Week 13 SAQ electronic

MODULE 13 short answer questions.

Below are 5 SAQs. Good luck!

Module 13 SAQS

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SAQ 1.

A 66 year old woman presents to the emergency department with fever and malaise. She has a past medical history of locally invasive breast cancer currently treated with Avastin (bevacizumab). Her last therapy was 6 days prior. She has no known drug allergies.

On arrival to the emergency department her vital signs are:

HR      134      /min
BP       89/60   mmhg
RR       28        /min
Sats     90%     RA
T          39.6     oC

Question 1. (6 marks)

Describe 3 immediate therapeutic actions you will immediately undertake.

Question 1. (6 marks) Describe 3 immediate therapeutic actions you will immediately undertake. *

Question 2. (10 marks)

Give 5 investigations will you order and justification for each?

Question 2. (10 marks) Give 5 investigations will you order and justification for each? *

Question 3. (4 marks)

The lab rings you to tell you the patient’s blood count sent on arrival has clotted. A repeat has been sent and will be ready in 45 minutes. How and why will this effect your immediate management of this patient?

Question 3. (4 marks) The lab rings you to tell you the patient’s blood count sent on arrival has clotted. A repeat has been sent and will be ready in 45 minutes. How and why will this effect your immediate management of this patient? *

SAQ 2.

A 78 year old female presents to your department with increasing dyspnoea and lethargy. She describes a decrease in her exercise tolerance from being able to walk 200m to 50m over 6 months.

Her vital signs are:
HR      96        /min
BP       134/65 mmHg
RR       18        /min
Sats     96%     RA
T          37.2     oC

She has been seen by your intern who has performed a full blood count, the results of which are shown below.

HB 92        mg/dL
White cell count                       8.7       x109/L
Platelet count                           474      x109/L

Haematocrit .31
MCV 76        fL
MCHC 22        g/dL

Neutrophils                             6.32     x109/L
Lymphocytes                           2.1       x109/L
Monocytes                              0.3       x109/L
Basophils                                0.02     x109/L
Eosinophils                             0.02     x109/L

Question 1. (7 marks)

Give 6 important findings from the full blood count and the likely underlying diagnosis.

Question 1. (7 marks) Give 6 important findings from the full blood count and the likely underlying diagnosis. *

Question 2. (4 marks)

Give 4 other investigations will you ask for from the emergency department?

Question 2. (4 marks) Give 4 other investigations will you ask for from the emergency department? *

Question 3. (3 marks)

Give 3 criteria for initiating blood transfusion in this patient?

Question 3. (3 marks) Give 3 criteria for initiating blood transfusion in this patient? *

SAQ 3

A 6 year old boy presents to the emergency department with his mother. He is complaining of a sore throat and decreased oral intake.

On examination he has large erythematous tonsils without any pus.

A full blood count has been taken by your registrar and is shown below.

HB 68        mg/dL
White cell count                       1.7       x109/L
Platelet count                           44        x109/L

Haematocrit                             .29
MCV 84        fL
MCHC 36        g/dL

Neutrophils                             1.12     x109/L
Lymphocytes                           0.1       x109/L
Monocytes 0.3       x109/L
Basophils 0.02     x109/L
Eosinophils 0.02     x109/L

Question 1. (5 marks)

Describe the blood film.

Question 1. (5 marks) Describe the blood film. *

Question 2. (4 marks)

List 4 differential diagnoses.

Question 2. (4 marks) List 4 differential diagnoses. *

Question 3. (4 marks)

Give four (4) features that will you examine the child for?

Question 3. (4 marks) Give four (4) features that will you examine the child for? *

SAQ 4

A 67 year old female presents with left sided thigh pain. There is no history of trauma. Her vital signs are:

HR      86                    /min
BP       153/92             mmHg
RR       20                    /min
Sats     99%                 RA
T          36.8                 oC

An xray of the affected area is shown below.

Question 1. (3 marks)

Give 3 important features of the x-ray.

Question 1. (3 marks) Give 3 important features of the x-ray. *

Question 2. (5 marks)

Select pathology results are shown below.

Describe the major abnormalities.

Na+                              135      mmol/L
K+                                4.6       mmol/L
Cl- 103      mmol/L
HCO3-                         18        mmol/L

Urea                            18        mmol/L
Creatinine 180      umol/L

Ca2+                             3.79     mmol/L
Mg2+                            0.85     mmol/L
PO43-                           0.78     mmol/L

Describe the major abnormalities. *

Question 3. (1 mark)

What is the most likely diagnosis?

Question 3. (1 mark) What is the most likely diagnosis? *

Question 4 (3 marks)

What management will you institute for this patient?

Question 4 (3 marks) What management will you institute for this patient? *

SAQ 5

A 63 year old man presents with fever and abdominal pain. He has no medical history of note. His vital signs on arrival are:

HR      105      /min
BP       120/80 mmHg
RR       29        /min
Sats     99%     RA
T          39.6     oC

His full blood count is shown below.

HB 88        mg/dL
White cell count                       136      x109/L
Platelet count                           44        x109/L

Haematocrit                             .31
MCV 82        fL
MCHC 34        g/dL

Neutrophils                             1.12     x109/L
Lymphocytes                           0.70     x109/L
Monocytes 0.3       x109/L
Basophils 0.02     x109/L
Eosinophils 0.02     x109/L

Smear – heterogeneous blasts noted.

Question 1. (7 marks)

What are the major abnormalites, and what is the likely diagnosis?

Question 1. (7 marks) What are the major abnormalites, and what is the likely diagnosis? *

Question 2. (3 marks)

Give 3 likely complications of this presentation?

Question 2. (3 marks) Give 3 likely complications of this presentation? *

Question 3. (3 marks)

Give 3 management points that you will institute?

Question 3. (3 marks) Give 3 management points that you will institute? *

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