Situational judgement

Question 1

How quickly should you report someone (to DVLA) for driving if medically unwise?

Answer 1

Should be last resort

Question 2

Anonymous letter vs filling out incident form?

Answer 2

Anonymous letter seems to be frowned upon.

Question 3

Should you admit kids to paeds if they have suspicious injuries

Answer 3

Yes

Question 4

Rules around children <16 consenting?

Answer 4

<16 you need to assess capacity.

If has capacity:

• Can consent to treatment
• Cannot refuse treatment
• Do need to respect their right to confidentiality but should encourage to involve parents

If does not have capacity:

• If in best interests and patient wants procedure then get parental consent
• If patient is refusing then can get consent from parent but seek legal advice as law complex

Question 5

Rules around children 16-18 consenting?

Answer 5

Presumed to have capacity

Question 6

Should you report gun and knife wounds to the police if patient does not request this?

Answer 6

Yes, have to report all to the police.

Question 7

Advice on when to inform DVLA about driving if not able? (how many chances do you give)?

Answer 7

If you have asked the patient more than once.

Question 8

Causes of ST depression on ECG?

Answer 8

Secondary to abnormal QRS (LVH, LBBB, RBBB)

Ischaemia

Digoxin

Hypokalaemia

Syndrome X

Question 9

Two main Sx of ARBs?

Answer 9

Hypotension and hyperkalaemia.

Question 10

ECG territory changes suggesting anterolateral (Circumflex or LAD) vs Lateral (circumflex)?

Answer 10

I, aVL +/- V5-6 - Lateral

V4-6, I, aVL - Anterolateral

Question 11

Pulse changes in aortic stenosis?

Answer 11

Narrow pulse pressure, slow rising pulse.

Question 12

Causes of a prolonged PR interval?

Answer 12

idiopathic
ischaemic heart disease
digoxin toxicity
hypokalaemia*
rheumatic fever
aortic root pathology e.g. abscess secondary to endocarditis
Lyme disease
sarcoidosis
myotonic dystrophy