Practical and Examination Tips

Question 1

In The Pouring Rain She Came - Neurological Examinations

Answer 1

• Inspection (assess gait for lower limb, DM foot and cerebellum examinations)
• Tone
• Power
• Reflex
• Sensation (Fine, Sharp, Vibration and Proprioception)
• Coordination

Question 2

DANISH - Cerebellum

Answer 2

• Dysdiadochokinesia
• Ataxia
• Nystagmus
• Intention tremor
• Slurred speech
• Hypotonia (decreased tone)/Hell-sheen test

Question 3

Look, Feel, Move, Special Tests - Joints

Answer 3

• Look: Inspection
• Feel: Palpation
• Move: Active and Passive Movements
• Special Tests (specific for each joint)

Question 4

DR ABC - Primary Survey

Answer 4

• Danger (make the area safe)
  Response (tap on their shoulders and call their names/shout)
• Airway (keep their airway open)
• Breathing (check for 10 seconds)
• Circulation (check the pulses and check for severe bleedings and treat life-threatening injuries)

Pulses: Adults and Child (carotid and femoral) and infants (brachial and femoral)

Question 5

CPR 30:2

Answer 5

Adults

Question 6

5 Initial Rescue Breaths + CPR 30:2

Answer 6

Children, Infants and Drowning

Question 7

Interfere with AED

Answer 7

• Drowning (dry the patient before using it)
• Medication patches
• Metal jewellery

Question 8

VT/VFib Management

Answer 8

• ABC (airway, breathing and circulation)
• Check pulse (no pulse - defibrillate; pulse - chemical cardioversion)
• CPR
• AED
• IV/IO Adrenaline 1 mg every 3-5 min (after the 3rd shock) or IV Amiodarone 300 mg (after the 3rd shock)

Question 9

Bradycardia Management

Answer 9

• ABC (airway, breathing and circulation)
• IV Atropine 1 mg every 3-5 min (total dose of 3 mg)
• Assess ROSC (return of spontaneous circulation)

Question 10

How to use EpiPen

Answer 10

• Check the medication window (must be a clear liquid)
• Check the expiring date
• Remove blue cap
• Hold with dominant hand
• Blue to the Sky
• Orange to the Thigh
• Single dose
• Hold it for 3 seconds
• Can repeat one more time (after 5-10 min with a new pen)

NOTE: Call ambulance in the meantime and mention anaphylaxis for a faster reply.

Question 11

Anaphylaxis Mx: >12 years old

Answer 11

• ABCDE
• IM Adrenaline 0.5 mg
• IM Chlorphenamine 10 mg
• IM Hydrocortisone 200 mg
• Symptomatic: Nebs

Question 12

Anaphylaxis Mx: 6-12 years old

Answer 12

• ABCDE
• IM Adrenaline 0.3 mg
• IM Chlorphenamine 5 mg
• IM Hydrocortisone 100 mg
• Symptomatic: Nebs

Question 13

Anaphylaxis Mx: < 6 years old

Answer 13

• ABCDE
• IM Adrenaline 0.15 mg
• IM Chlorphenamine 2.5 mg (6 months to 6 years old)
• IM Hydrocortisone 50 mg (6 months to 6 years old)
• Symptomatic: Nebs

Question 14

Anaphylaxis Mx: < 6 months

Answer 14

• ABCDE
• IM Adrenaline 0.15 mg
• IM Chlorphenamine 250 micrograms
• IM Hydrocortisone 25 mg
• Symptomatic: Nebs