Other

Question 1

Diagnose sepsis syndrome - SIRS

Answer 1

Temp <36 or >38

Respiratory rate >20

Pulse >90bpm

2/3 required for SIRS
- urgent referral if so

Always refer urgently if
- submandibular space or pharyngeal space
- systemic manifestations and immunocompromised
- trouble swallowing or breathing
- rapidly progressing

Question 2

Formulation and max doses of anaesthetics?

Answer 2

Articaine 4%, 1:100k, 6mg/kg

Lidocaine 2%, 1:80k, 7mg/kg

Prilocaine - 8mg/kg

Question 3

How clean down a pod / station?

Answer 3

Wear appropriate ppe

Sharps removed first

Clinical waste in orange

Non clinical in black

Wipe from top down

Change new tips / spitoon etc

Wipe benches

Question 4

Difference between type N, B and S steriliser?

What can they each process?

Answer 4

N = non vacuum, passive air removal, unwrapped solid products, non hollow and non lumened

B = vacuum with active air removal. Packaged instruments with lumens, cannulated or porous

S = special and can do hand pieces n shit

Question 5

Tests for sterilisers?

Answer 5

Daily
- ACT - temp reached for what time
- wipe clean and check components functioning properly e.g. door seals
- Bowie dick / steam penetration test

Weekly ACT
- steam penetration test
- vacuum leak tests
- automatic air detector function test

Quarterly
- validation report

Yearly
- annual report for safety

Question 6

How identify and deal with an asthma medical emergency

Answer 6

A - difficult to complete sentences

B - increased rate with wheezing

C - increased rate

D - alert

E - tripods

Treatment
- ring ambulance

• salbutamol inhaler - SABA relaxing smooth muscles in bronchi - 100ug per actuation
• 100% oxygen 15L/min flow

Question 7

How identify and deal with anaphylaxis?

Answer 7

ABCDE signs
- redness and angio-oedema
- tachycardia but weak pulse
- airway constriction
- irregular but fast breathing

Tx
- phone ambulance

• adrenaline 500ug injection, Z track technique into thigh, spread skin and insert, aspirate then inject, release tension and pull out
• reassess ABCDE
• 100% oxygen 15L/min

Question 8

How identify hypoglycaemia and treat?

Answer 8

A - initially talking

B - initially increased rate

C - initially increased

D - initially alert

E - irritable, confused, pale

Treatment
- glucose
- glucagon 1mg IM injection

Question 9

How identify angina / MI and treat?

Answer 9

A - able to talk

B - increased

C - increased

D - alert

E - pale, clammy, central chest pain

Treatment
- GTN sublingual - 400ug per dose x 2 sprays
- aspirin 300mg chewed if MI

Question 10

How do bisphosphonates work?

Answer 10

Inhibit osteoclastic activity and so inhibit bone resorption and therefore bone renewal

Question 11

How do anticoagulants vs antiplatelets work?

Answer 11

Antiplatelets e.g. clopidogrel typically inhibit clot formation through preventing platelet activation

Anticoagulants inhibit a stage in the coagulation cascade preventing fibrin formation for clots.

Question 12

How go about a medical emergency?

Answer 12

A-airway
- loss of consciousness
- obstruction
- inflammation/swelling/constriction of muscles

B-breathing
- demand for oxygen
- look/listen/feel
- supplemental oxygen

C-circulation
- arrhythmia/arrest
- pulse check
- elevate legs if weak pulse

D-disability
- drugs/brain injury
- hypoglycaemia
- ACVPU level
- optimise ABC first

E-exposure
- clinically relevant information

And treat as you meet

REASSESS

Question 13

What is fluoride toxicity levels?

How many mgF in a tube of toothpaste?

Answer 13

5mg/kg for a child

1000ppmF is 1mg/g of toothpaste, so a 100g tube would contain 100mg - enough to be toxic to anyone 20kg and under