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WorksheetsPre test fellow penyegaran
Total questions: 15
Worksheet time: 10mins
A boy, four years old, in ER, collapse and apnea, unpalpable pulse, ECG with sinus rhythm, heart rate 70 x/m, SpO2 85%, BP cannot be detected in monitor.
What should you do immediately?
Ventilation 20 – 30 times in a minute
Head tilt and chin lift maneuver
High Quality CPR in 2 minute
Intubation
Defibrillation
A 5-year-old girl, leukemia, in ER with lethargy and a high fever.
HR 170/min; RR 35/min; BP 86/35 mmHg (P5-50) ; bounding pulse and flash capillary refill time, petechiae in extremities.
What is the child's most likely condition?
Obstructive shock
Hemorrhagic shock
Septic shock
Hypovolemic shock
Cardiogenic shock
A 6 year old girl brought to emergency department due to syncope. The physical examination showed: patient unconscious, gasping and no pulse.
The monitor showed:
What is the next management after you did CPR?
Give epinephrine 1:10.000
0.1 ml/kgBW
Give amiodarone 5 mg/kgBW
Do cardioversion 1 J/kgBW
Do defibrillation 4 J/kgBW
Do cardio-pulmonary resuscitation
The following were included in exposure evaluation in primary survey:
GCS evaluation before admitted to emergency
Difficulty of breathing
Previous history of shock
History of medication
Evaluation for pale or mottled
A 2 years old girl was admitted in emergency department with respiratory failure and planned for intubation.
What is estimated ETT size in this case?
Uncuff 4.5 mm
Cuff 4.5 mm
Uncuff 5.0 mm
Cuff 5.0 mm
A, 10 month old girl, 8 kg, diarrhea since 3 days ago.
PE: lethargic, sunken fontanel. The baby was assessed as severe dehydration.
Lab: Sodium 125, potassium 3.5, chloride 97.
What is the next appropriate management for this electrolyte imbalance of this case?
Give 48 ml NaCl 0.9% in 3 hours
Give 155 ml NaCl 0.9% in 6 hours
Give 48 ml NaCl 3% in 3 hours
Give 155 ml NaCl 3% in 6 hours
According to Surviving Sepsis Campaign 2020 (paediatric sepsis). If we have a shock septic child without hypotension and have no PICU facility, we should:
Give crystalloid maintenance
Give crystalloid 10 mL/kg BW until are
achived therapeutic goal
Give albumin 5% 20 mL/kg BW until hepatomegaly found
Give crystalloid 40 mL/kg BW until rales found
Give albumin 5% 40 mL/kg BW until MAP > P5
A 6 months old, girl, in PICU due to severe bronchiolitis. Patient was intubated and alarm was sounded.
PE: irritable, prolonged expiration, rales at posterior aspect of both lung.
Ventilator settings: PC/AC, PIP 15, PEEP 5, RR: 30 x/min, Ti: 0.6. FiO2 30%. MV 1.1. Lab: pH 7.24, pCO2 60, pO2 95.
What is appropriate management for this case?
Reintubate the patient
Decreased Δpressure
Decreased Ti
Give more sedation
Give bronchodilator
P, 6 mo, BW 7 kg, post Kasai Procedure, failed to extubate with increased respiratory effort. Patient was sedated with Midazolam 1 mcg/kg BW/minute. BP P50. Edema +, increased inspiratory effort, saturation 95-97%, symmetric lung air entry, TV 6-7 ml/kg, intraabdominal pressure 14 cmH2O.
Which of the following option is the most possible cause of increased respiratory failure?
The patient was still under sedation
The patient had intrathoracal intraparenchymal lung problem
The patient had intrathoracal extraparenchymal problem
The patient had extrathoracal problem
The patient had hemodynamic problem
A, 4 months-old, 5 kg BW, post laparatomy exploration due to invagination. Patient was bleeding 20 ml from surgical site and had fluid loading. About one hour after loading, the patient suddenly had sinus bradycardia, with blood pressure below P5 (systolic and diastolic).
The result of non-invasive hemodynamic measurement revealed:
low FTC, normal INO, low SVRI, normal PKR.
What is the most appropriate treatment for this condition?
Sulfas Atropin
Furosemide
Dobutamine
Epinephrine
Amiodaron
A fifteen years old boy, brought to emergency department due to bicycle accident, examination: somnolent, cold skin, mottled, HR 150 bpm, RR 35 x/min with unequal breath sounds, BP 60/30 mmHg (<P5), T 37C, SpO2 65%. The patient had fluid resuscitation and transfusion of red blood cell but still showing the sign of shock. Radiologic examination showed peribronchial cuffing.
What is the cause of shock in this patient?
Cardiogenic shock
Obstructive shock
Hypovolemia shock
Dissociative shock
Distributive shock
Seesaw respiration is a sign of
Upper airway obstruction
Lower airway obstruction
Disorder of lung parenchymal
Central breathing pattern
Diaphragm paralysis
A, 5 years-old, BW 20 kg, boy, was admitted to ER with dyspnea and abdominal pain. PAT: cardiorespiratory failure.
The patient got fluid bolus of RL until 60 ml/kg BW and intubation.
Laboratory examination : Natrium 124, Kalium 3.8, Chloride 95.6. Albumin 2.8 g/dL.
What is the appropriate treatment for hyponatremia in this patient?
Give Sodium Bolus
Give Slow Sodium Rate
Fluid restriction
Increase sodium maintenance
No sodium intervention
A 5 years old girl, was admitted to PICU because of sudden worsened of her respiratory effort and marked desaturation within a day. The patient was admitted initially due to COVID-19. PF ratio showed 120, and chest X-ray showed widespread infiltrates on both of her lung. Oxygen support was given 6 lpm with simple mask.
What is the next appropriate management for this patient?
Change into rebreathing mask
Change into non-rebreathing mask
Give non-invasive ventilation
Intubate the patient
Keep the oxygen support
The value that can be determined from near infra-red spectroscopy (NIRS) is:
Cardiac index (CI)
Systemic vascular resistance (SVR)
Mean arterial pressure (MAP)
Regional tissue oxygen saturation (rSO2)
Stroke volume variation (SVV)
