Medical Quiz

Question 1

Name organ system level cellular changes due to heat.

Answer 1

• rhabdomyolisis
• pulmonary edema
• disseminated intravascular coagulation
• cardiovascular dysfunction
• electrolyte disturbance
• renal failure
• liver failure

Question 2

Name 3 clinical emergencies of altitude illness

Answer 2

Acute mountain sickness (AMS)
High altitude cerebral oedema (HACE)
High altitude pulmonary oedema (HAPE)

Question 3

Name 4 causes of hyperthermia

Answer 3

Exertion in hot conditions
Thyroid storm (thyrotoxic crisis)
Malignant hyperthermia
Poisoning (stmpathomimetic eg ecstasy) - MDMA 5-HTZ receptors

Question 4

Name the temperature controls centre in the brain

Answer 4

Hypothalamus

Question 5

Name the 3 internal processes for regulating heat production

Answer 5

Basal metabolism
Sweating
Skin arterioles

Question 6

Signs of CO2 retention

Answer 6

Increased drowsiness
Increased/irregular respiratory rate
Abdominal paradox
Use of accessory muscles for respiration
Anxiety
Confusion

Question 7

Name four types of lower GI bleeding

Answer 7

Hematokesia - blood mixed in with stool
Rectorhagia - leaking blood from the rectum
Melena - dark tarry stool
Whole clots

Question 8

How to determine defibrillator voltage for paediatrics

Answer 8

4 joules/kg

Question 9

Name 4 structural changes to the obese pts airway/respiration

Answer 9

O2 consumption and CO2 production increased, due to metabolic activity in adipose tissue and increased work from supportive tissues.
Safe apnea period during RSI increased.
increased airway resistance, abnormally elevated diaphragm, and increased work of breathing secondary to chest wall elasticity and resistance to caudal capacity - resulting in shallow rapid breathing, reduction in capacity to pre-oxygenate and limited ventilatory capacity.
increased fat distribution in pharyngeal tissues increasing likelihood of pharyngeal wall collapse.

Question 10

Early and late signs of pediatric shock

Answer 10

early:
peripheral temp
cap refill
HR

late:
bradycardia
hypotension

Question 11

Identifying pain in the unconscious patient

Answer 11

hypertension
tachycardia
tearing
restlessness

Question 12

Possible systemic complications of crush injury

Answer 12

rhabdomyolysis
kidney injury
hyperkalemia
sepsis
loss of limb

Question 13

Name 5 types of shock

Answer 13

Anaphylactic
Cardiogenic
Hypovolemic
Neurogenic
Septic

Question 14

Name and describe 4 causes of hypoxia.

Answer 14

Hypoxia hypoxia - normal O2 capacity but diminished O2 tension in arterial blood, with varying degrees of Hemoglobin unsaturation e.g. most respiratory diseases.

Stagnant hypoxia - cardiovascular compromise e.g. MI, thrombus, embolus.

Anaemic - fewer functioning Hemoglobin.

Histoxic - utilisation is diminished due to poisoning of the tissue cells, e.g. cyanide poisoning.

Question 15

ECG: the 8 step method

Answer 15

1. Rate
2. Regularity
3. P waves (atrial activity)
4. PR intervals and conduction ratio
5. QRS complex
6. Origin of the dysrhythmia
7. Identify dysrhythmia
8. Clinical significance

Question 16

Should dystopia management acronym

Answer 16

** time - 5 minute emergency **

H - help
E - explain
L - legs in McRoberts
P - pressure suprapubically
E - enter the vagina
R - remove posterior arm
R - roll over and try again

• if this fails, transport rapidly

Question 17

Outline the APGAR score

Answer 17

Score out of 10. Less than 7 requires intervention.

A - activity (muscle tone): absent; flexed arms and legs; active

P - pulse: absent; < 100bpm; > 100bpm

G - grimace (reflex irritability): floppy; minimal response to stimulation; prompt response

A - appearance: blue, pale; pink body, blue extremities; pink

R - respiration: absent; slow and irregular; vigorous cry

Question 18

Rules for splinting

Answer 18

Treat critical injuries first
Consider tx vs splinting in field
Pail relief before splinting
Pad splints and remove clothing
Straighten deformities; immobilise joints
Check and recheck neurovascular function
Irrigate open wounds
Cover open wounds
Protect exposed bone

Question 19

Treatment options for headache

Answer 19

Aspirin (caution in rapid onset, worst headache, could be bleed)
Anti-emetic
Ibuprofen
Triptans (serotonin receptors antagonist) —> selectively restrict cerebral blood vessels
Acupuncture
Opiates
HRT

Question 20

List 7 possible causes of junctional escape rhythm

Answer 20

Severe sinus bradycardia
Sinus arrest
Sinoatrial exit block
High-grade second degree AV block
Third degree AV block
Hyperkalemia
Drugs- beta blockers, calcium-channel blockers, or digoxin poisoning.

Question 21

List some signs of inadequate ventilation

Answer 21

Rate issues
Irregular
Inadequate depth
Use of accessory muscles
Nasal flaring (paeds)
See-saw breathing (paeds)
Head bobbing
Abnormal noises
Tripod position

Question 22

Name the four presenting features of hypercalcaemia and the three most common causes

Answer 22

Rentals stones
Painful bones
Abdominal groans
Psychiatric moans

Calcium supplements
Hyperparathyroidism
Cancer

Question 23

3 mechanisms of reperfusion injury

Answer 23

1. Increased formation of reactive oxygen species
2. Micro vascular vasoconstriction
3. Adhesion of neutrophils to endothelial lining, their activation, and release of cytokines