24/2

Question 1

Mx severe hyponatraemia

Answer 1

hypertonic saline if hyponatraemia <120

Question 2

klinefelter’s syndrome - features

Answer 2

above average height
infertility
gnyaecomastiasmall testes
elevated gonadotrophin but low testosterone
(additional x chromosome)

Question 3

kallman’s syndrome - features

Answer 3

failyre of GnRH

anosmia

Question 4

kartagener’s syndrome - features

Answer 4

dextrocardia

recurrent sinusitis/ bronchiectasis

Question 5

broad complex tachycardia - ddx

Answer 5

regular

• VT - give loading dose amiodine 300mg over 10-60mins, 24hr infusion
• SVT with BBB - treat as regular narrow complex

irregular

• AF with BBB, AF with ventricular pre-excitation - treat as irreg narrow complex
• torsades do pointes - magnesium 2g IV over 10 mins

Question 6

___ is CI in ventricular tachycardia

Answer 6

verapamil

Question 7

narrow complex tachycardia - ddx

Answer 7

regular - SVT or atrial flutter
- vagal manoeuvres&raquo_space;unsuccessful&raquo_space; IV adenosine 6mg (then 12mg, then 18mg) (treats SVT)&raquo_space; unsuccessful&raquo_space; verapamil/ bblocker

irregular
- AF - b blocker, give digoxin/ amiodarone if HF, anticoag if >48hrs

Question 8

A-E - b check

Answer 8

inspect
equal expansion
percuss
auscultate
tracheal deviation
RR, O2

Question 9

airway check

Answer 9

stridor
swelling
hoarseness

Question 10

fluid bolus

Answer 10

500ml crystalloid over 10mins

Question 11

adrenaline dose

Answer 11

500micrograms (0.5ml) 1:1000 adrenaline IM

frrom adrenaline box - ask nurse to fetch it

Question 12

A-E - circulation checkq

Answer 12

HR
heart sounds
CRT
BP
bloods, cannula