Acute emergencies

Question 1

What is the commonest cause of unexpected death in children following small burns

Answer 1

Toxic shock syndrome due to unhealed burns

Question 2

Which organisms are involved in Toxic shock syndrome

Answer 2

Staph aureus/
Group A strep

Question 3

What is the dx: recent travel to mexico + dysentry. Now presents with RUQ pain + fever + N+V

Answer 3

Ameobic liver abscess

Question 4

Ameobic liver abscess-causative organism

Answer 4

Entameoba histolytica

Question 5

Investigations for ameobic liver abscess

Answer 5

USS/ CT
Percutaneous aspirate- gives thick anchovy sauce looking fluid

Question 6

Managemnt of ameobic liver abscess

Answer 6

Metronidazole +/- percutaneous drainage

Question 7

Commonest type of bowel obstruction in elderly and initial management

Answer 7

Sigmoid volvulus
Initial mx= flatus tube

Question 8

What is Borchardts triad and what does it indicate

Answer 8

1. epigastric pain
2. retching without vomiting
3. unable to pass NGT

Indicates gastric volvulus

Question 9

What are the 2 ways in which twisting of the stomach can occur?

Answer 9

organocentric (likes twisting a towel)

mesterocentric (proximal part comes down and distal part of stomach goes up)

Question 10

What are the 3 signs that can be elicited during an abdo exam that indicate appendicitis

Answer 10

Dunphys sign -pain at RIF when coughing

Aarons sign- prolonged pressure over epigastric region elicits pain at RIF

psoas sign- extension of hip elicits pain at RIF (inflamed appendix is retrocaecal)

Question 11

Management of ARDS

Answer 11

Avoid causes of pul oedema
Respiratory support
Dependant positioning (prone/ sat up)
Secretions (chest physio)

Question 12

What is Boerhavves syndrome

Answer 12

oesophageal perforation secondary to excessive vomiting