Revision Day

Question 1

Define major haemorrhage

Answer 1

1) 50% total blood volume in 3h

2) 150mls/min blood loss

Question 2

What is the trauma triad of death?

Answer 2

1) Coagulopathy

2) Acidosis (due to increased lactic acid)

3) Hypothermia

Question 3

Bladder symptoms above vs below injuries at T12?

Answer 3

Above T12 –> bladder spasticity

Below T12 –> bladder flaccidity

Question 4

MSCC: UMN symptoms?

Answer 4

These occur BELOW the level of the lesion e.g. hyperreflexia, Babinski’s sign, hypertonia, clonus

Question 5

MSCC LMN symptoms?

Answer 5

Typically AT the level of the lesion e.g. absent reflexes

Question 6

Doses of adrenaline for anaphylaxis?

Answer 6

IM adrenaline at 1mg/ml (1:1000) concentration

Adult & child >12y/o: 500 micrograms IM (0.5 ml)

Child 6-12 y/o: 300 micrograms (0.3 ml)

Child 6m to 6y: 150 micrograms (0.15 ml)

Child <6m: 100-150 micrograms (0.1-0.15 ml)

These doses are for IM injection only.

Question 7

Mx of refractory anaphylaxis?

Answer 7

Give rapid IV fluid bolus

and

Start IV adrenaline infusion (specialist)

Question 8

Virchow’s triad?

Answer 8

1) endothelial injury
2) hypercoagulability
3) venous stasis

Question 9

Pathophysiology of a PE:

Answer 9

1) Ventilation/perfusion mismatch: impaired gas exchange resulting in T1RF and raised RR

2) Pulmonary arterial HTN: from raised pulmonary vasculature resistance –> RV overload +/- dysfunction

3) Pleural & lung inflammation and infarction: pleuritic chest pain +/- haemoptysis

Question 10

Well’s score results for PE?

Answer 10

> 4 –> PE is likely

≤4 –> PE is unlikely