Emergency

Question 1

patient with sepsis, low BP

given IV 0.9% saline at 125ml/h

Answer 1

noradrenaline/norepinephrine!!!

adequate if not overhydration, needs vasoconstriction

Question 2

amytriptiline hydrochloride overdose 4 hours ago

ECG shows QRS prolongation

most appropriate immediate management?

Answer 2

IV sodium bicarbonate!!!

bicarbonate is the treatment of choice in patients with prolonged QRS following a tricyclic antidepressant overdose

(within 1 hour and no qrs prolongation = activated charcoal)

Question 3

26 yo. Head injury in car accident.
Eyes closed but opens them when asked to. Confused about where she is and what happened but attempts to talk about it. Repeatedly attempting to remove cannula from right wrist.

Best estimate of GCS score?

Answer 3

12!!!

E3, V4, M5

Question 4

Man weighting 70kg with underlying cardiac disease. What is the most appropriate volume of maintenance fluids to prescribe in next 24hours?

Answer 4

20-25ml/Kg in patients with underlying cardiac disease.

70 x 25 (upper limit) = 1750

Question 5

Patient experiencing a myaesthenuc crisis. Most appropriate tests to monitor respiratory function?

Answer 5

FVC