Emergency Medicine

Question 1

Antomical differences between infants an older children

Answer 1

large head, short neck
large tongue
floor of mouth is compressible
loose teeth
airway narrowest at cricoid cartilage

Question 2

ET intubation in infants

Answer 2

larynx anterior is C2/C3
Epiglottis is horse shoe shaped
Straight larnyngoscope is used

Question 3

ET intubation in older infants

Answer 3

larynx anterior C5/6
Curved laryngoscope is used

Question 4

Causes of shock

Answer 4

Hypovolaemia
cariogenic
distributive
obstructive

Question 5

Features of Neurogenic shock

Answer 5

Sympathetic tone has been lost – heart rate stays normal
Lack of vasoconstriction – limbs stay warm
Hypotensive

Question 6

Features of Digoxin overdose

Answer 6

Bradycardia
Hypotension
Hypoglyceamia
Flattened t waves
short QT interval

Question 7

Benzodiazepine overdose antidote

Answer 7

Flumenazil

Question 8

What can iron overdose cause

Answer 8

scarring of gut tissue
Most commonly leads to pyloric stenosis

Question 9

Iron overdose antidote

Answer 9

Desferioxamine

Question 10

Effects of MDMA

Answer 10

Cardiac arrythmias
Hyponatremaia
Hypertension
Hyperthermia

Question 11

What part of nervous system dose MDMA stimulate?

Answer 11

Stimulates sympathetic nervous system

Question 12

Shifts in oxygen-heamaglobin curve to left

Answer 12

rise in pH = alkalosis = shift in curve to left

Decrease in body temperature

Question 13

Shifts in oxygen-heamaglobin curve to right

Answer 13

decrease in pH = acidotic
Blood becomes more acidotic at times of stress (infection or exercise)
Blood needs to be more able to bind to oxygen
Curve moves right

Question 14

Most common nerve injury in supracondylar fracture

Answer 14

Median nerve - branch called anterior interosseous nerve

Assess - can’t make OK sign

Question 15

Signs and symptoms of aspirin overdose

Answer 15

headache
tinnitus
confusion
fever

Question 16

pH levels in aspirin overdose

Answer 16

initially respiratory alkalosis - salicylate acid stimulates respiratory centre
Changes to metabolic acidosis - reduction in ATP production and increase in lactate acidosis

Question 17

Treatment for aspirin overdose

Answer 17

harm-dialysis and difiltration
urinary alkalisation with IV sodium bicarbonate

Question 18

Treatment of beta-blocker overdose

Answer 18

Glucagon
If symptomatic bradycardia - atropine
If bradycardia and hypotension - dobutamine or isoprenaline

Question 19

Most common types of burns

Answer 19

Scald burns <4 years old
Flame burns in older children

Question 20

First degree burns classification

Answer 20

No blisters
Only epidermis
minimal damage

Question 21

Second degree burn classification

Answer 21

Involves epidermis, and parts of dermis
Vesicles and blistering
Metobolic derangements and fluid loss
Extremely painful - exposed nerve endings

Question 22

Third degree burns

Answer 22

All epidermis and dermis - can involve muscles/ bones - full thickness burns
Not painful - no nerve endings
No capillaries - no CRT

Question 23

Pathophysiology of full thickness burns

Answer 23

0-72 hours - massive capillary leak -> shock
1-7 days - hyper dynamic and catabolic state - high risk of wound infection
1 - 7 weeks - continued catabolic state with high risk of non-wound septic events
6 weeks - recovery

Question 24

Pathophysiology of inhalation injury

Answer 24

Sloughing of mucosa - pulmonary oedema and airway obstruction -> atelectasis