Fellowship - resus Flashcards
An adult is brought to your district hospital after a house fire. They have sustained burns to 75% of their total body surface area (TBSA). Discuss your management prior to their transfer to a Burns Unit.
You have just intubated a patient who has respiratory failure due to severe bacterial pneumonia. They remain hypoxaemic with an SpO2 of 82%. Describe your immediate actions and justify your strategies to improve oxygenation whilst awaiting the patient’s retrieval to a tertiary centre.
List the signs of malignant hyperthermia. (30%) Outline the immediate management of a patient where malignant hyperthermia is suspected. (70%)
Outline the anatomical relations of the internal jugular veins highlighting how the left internal jugular vein differs from the right. (70%) Describe how the anatomy relates to complications that may arise at the time of central venous cannulation. (30%)
A patient is due to have intramedullary reaming and nailing of a pathological fracture of the femur secondary to metastatic renal cell carcinoma. Outline the key issues this case presents. (50%) Describe how you would manage these issues. (50%)
A. List the clinical features that support a diagnosis of malignant hyperthermia in an anaesthetised patient. (30%) B. Describe your immediate management of suspected malignant hyperthermia. (70%)
A 20 year old patient has been successfully resuscitated from suspected anaphylaxis. Describe your immediate and longer term post crisis management.
You are called to see a 30 year old man with bilateral fractured femurs. He has been diagnosed with Fat Embolism Syndrome.a. Outline the pathophysiology of Fat Embolism Syndrome? (50%)b. Describe the principles of management of Fat Embolism Syndrome? (50%)
In regard to serotonin syndrome a. What are the risk factors? (20%) b. What are the clinical manifestations? (40%) c. What is the treatment for an acute episode of serotonin syndrome? (40%)
A 60-year-old man is booked for plating of a fractured ankle. He arrests on induction. His ECG shows ventricular fibrillation.Outline the immediate management of his cardiac arrest with particular reference to current resuscitation guidelines.
Outline the principles of an initial management plan for diabetic ketoacidosis, having regard to the physiological derangements involved.
“A 40-year-old 100 kg patient presents with septicaemia of unknown cause. After receiving two litres of 0.9% NaCl (Normal Saline) as initial resuscitation the patient has the following observations: HR 126 bpm BP 80/40 mmHg Outline your initial resuscitation goals. (30%)
Evaluate options for ongoing fluid resuscitation at this time. (70%) “
Outline the clinical features, differential diagnoses, and management of serotonin syndrome in the perioperative period.
A 55 year old patient is undergoing emergency laparotomy for acute bowel obstruction. Intraoperative blood tests include the following result: Serum Mg++ 0.40 mmol/L (Normal 0.70 – 1.00 mmol/L) a) Outline the potential causes for this result and the effects it may produce. (70%) b) Describe the management of this abnormality. (30%)
Outline the immediate management of an unconscious trauma patient in the emergency department who has a suspected cervical spine injury
Discuss the use of ultrasound during the initial presentation of a patient with major trauma
Discuss the principles of damage control resuscitation in severe trauma.
Discuss your strategy for the management of coagulopathy in the multitrauma patient.
A trauma patient presents thirty minutes after a significant crush injury, with an estimated 40% blood loss. He was previously well. 1. Explain the coagulation abnormalities you would expect in this patient at this stage. (60%) 2. Discuss the current evidence for treatment of these abnormalities. (40%)
(a) What are the clinical consequences of hypothermia to 34⁰C in adults? (50%) (b) How can you manage body temperature in a multi-trauma patient? (50%)
a. Describe the pathophysiological effects of an inhalational injury following a house fire. (60%)b. What implications would this have for anaesthesia one week after the injury? (40%)
Discuss the non-technical skills required for management of an intraoperative crisis.
Your patient is midway through a laparoscopic cholecystectomy. You smell smoke and can see flames in the room adjacent to your theatre. Describe your management of this situation. (39.7%)
You are involved in the planning of a new Day Surgery Unit.(a) What systems would you put in place to reduce the likelihood of a power failure? (50%)(b) Outline a protocol for dealing with power failures. (50%)
Discuss the strategies you would use to mitigate the risk of a fire in the operating room. (50%) Outline the steps to take in the event of fire in the operating room. (50%
Describe the assessment and management of a patient with a suspected pneumothorax in the post anaesthesia care unit (PACU) following a paravertebral block for a mastectomy
A patient 12 hours after liver resection in the ICU requires transfer to theatre for urgent exploratory laparotomy. The patient has been significantly hypotensive for the past few hours requiring increases doses of vasopressors.
What are the possible causes of this patient’s hypotension? (30%)
What pharmacological management would you consider to treat the hypotension? (40%)
How can you assess volume status in this patient? (30%)
List the risk factors for venous air embolism and arterial air embolism. (30%)Discuss the diagnosis and management of intraoperative massive venous air embolism in a patient under general anaesthesia. (70%
Discuss the management of a patient with life-threatening haemorrhage from major pelvic trauma
List the clinical features that suggest a diagnosis of pulmonary embolism under general anaesthesia. (30%)Outline your immediate management of intraoperative pulmonary embolism. (70%)
