Acute care 1

Question 1

high risk groups for head injury

Answer 1

high risk mechanism
anticoagulant/coagulopathy
alcohol
epilepsy

Question 2

subdural

Answer 2

tearing of bridging arteries

Question 3

secondary brain injury

Answer 3

hypoxia
hypoperfusion
hypovalaemia
haematoma
increased ICP
seizures

Question 4

temporal herniation stretches what

Answer 4

in the context of increased ICP

oculomotor nerve - ipsilateral pupil dilatation

Question 5

cushings reflex dangerous when

Answer 5

increased BP
decreased HR ins Response to the increased BP
irreg respirations

Question 6

signs of a basal skull fracture

Answer 6

external bleeding 
epistaxis
CSF rhinorrhoea/ottorhoea
panda eyes
mastoiditis (battle sign)
subconjunctival haematoma without posterior border

Question 7

mastoiiddit is what

Answer 7

a late sign

Question 8

why is it important to maintain normocapnia in head injury px

Answer 8

hypercapnia - vasodilatation - increased ICP

Question 9

paediatric head injury admit for obs if

on discharge what advice

Answer 9

more than 2 episodes of vom

when asleep wake them up to check normal rousing

Question 10

DKA protocol to change from IV to SC insulin

Answer 10

eating normally - stop IV insulin 30 mins after their SC insulin has been started

Question 11

husband doesn’t know what drugs they took and had been depressed

Answer 11

check coag

Question 12

31 yearly smoker wants contraception but previous arterial disease

Answer 12

POP

Question 13

saline has how much sodium
chlorine
k

Answer 13

154
154
0

Question 14

glucose Na
clorine
K

Answer 14

0
0
0

Question 15

hartmanns

Answer 15

some Na
Ca
K
Cl

Question 16

adrenaline 1:1000

Answer 16

1g in 1000ml

Question 17

1% of lidnocaine

Answer 17

100%=100g=100mls

1%=1g=100mls

Question 18

type of shock in hypothermia

Answer 18

heart attack due to vasoconstriction

Question 19

CPR how long should you exhale in the rescue breaths

Answer 19

3 seconds

Question 20

INR over 8

Answer 20

give oral vit K

if bleeding give IV vit K

Question 21

pelvic fracture mid femur fracture and ink respiratory distress

Answer 21

fat embolism

Question 22

reversal of BZD - Flumazenil

Answer 22

200mcg over 15 seconds then 100mcg every 1 min if required