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I mark for each.
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Principles:
Avoid dynamic hyperinflation Permissive hypocapnoea to facilitate oxygenation Ventilator settings:
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1 mark for each principle 1 mark 1marks 1 mark 3 marks 2 marks 1 mark 1 mark |
Must include:
Normocyctic anaemia Leucopaenia Thrombocytopaenia Blasts present Likely new diagnosis of acute leukaemia |
1 mark each 1 mark for diagnosis |
Must include the elements of:
1. Record and register the complaint for investigation 2. Refer the patient for admission under paediatrics/haematology |
1 mark for each element |
Must include the elements of:
1. Review the medical record 2. Interview the staff concerned in the prior presentations 3. Summarise the important findings and report back to the Director 4. Outline areas to improve and institute a quality cycle |
1 mark for each element
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Anything reasonable such as:
Staff education via M+M Develop policy of senior review for representations Improve orientation manual to outline expectations of junior doctors |
1 mark for each element.
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1. Wide complex tachycardia rate approximately 142
2. Leftward axis 3. AV dissociation 4. Concordant chest leads Likely VT |
1 mark for each point and the diagnosis.
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OPTION
ELECTRICAL CARDIOVERSION CHEMICAL CARDIOVERSION |
PRO
applies for all arrythmias highest success rate does not require sedation |
CON
requires anaesthetic lower success rate dangerous if there is an accessory pathway |
Must include:
Rate 72 Sinus rhythm Right axis deviation T wave inversion inferior and praecordial leads Epsilon wave seen Diagnosis – arrythmogenic right ventricular dysplasia |
1 mark for each descriptor 2 marks for diagnosis. |
BSL – hypoglycaemia
ECG – conduction changes (electrolytes) FBC – anaemia UEC – renal failure and electrolyte levels bHCG – exclude pregnancy VBG – starvation ketoacidosis |
1 mark for each point accompanied by a reason.
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Indications for admission to a medical unit rather than mental health unit include:
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1 mark for each criteria. |
RAGMA
Metabolic alkalosis Respiratory compensation |
1 mark each
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ANION GAP 35
DELTA RATIO 2.3 |
1 mark each
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Must include:
Low EXTEM Low INTEM Low FIBTEM Low APTEM Which indicates administration of CRYOPRECIPITATE |
1 mark for each statement 1 mark for product |
Collapse of EXTEM, INTEM and FIBTEM after initial clot formation.
Maintenance of APTEM Indicates fibrinolysis and administration of tranexamic acid. |
1 mark for each statement
1 mark for product |
Multiple fractures of the nasal bones
Multiple bilateral fractures of the maxillary sinuses Bilateral fluid levels in maxillary sinuses Fracture through L base of skull |
1 mark for each statement.
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Consent must be carried out by the surgeon performing the procedure, and therefore ED will not undertake this.
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1 mark each:
consent is a surgical issue ED will not undertake it |
Must include:
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1 mark for each point
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Themes to include
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1 mark for each theme |
Should include: immediate intraosseous access
1. IO drill or gun 2. Swabbed skin 3. 1-2cm below and medial to tibial tuberosity 4. Advanced until loss of resistance and marrow aspirated |
1 mark for intraosseous route
1 mark for each item |
Must include appropriate doses of the below, for a calculated weight of 12kg:
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1 mark for calculated weight and 7 other interventions.
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1 mark for each element
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1 mark per element
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1. Primary metabolic akalosis
2. Appropriate respiratory compensation 3. A raised anion gap acidosis |
1 mark for each of these. |
1. Rate 84/min
2. Normal axis 3. Normal PR/QRS intervals 4. No conduction defect This is a NORMAL ECG |
1 mark for each and 1 mark for understanding this ECG is normal.
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Must include:
1. Recheck Potassium: the VBG and ECG results are discrepant, and one must be incorrect 2. Telemetry while this is established 3. IV fluid rehydration given underlying metabolic acodosis and vomiting illness. |
Note - 2 marks for each element.
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MUST INCLUDE:
Brain tumour Dural venous sinus thrombosis Encephalitis And any from: Meningitis Migraine Sub arachnoid haemorrhage Tension headache Cluster headache Conversion disorder Mental illness Gateway presentation Or other reasonable cause of headache |
1 mark for each of these two diagnoses. NOTE, these are critical omissions if not stated, and will reduce mark to 1.
1 mark to a maximum of three for further diagnoses. |
Filling defect in R transverse sinus
Loss of cerebral architecture Diagnosis: transverse dural venous sinus thrombosis. |
1 mark for each reasonable item
2 marks for diagnosis. |
1. Anticoagulation - either heparin infusion or 1-1.5mg/kg enoxaparin
2. Referral to neurology. |
1 Mark each
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Must include:
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1 mark 1 mark 2 marks |
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1 mark
1 mark 2 marks: must mention serial exams are needed. |
Must include:
Non toxic serum iron level But 1 hour post ingestion. Needs to be repeated at 4-6 hours. If iron levels <90 micromol/mg then repeat again at 4 hours If falling then no further treatment necessary. |
1 mark for each |
Start desferrioxamine 15mg/kg.hr
Admit under paediatrics/PICU or toxicology |
1 mark each.
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