ICM

Question 1

Device for measuring BP?

Answer 1

Sphygmomanometer

Question 2

Korotkoff sound level 1?

Answer 2

As the cuff is deflated (no greater than 5mmHg per second) a sharp tapping sound is heard as the cuff pressure equals the systolic pressure. At systolic the pressure is enough to force open the artery walls for blood to spurt through. The level at which you hear consistent beats is recorded as the systolic pressure

Question 3

Korotkoff sound level 2?

Answer 3

This phase is characterised as a swishing sound caused by the swirling currents on the blood as the flow through the artery increases. Sometimes if the cuff is deflated too slowly the sounds vanish temporarily. This happens when the blood vessels beneath the cuff become congested, and is often a sign of hypertension. The congestion eventually clears and sounds resume. This is known as the auscultatory gap.

Question 4

Korotkoff sound level 3?

Answer 4

In this phase the sounds become louder and have a tapping quality similar to phase 1. At this stage the increased blood flow is pounding against the artery walls.

Question 5

Korotkoff sound level 4?

Answer 5

At this point the tapping sounds of Phase 3 are abruptly replaced by a muffled sound.

Question 6

Korotkoff sound level 5?

Answer 6

This is the point at which sounds cease to be heard all together. The blood flow has returned to the normal and is now laminar. This is the diastolic pressure. This phase is absent in some people in which case some medical practitioners choose to record Phase 4 as the diastolic pressure.

Question 7

List all the pulses

Answer 7

Radial, Brachial, Axillary, Carotid, Subclavian, Femoral, Popliteal, Dorsalis Pedis, Posterior Tibial

Question 8

ANTT: Define clean

Answer 8

Free from dirt, stain, or impurities; unsoiled

Question 9

ANTT: Define asepsis

Answer 9

The state of being free of pathogenic microorganisms.

Question 10

ANTT: Define sterile

Answer 10

Free from live bacteria or other microorganisms

Question 11

Difference between situation where you so standard or surgical ANTT?

Answer 11

If you need to touch the key part- surgical

Question 12

What are the 5 moments for hand washing?

Answer 12

before touching a patient,
before clean/aseptic procedures,
after body fluid exposure/risk,
after touching a patient, and.
after touching patient surroundings.

Question 13

ANTT: What is a key site?

Answer 13

Open wounds, including insertion and puncture sites.

Question 14

ANTT: What is a key part?

Answer 14

Critical parts of the procedure equipment that come into direct or indirect contact with active Key-Parts connected to the patient, any liquid infusion or Key-Site

Question 15

Abdominal pain in neonate -3 months?

Answer 15

Intestinal obstruction (ie. volvulus, Hirshsprung,
pyloric stenosis)
Peritonitis (i.e. necrotising enterocolitis, GI
perforation)
Hernia
Gastroesophageal Reflux
Trauma (i.e. during birth)

Question 16

Abdominal pain in infant under 2 years old?

Answer 16

Constipation
Acute gastroenteritis
Trauma
Hernia
Volvulus
Intussusception
Respiratory illness

Question 17

Abdominal pain in children?

Answer 17

Acute gastroenteritis
Urinary tract infection/ Pyelonephritis
Constipation
Ingestion
Intestinal obstruction
Trauma
Testicular torsion 
Dawn Edwards
November 2017, Week 108 Page 2
Henoch-Schonlein Purpura
Respiratory illness, pneumonia
Appendicitis
Pancreatitis
Cholecystitis
Mesenteric adenitis
DKA

Question 18

Abdominal pain in teenagers?

Answer 18

Trauma
Ingestion
Food poisoning
Dysmenorrhea
Pregnancy (i.e. ectopic)
Pelvic inflammatory disease
Testicular torsion
Ovarian torsion/cysts
Gastroenteritis
Constipation

Question 19

Name for newborn blue hands and feet?

Answer 19

Acrocyanosis

Question 20

What skin abnormalities in newborn exam?

