Mock Exam Part 2, unnumbered

Question 1

You observe a wound. it measures 3x4cm ulceration which is dark brown with black eschar. What do you think is the cause of injury?
A. Hydrochloric acid
B. Formic acid
C. Oxalic acid
D. Lime

Answer 1

A. Hydrochloric acid
Hydrochloric acid and sulfuric acid can burn the skin dark brown or black.
Toilet bowel cleaners: may contain 80% sulfuric acid solutions
Automobil battery fluid: 25% sulfuic acid.
household bleach: 3-6% hypochlorite solutions

Question 2

most important chemical burn features that healthcare professionals may alter

Answer 2

contact time with the skin

Question 3

TRUE or FALSE
An isopropyl alcohol rinse is equivalent to polyethylene glycol in removing phenol (carbolic acid)

Answer 3

TRUE

Question 4

chromic acid burn of this surface area is fatal

Answer 4

10% TBSA burn
due to systemic toxicity (hepatic necrosis, hephrotoxicity)

Question 5

systemic toxicity of phenol

Answer 5

phenol = carbolic acid
cardiovascular and CNS toxicity

Question 6

unlike other acids, this acid penetrates deeply and will cause progressive tissue loss

Answer 6

Hydrofluoric acid

Question 7

Systemic toxicity of hydrofluoric acid

Answer 7

Hypocalcemia
Hypomagnesemia
Hyperkalemia
Cardiac arrhythmias
Sudden death

Question 8

agent of choice for hydrofluoric acid chemical burn

Answer 8

calcium gluconate
GEL: 25 mL of 10% calcium gluconate in 75 mL of water-based lubricant

INTRA-ARTERIAL INFUSION (within 6 hours of insult to prevent tissue necrosis and stop the pain)
40 mL of 5% destrose in water with 10 mL of 10% calcium gluconate over 4 hours

Question 9

systemic toxicity of formic acid

Answer 9

hepatic necrosis and nephrotoxicity
these toxicities are also seen in:
- tannic acid
- chromic acid
- picric acid
- phosphorus

Question 10

Remarks on oxalic acid

Answer 10

Oxalic acid bind calcium and prevents muscle contraction
Wound should be irrigated with water
IV calcium may be required.

Question 11

How to manage Lime burns

Answer 11

Lime = calcium oxide
Lime is converted by water to the alkali calcium hydroxide
All dry lime particles should be brushed away before irrigation. Even small amount of water may generate an exothermic reaction resulting in calcium hydroxide formation and tissue injury

Question 12

dose of epinephrine for a 10 month old for anaphlaxis

Answer 12

0.01 mg/kg
(up to 0.3 mg)

Question 13

When do most anaphylactic reactions occur with bee/wasp stings

Answer 13

15 minutes

Question 14

At what voltage do we admit patients for observation even if there’s no apparent injury?

Answer 14

>600 V
The risk for serious and fatal electrical injury increases with voltage, especially >600 V.

Question 15

In marine trauma and envenomation, patients with underlying conditions such as liver disease, immunosuppression, and diabetes are more susceptible to what bacteria?

Answer 15

VIBRIO

Question 16

Boyle’s law states that:

Answer 16

at constant temperature, the volume of gas increases when the pressure decrease
P1V1=P2V2

Question 17

Dalton’s law states that:

Answer 17

the total pressure exerted by a mixture of gases is the sum of the partial pressure of each gas

Question 18

This law states that at equilibrium the quantity of a gas dissolved in a liquid is proportional to the partial pressure of the gas, along with Dalton’s law, explains the uptake of inert gas into tissues when breathing compressed air at depth

Answer 18

HENRY’S LAW
It is the uptake of inert gas that’s intrinsic to the development of decompression sickness.

Question 19

Most fire-related deaths are due to

Answer 19

smoke inhalation

Question 20

Alternating current (AC) can pose more danger than direct current (DC) as it can cause what type of cardiac rhythm?

Answer 20

VENTRICULAR FIBRILLATION
Standard household electricity is AC.
Electricity in batteries and lightning is DC.
Low-frequency (50- to 60-Hz) AC can be more dangerous than similar levels of DC because the AC fluctuations can result in ventricular fibrillation

Question 21

High voltage is defined as

Answer 21

> 1000 V

Question 22

What is the term used to describe cardiac arrest that can commonly occur during extrication, transport, or treatment of a deeply hypothermic patient?

Answer 22

rescue collapse

Question 23

What is the predominant clinical feature of prickly heat?

Answer 23

itching

Question 24

Is phyton venomous or non-venomous?

Answer 24

non-venomous

Question 25

Discharge patients with dry bites who have been observed for ______ hours with instructions to return if pain, swelling, or bleeding develops

Answer 25

6 to 8 hours

Question 26

A diver had sudden loss of fine motor skills and high-order processes and was diagnosed as nitrogen narcosis. This type of narcosus occurs when air is breathed at a depth of

Answer 26

100 fsw or greater
Inert gas narcosis occurs when air is breathed at a depth of 100 fsw or greater

Question 27

A 23-year-old man presents to the ED after sustaining a bee sting.The pain is isolated to his left arm where the bee sting occurred.Upon physical examination, you see a single puncture woundwith surrounding erythema and swelling. He denies respiratory distress and is phonating well. Chest auscultation reveals clear breath sounds
bilaterally without wheezing. The oropharynx is patent without tongue or lip swelling or uvular displacement. Vital signs are within normal limits.Which of the following is the most appropriate next step in management?
A. Subcutaneous epinephrine 0.01 mL/kg
B. IV epinephrine 0.01 mL/kg
C. IV steroid administration
D. Observation
E. Oral antihistamine

Answer 27

A. Subcutaneous epinephrine 0.01 mL/kg