WorksheetsModule I
Total questions: 10
Worksheet time: 10mins
With regard to bleeding and coagulopathy in the critically ill patient except:
If a platelet transfusion is indicated, 1 unit will raise the count by approximately 20 ,000/cumm
Fresh frozen plasma
Desmopressin at a dose of 0.3μg/kg is a useful treatment in patients with coagulopathy related to uraemia, cirrhosis and aspirin use.
All the above
The following are considered useful management options in the treatment of Thrombotic Thrombocytopaenia Purpura (TTP) except :
Steroid therapy.
Platelet transfusion
Monoclonal antibody infusion
Fresh frozen plasma
Identify the following xray
A tension pneumothorax
An acute pneumonia of the right lung
Pulmonary embolism
A simple pneumothorax
Identify following contrast Abdominal CT
A ruptured gastric ulcer
A ruptured abdominal aortic aneurysm.
Acute appendicitis.
Acute renal failure.
Regarding parenteral nutrition in the critically ill patient which is true:
A patient with enteral feeds running at 40ml/hr with 4-hourly aspirates of >200ml is deemed to be failing enteral nutrition.
Daily caloric intake should be 100-130% of the patient’s calculated daily energy expenditure.
Parenteral nutrition can be administered peripherally.
Approximately 3.5g/kg/day of Protein is required
A 60-year-old man with chronic obstructive Bottom pulmonary disease (COPD) presents with sudden onset shortness of breath to the emergency department. He has a respiratory rate of 24 breaths per minute. His saturations are 92% on room air. A 5cm right-sided pneumothorax is diagnosed on a plain chest X-ray. The most appropriate course of action is:
Simple needle aspiration of the pneumothorax with a 16G or 18G cannula
Insertion of an intercostal chest drain on the right side
High-flow oxygen therapy and close observation in a monitored area
Discharge home if there is no deterioration over a 4-hour period with return next day with repeat chest X-ray
A 32-year-old male asthmatic is admitted to the emergency department with a 2-day history of increasing wheeze and shortness of breath. His HR is 115bpm, blood pressure is 120/60mmHg, and respiratory rate is 28 breaths per minute with saturations of 92% on room air. He has a widespread expiratory wheeze refractory to his normal inhalers. The most appropriate next step in his management is:
Intubation and ventilation
Intravenous magnesium 2g
Urgent HRCT
Bronchodilator nebulizer therapy back to back
In a trauma patient with a high cervical spine injury, which of the following statements is most likely to be INCORRECT:
Progressive tachycardia and hypotension is most likely to be due to developing spinal shock
In the hypotensive patient, haemorrhage should be sought and excluded as a matter of priority
A mean arterial pressure of 90mmHg is advised to optimise cord perfusion
Abdominal breathing is a sign of impending respiratory deterioration
Giving your patient a FAST-HUG means paying strict attention to :
Airway concerns
Falls prevention
Humidification of ventilatory support
Stress ulcer prophylaxis
An 89-year-old man is found on the floor of his house. There is evidence of severe diarrhoea and vomiting. He is confused and complaining of lethargy and tingling of his hands and feet. While being transferred to hospital he suffers a brief, self-terminating seizure. On arrival, examination shows muscle weakness with positive Chovstek’s and Trousseau’s signs. ECG shows ST depression, T-wave flattening and U-waves, and a QTc of 500ms. Which primary electrolyte disturbance best explains all these findings?
Hypocalcaemia
Hypokalaemia
Hypomagnesaemia
All of the above
