesitublar reflex
Cough reflex
Absent response to super-orbitl pressure
No spontaneous respiratory effort

Question 7

ABG in salicylate poisoning?
1. Immediately
2. A few hours later

Answer 7

1. Respiratory alkalosis
2. Metabolic acidosis

Question 8

Respiratory alkalosis affect in calcium and phosphate?

Answer 8

Hypocalcaemia
Normal phosphate

Question 9

Brainstem testing should be carried out by?

Answer 9

2 separate doctors on separate occasions

Question 10

What deficiency increases risk of anaphylactic reaction to a blood transfusion?

Answer 10

IgA deficiency

Question 11

Management of patients on anticoagulation with head injury?

Answer 11

CT head within 8 hours

Question 12

At what paracetamol OD should NAC be started before return of plasma-paracetamol concentration?

Answer 12

150mg/kg (if presented 8-24 hours post ingestion)

Question 13

Maintenance fluid requirement?

Answer 13

20-30ml/kg

Question 14

Management of paracetamol OD if > 24 hours since ingestion and patient is jaundice, hepatic tenderness or raised ALT?

Answer 14

Start NAC immediately

Question 15

Signs and symptoms of hypernatraemia?

Answer 15

Jittery movements
Increased muscle tone
Hyperreflexia
Convulsions
Drowsiness
Coma

Question 16

Inidications for IV Magnesium Sulphate in hypomagnesaemia?

Answer 16

Mg < 0.4 or
tetany/ arrythmia/ seizures

Question 17

Management of patient requiring immediate surgery, that is on Warfarin?

Answer 17

4 factor prothrombin complex concentrate

Question 18

Widened QRS or arrhythmia in tricyclic overdose?

Answer 18

Give bicarbonate IV

Question 19

LSD intoxication symptoms?

Answer 19

Colourful visual hallucinations
Depersonalisation
Psyhcosis
Paranoia

Question 20

Overdose of what illicit drugs can cause serotonin syndrome?

Answer 20

Ecstacy

Question 21

Which other electrolyte abnormally has a similar presentation to hypomagnesiaemia?

Answer 21

Hypocalcaemia

Question 22

ASA if BMI is > 40?

Answer 22

ASA III

Question 23

Hypothyroidism VT?

Answer 23

TDP

Question 24

Type of reaction that NAC can cause ?

Answer 24

Non-IgE mediated mast cell release

Question 25

Pulmonary oedema and severe metabolic acidosis are indications for what?

Answer 25

Haemodialysis

Question 26

What markers are raised in neuroleptic malignant syndrome?

Answer 26

CK and WCC

Question 27

Single most important prognostic factor in paracetamol OD?

Answer 27

Arterial pH

Question 28

Management of high altitude cerebral oedema?

Answer 28

Prevention = acetazolamide Treatment = dexamethasone

Question 29

In trauma what do you measure from fluid leaking from nose or ear to check if it is CSF?

Answer 29

Glucose