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Question 1

1) When performing advanced life support, if IV access can’t be achieved, what route should drugs be given via?

Answer 1

Intraosseous route (intraosseous line insertion)

Question 2

If thrombolytic drugs are given during ALS, how long should CPR be done for?

Answer 2

60-90 minutes

Question 3

1) What can cause J waves?
2) Which part of an ECG can J waves be seen in, and how do they look?

Answer 3

1) Hypothermia?
2) QRS complex - small hump at the end of the complex

Question 4

If a patient on warfarin has an INR of 5-8, and there’s no bleeding, how is it managed?

Answer 4

Withhold 1 or 2 warfarin doses and reduce subsequent maintenance doses

Question 5

If a patient on warfarin has an INR of 5-8, and there’s minor bleeding, how is it managed?

Answer 5

Stop warfarin and give 1-3mg of vitK. Restart warfarin when INR <5

Question 6

If a patient on warfarin has an INR of >8 and there’s no bleeding, how is it managed?

Answer 6

Stop warfarin and give 1-5mg of vitK orally using the IV preparation. Repeat dose of vitK if INR still too high after 24 hours. Restart warfarin when INR < 5

Question 7

If a patient on warfarin has an INR of >8 and there’s minor bleeding, how is it managed?

Answer 7

Stop warfarin and give IV vitamin K 1-3mg
and repeat dose of vitK if INR still too high after 24 hours. Restart warfarin when INR < 5.0

Question 8

If a patient on warfarin has a major bleed, how is it managed?

Answer 8

Stop warfarin, give IV vitamin K 5mg
and a prothrombin complex concentrate - if not available then fresh frozen plasma

Question 9

How does subclavian steal syndrome typically present?

Answer 9

Posterior brain circulation symptoms i.e. dizziness and vertigo, and arm claudication

Question 10

Buerger’s syndrome (thromboangiitis obliterans) a disease of what?

Answer 10

Small and medium vessels (vasculitis)

Question 11

Buerger’s syndrome has a strong association with what?

Answer 11

Smoking

Question 12

Name a feature of Buerger’s syndrome

Answer 12

• Raynaud’s phenomenon
• Extremity ischaemia (ischaemic ulcers, intermittent claudication)
• Superficial thrombophlebitis

Question 13

When would statins be given 20mg, and when would they be given 80mg?

Answer 13

20mg for primary prevention and 80mg for secondary prevention

Question 14

What’s the inheritance pattern of marfan syndrome

Answer 14

Autosomal dominant

Question 15

What kind of disease most commonly causes a bloody pericardial effusion?

Answer 15

Malignant