Surgery

Question 1

What is Ramsay Hunt syndrome?

Answer 1

An acute perifacial neuropathy with associated erythematous vascicular rash of the ear canal, auricle and mucous membrane of the oropharynx due to VZV infection of the facial nerve (or VIII, IX, V and or VI)

+/- Cerebellar dysfunction and ataxia

Question 2

What must you consider before performing a gastric lavage?

Answer 2

The time since the offending agent was ingested

The speed at which the agent is absorbed

If the agent is corrosive

Whether the airway is safe

Question 3

What is the pathophysiological mechanism of cyanide poisoning?

Answer 3

Binding to cytochrome C oxidase in the mitochondria to inhibit oxidative phosphorylation

Question 4

How do you reverse cyanide poisoning? Do you determine whether it’s necessary?

Answer 4

Give the patient methaemoglobin that will competitively bind the cyanide

Monitor lactate levels

Question 5

Which food stuffs contain high levels of cyanide?

Answer 5

Apple seeds

Apricot kernels