Answer 20

Milia (White papules found on the nose and cheeks that resolve in the first few weeks of life and are benign)
Erythema toxicum (White papules 1-2 mm in size, Develop on 2nd – 3rd postnatal day, Benign)
Mongolian blue spots (Blue/grey/greenish blue macules with a definite border, benign)
Capillary haemangioma “stork bite” (Can be found in middle of forehead, nape of neck, upper eyelid )
Port wine stain (can be found anywhere- may not be a benign sign in a newborn)

Question 21

What head abnormalities in newborn exam?

Answer 21

Caput succedaneum - Oedema over the presenting part of the head, Common at birth, Crosses suture lines, Resolves within a few days
Cephalohaematomas - Subperiosteal collections of blood, Occur in 1-2% of newborn babies, feel like a fluctuant mass that does not cross suture lines, May increase in size after birth, Take weeks to months
resolve
Subgaleal haemorrhages - Collections of blood between the aponeurosis covering the scalp and
the periosteum, Extend across suture lines, Feel firm and fluctuant, Can be associated with significant blood loss

Question 22

Abnormalities in mouth in newborn exam?

Answer 22

Micrognathia
Cleft lip and palate
Macroglossia
Teeth (Usually occur in isolation but may be associated with syndrome)
Epstein’s pearls( Benign white cysts, Seen in most babies)
Mucous retention cyst
Tongue tie

Question 23

Abnormalities in face in newborn exam?

Answer 23

Facial palsies
Asymmetric crying facies - Due to congenital absence or hypoplasia of the depressor anguli oris
muscle, Benign

Question 24

Abnormalities in neck in newborn exam?

Answer 24

Excess skinfold (Turner’s syndrome)
 Masses
 Sterocleidomastoid tumour
 Cystic hygroma
 Branchial cyst
 Thyroglossal cyst
 Cervical lymph nodes
Decreased movement (Torticollis)

Question 25

Abnormalities in chest in newborn exam?

Answer 25

Size- (Small or malformed may suggest pulmonary hypoplasia)
Asymmetry (Pectus excavatum, Pectus carinatum)
Breast (Breast hypertrophy van be due to maternal hormones. Occasionally the breast can secrete a thin milky fluid known as “witch’s milk” and this can last for several days to weeks)
Widely spaced nipples (Turner’s syndrome)
Accessory nipple

Question 26

Abnormalities in abdominal wall in newborn exam?

Answer 26

Omphalocoele
Gastroschisis
Umbilical hernia

Question 27

Hip tests in newborn exam?

Answer 27

Ortolani and Barlow’s test

Question 28

Milestones at 6 week newborn exam?

Answer 28

Baby looks at, recognises and smiles at mother

Baby able to feed properly

Question 29

Milestones at 6 months old?

Answer 29

Baby able to hold up own head
Baby able to weight bear if held upright
Baby can grab block in palmer grasp and pass from one had to the other

Question 30

Milestones at 9 months old?

Answer 30

Pincer grip
Wary of strangers
Sits independently

Question 31

Milestones at 1 year?

Answer 31

Crawling
Recognise name
Ask for a drink
Wave goodbye

Question 32

Milestones at 15 months old?

Answer 32

Able to toddle around
Is able to make 2 block tower
Drink out of a cup

Question 33

Milestones at 18 moths old?

Answer 33

Nearly running
3 blocks tower
Eats with a spoon

Question 34

Milestones at 2 years old?

Answer 34

Running
Temper tantrums
6 block tower

Question 35

Milestones at 2.5 years old?

Answer 35

Can kick a ball
Potty trained
Can sit on tricycle and use legs to push

Question 36

Milestone at 3 years old?

Answer 36

Jump off bottom step of stairs
Use scissors
Talks
Ride tricycle 
9 block tower 
Eat using fork

Question 37

Order of draw for bloods? And what for?

Answer 37

Blood culture
Blue (Haem - clotting tests, INR)
Red (Biochem- Thyrogoubin &ab, Digoxin. Micro - serology and abs)
Gold (Biochem - Thyroid, all proteins, FSH, LH, prolactin etc, hGH, B12, tumour markers)
Green (Biochem- amino acids, carboxyhaemoglobin, chromosomes, insulin)
Lavender (Haem - FBC, ESR, PCR)
Pink (Blood transfusion, cross matching)
Grey (Biochem- glucose, alcohol, lactate)