A&E CCT Flashcards
Right leg under rubble for 12 hours in an earthquake. Alert and oriented. BP: 106/70. RR 28. SpO2 90%. Pulse 90. Which of the following is the most appropriate management during the extrication process?
A. Field amputation of right leg
B. Urgent consult nephrologist for dialysis
C. Infuse sodium and potassium containing fluids
D. Give high flow supplemental oxygen
D. Give high flow supplemental oxygen
You are in Tibet at 3000m and the nearest helicopter pad is at 3600m. Your friend develops vomiting and headache. He is alert (GCS 15/15). What to do as soon as possible. (? BP: 10Xz/7X, HR: 9X)
A. Give 0.9% NS
B. Ascend to the helicopter pad
C. Dexamethasone
D. Restrict oral intake
Ans: C
- Man with pelvis and both lower limbs under rubble for 10 hours (…) After extrication, he developed cardiac arrest. Which of the following is CORRECT?
A. Hypokalaemia might have caused the cardiac arrest.
B. Extrication worsens his hypovolaemic shock.
C. Bilateral lower limb fasciotomy should be performed in the extrication process.
D. Potassium-containing fluid should be given in the extrication process.
B. Extrication worsens his hypovolaemic shock.
25-year-old man trapped under rubble in an earthquake for 4 hours. His GCS is 15/15, BP 130/70, RR 18. Well oriented and alert. Which of the following should be performed during extrication?
A. Aggressive IV rehydration with potassium containing fluid
B. Urgent nephrologist consultation for hemodialysis
C. Urgent fasciotomy of the right leg
D. Force urine alkalinization by NaHCO3 and mannitol
D. Force urine alkalinization by NaHCO3 and mannitol
You are in a mission in Tibet at the altitude of 2800 m. A teammate, 23-year-old male, has been presenting with headache and nausea. There is Helipad on 3300 m which is an 1-hour walk. His GCS is 15/15, RR 18, BP 130/70, Pulse rate 90. Which of the following is the correct management?
A. If he can walk, send him downhill alone to a lower altitude
B. Accompany him to the helipad for urgent helicopter evacuation
C. Give him the portable hyperbaric oxygen if desend is not feasible
D. Give him nifedipine which is a calcium channel blocker
C. Give him the portable hyperbaric oxygen if desend is not feasible
Never let someone descend alone
A trauma patient is admitted to the emergency department with suspected skull base fracture. Which of the following airway devices are contraindicated?
A. Laryngeal mask airway
B. Oropharyngeal airway
C. Nasopharyngeal airway
D. Endotracheal intubation
C. Nasopharyngeal airway
Which of the following statements is correct? (disaster)
A. Flooding is the commonest natural disaster in human history
B. Industrial accident is the commonest technological disaster
C. Asia is the safest continent and less prone to disaster
D. Meteorological disaster is static over the past 50 years
A. Flooding is the commonest natural disaster in human history
You are a volunteer doctor for an overnight marathon. A 33-year-old gentleman presents to you with dizziness. The environmental ambient temperature is 2 degrees, the core body temperature is 33 degrees. Which of the following options is correct?
A. Shivering response will be diminished
B. Pupil is fixed and dilated
C. Urgent active rewarming by warmed IV dextrose infusion is required
D. Frostbite of toes is unlikely
D. Frostbite of toes is unlikely
Trekking at Nepal. A friend, 22/M, good past health, become breathless at rest at 4000m. BP 120/80. RR 22. PR 110. O2 saturation 84%.
A. Nifedipine is recommended
B. O2 saturation will drop as he descends
C. If measured, pulmonary arterial pressure is lower than normal
D. Hyperbaric oxygen is contraindicated
A. Nifedipine is recommended (pulmonary vasodilator for HAPE)
Hypoxia stimulates pulmonary vasoconstriction which increases pulmonary arterial pressure
Which one is true abt burn?
A. Head and neck burn is the same proportion in 15 month and 5 years old
B. Severe burn is >10% for all age group
C. Grade 2 burn is only epidermis histologically
D. Grade 3 burn may be painless
D. Grade 3 burn may be painless
Earthquake, a man is trapped under rubble for 12 hours. He is alert and conscious. BP is 112/80, Pulse is normal. What should be done during extrication?
A. IVfluid
B. neckcollar
C. paracetamoloral
D. amputation
E. oxygen
A. IVfluid
0.9% NS 1000 ml/kg/hr to prevent AKI
Which of the following about natural disaster is correct?
A. The number of meteorological disaster is static in the past 40years.
B. Earthquake is the commonest natural disaster worldwide.
C. Africa is most prone to natural disaster
D. Extreme temperature is a major cause of natural disaster
E.Natural disaster and technological disaster can coexist.
E.Natural disaster and technological disaster can coexist. (japan earthquake and fukishima nuclear plant)
You are responsible to resuscitate a young female, cardiac arrest with massive pulmonary embolism. On direct laryngoscopy for endotracheal tube intubation, you found a grade 3 larynx, failed to intubate. What is the MOST appropriate management?
A. Bag Valve Mask ventilation
B. Nasopharyngeal Airway Insertion
C. Endobronchial Intubation
D. Cricothyroidotomy
E. Tracheostomy
A. Bag Valve Mask ventilation (ensure there is O2 supply)
Obese and OSA patient undergoing sedation. Noisy Breathing. DL grade 3?? A. Oropharyngealairway
B. Nasopharyngealairway
C. LMA
D. ETtube
E. Tracheostomytube
C. LMA
70/M on irinotecan, 5-FU, oxaliplatin, retinoic acid for metastatic CA rectum. On second cycle of chemotherapy, he developed tearing, sweating, abdominal colic. What is the most appropriate treatment?
A. Metoclopramide B. Loperamide
C. Atropine
D. Dexamethasone
E. Chlorpheniramine
C. Atropine
To treat the acute cholinergic syndrome (caused by irinotecan)
Acetylcholine accumulation due to inhibition of acetylcholinesterase activating muscarinic receptors which can manifest as bronchorrhea, salivation, tearing and sweating, abd pain, diarrhea
78/M, Hx of ischemic heart disease, planning for knee surgery, now complain of SOB, chest pain etc.
What does his ECG show?
A. SVT
B. sinus tachycardia
C. Monomorphic VT
D. Polymorphic VT
E. VF
C. Monomorphic VT
