PassTest Acute Care

Question 1

If you are alone and find a responsive patient, what does the guideline suggest?

Answer 1

Leave patient to summon help

Question 2

If a patient begins breathing after CPR, what does the guideline suggest?

Answer 2

Placing the patient in the recovery position

Question 3

What do you do before starting chest compressions?

Answer 3

Check airway

Question 4

What is the treatment for a post Dural puncture headache?

Answer 4

Blood patch - am injection of blood down the epidural tract

Once blood enters the epidural space it clots and forms a seal

Question 5

Treat hyperkalaemia a

Answer 5

Give calcium gluconate 10% 10mls by slow IV injection
Then
10 units act rapid in 100ml of 20% glucose
Salbutamol nebs
Calcium resonium 15g orally or rectally

Question 6

Where can you fit a CVC?

Answer 6

Internal jugular
Subclavian vein
Femoral vein
Venous cutdown on the basilic vein

(Depends on whether peripheral or central vein cannulation is required)

Question 7

What prep is needed for insertion and maintenance of a CVC?

Answer 7

Patients coag status and platelet count should be normalised before insertion
Sterile insertion

Question 8

After a subclavian or internal jugular catheter is inserted what needs done?

Answer 8

Chest radiograph

Question 9

To prevent cardiac arrhythmias catheters in the right atrium or ventricle should be withdrawn until the

Answer 9

Tip is within the superior vena cava

Question 10

What are the complications involved with CVC?

Answer 10

Pneumothorax
Accidental arterial cannulation
Sepsis

Question 11

Who needs to diagnose brain death?

Answer 11

Two doctors at least one a consultant and both registered for 5 years

Question 12

Causes of confusion in the ICU

Answer 12

Cerebral hypoxia 
Hypoglycaemia 
Sepsis or toxins
Anaesthetic and other drugs 
Head injury

Question 13

Anyone that has an anaphylactic reaction gets what home with them

Answer 13

Two adrenaline autoinjectors

Question 14

Treat Addisonian crisis

Answer 14

Give 100mg hydrocortisone IM STAT

Question 15

Dose of adrenaline for anaphylaxis in a kid under 6

Answer 15

150 micro grams IM

Question 16

Dose of adrenaline for anaphylaxis in a kid between ages 6-12

Answer 16

300 micro grams IM

Question 17

How are patients with traumatic brain injury treated ?

Answer 17

Maintain pco2 of 4.5
Maintain po2 above 13
Maintain oxygen above 95%
In extreme patients hyperventilation may help

Question 18

Mild aspirin overdose presents as

Answer 18

Tinnitus nausea vomiting

In severe cases you can get hallucination sconfusions seizures and pulmonary oedema

Question 19

When does hepatic necrosis develop after paracetamol overdose

Answer 19

After 24 hours

Question 20

How do you treat laryngeal oedema and bronchospasm associated with inhalation burns?

Answer 20

Bronchodilators and steroids
Positive pressure ventilation
Prophylactic systemic antibiotic cover
IV crystalloid

Question 21

Why is sodium nitroprusside in a bag?

Answer 21

Used to treat malignant hypertension and comes in a silver bag to be protected from sunlight which degraded it to cyanide

Treat cyanide poisoning with dicobalt edetate. If unavailable give sodium nitrate or sodium thiosulphate

Question 22

Abdo pain nausea and then develops SOB (bilateral pulmonary infiltrates seen)

Answer 22

Is it ARDS associated with acute pancreatitis?

Question 23

Raised j wave on ecg

Answer 23

Hypothermia

Question 24

Woman on ocp with extreme abdo pain

Answer 24

Could it be acute porphyria?

Question 25

List three things that cause SIRS other than sepsis

Answer 25

Acute pancreatitis
Major trauma
Burns

Question 26

Give criteria for SIRS

Answer 26

Temp >38 or less than 36
HR>90
Resp rate >20
WBC >12000 or <4000

Question 27

What is wernikes encephalopathy

Answer 27

Eye movement disorders ataxia and confusion

Thiamine deficiency

Question 28

Treat digoxin toxicity

Answer 28

Digifab

If not available treat ventricular arrhythmias with phenytoin or lidocaine

Question 29

What causes a stress ulcer in a critically ill patient?

Answer 29

Ischaemic injury time gastric mucosa loss of cytoprotectabts and disruption of the gastric mucosal barrier to acid injury

Question 30

What are the main risk factors in ICU for a stress ulcer?

Answer 30

Resp failure
Coagulopathy
Sepsis 
Hypotension 
Hepatic/ renal failure

Question 31

How do you prevent Cushings ulcer? And what is the main complication of this?

Answer 31

PPI H2RA

Pneumonia

Question 32

What factors are involved in blood transfusion reactions?

Answer 32

Allergens

Gram negative endotoxins

Question 33

What is the effect of transfusion reactions on liver function and clotting factors ?

Answer 33

Acute liver failure and hepatic coma are rare complications

Acute intravascikar coagulation