Emergency medicine

Question 1

Median nerve block causes

Answer 1

inability to perform abduction of thumb

Question 2

Serotonin toxidrome

Answer 2

tachycardia
HTN
hyperthermia
agitation

management: diazepam

Question 3

ethylene glycol toxicity management (Alcohol OD or anti freeze)

Answer 3

Fomepizole IV

Question 4

Decorticate posturing

Answer 4

flexed arms and extended legs
GCS 3
posturing can be elicited in response to painful stimuli

Question 5

Klumpke’s palsy

Answer 5

excessive abduction of arm
T1 nerve root
impairs action of ulnar and median nerves
unable to move arm but can use hand

Question 6

Decerebrate posturing

Answer 6

involuntary extension of arms and legs
GCS 2
more severe injury than decorticate posturing

Question 7

salicylate overdose

Answer 7

hyperventilation –> resp alkalosis
nausea and vomiting
tinnitus
dizziness
lethargy

initial resp alkalosis, bicarb is released in urine causing hypo Na and K , causes compensatory metabolic acidosis

Management: gastric lavage/activated charcoal if within one hour, sodium bicarb, haemodialysis

Question 8

serotonin syndrome

Answer 8

sweaty
dilated pupils
increased tone and reflexes
agitated

Question 9

how often to give adrenaline in CPR

Answer 9

every 4 mins
every 8 mins if 30-35 degrees
contraindicated if below 30

Question 10

median nerve supplies

Answer 10

flexor polices brevis
abductor police brevis
opponens pollicis
lateral two lumbricals