THE WRITTEN EMERGENCY MEDICINE FELLOWSHIP COURSE
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MODULE 15 short answer questions.
Below are 5 SAQs. You have 30 minutes. Good luck!
Module 15 saQS
SAQ 1.
A 32 year old female presents to the emergency department complaining of fever and pain in the hands and feet. She describes increasing fatigue and 3kg of weight loss over a two month period. She has also noted a rash to her face, a picture of which is shown below.
Her vital signs are:
HR 75 /min
BP 110/82 mmHg
RR 16
Sats 96% RA
T 37.8 oC
A clinical photo of the patient’s face is shown below.
Question 1. (4 marks)
Describe the rash.
Question 1. (4 marks) Describe the rash.
*
Question 2. (6 marks)
Give 5 differential diagnoses, nominating your most likely diagnosis first.
Question 2. (6 marks) Give 5 differential diagnoses, nominating your most likely diagnosis first.
*
Question 3. (10 marks)
Give 5 investigations you will order and indication for each.
Give 5 investigations you will order and indication for each.
*
SAQ 2.
A 4 year old girl presents with an acutely painful right hip. The child’s vital signs are:
HR 115 /min
BP 98/61 mmHg
T 37.1 oC
RR 24
Sats 99% RA
Question 1. (4 marks)
List 4 differential diagnoses.
Question 1. (4 marks) List 4 differential diagnoses.
*
Question 2. (4 marks)
Give 4 elements of the history that you will enquire about.
Question 2. (4 marks) Give 4 elements of the history that you will enquire about.
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Question 3. (4 marks)
List 4 investigations you may perform on this child.
Question 3. (4 marks) List 4 investigations you may perform on this child.
*
SAQ 3
An 81 year old female with a history of rheumatoid arthritis presents after tripping and falling from standing height while gardening. She did not hit her head and there is no loss of consciousness, amnesia or vomiting. She is complaining of midline neck pain without any neurology.
Question 1. (3 marks)
Give 3 reasons this patient may be at increased risk of a c-spine injury.
Question 1. (3 marks) Give 3 reasons this patient may be at increased risk of a c-spine injury.
*
Question 2. (2 marks)
What investigation will you perform on this patient and why?
Question 2. (2 marks) What investigation will you perform on this patient and why?
*
Question 3. (5 marks)
An image from the investigation you perform is shown below. Give 5 abnormalities seen.
Question 3. (5 marks) An image from the investigation you perform is shown below. Give 5 abnormalities seen.
*
SAQ 4
A 24 year old man presents with a painful swollen left knee of 48 hours duration. There is no history of trauma. His vital signs are:
HR 99 /min
BP 125/81 mmHg
RR 16 /min
Sats 98% RA
Temp 37.6 oC
Question 1. (4 marks)
Give 4 differential diagnoses.
Question 1. (4 marks) Give 4 differential diagnoses.
*
Question 2. (4 marks)
Give 2 features on history and 2 on examination that would suggest a diagnosis of reactive arthritis?
Question 2. (4 marks) Give 2 features on history and 2 on examination that would suggest a diagnosis of reactive arthritis?
*
Question 3. (2 marks)
Given your differential diagnoses, give 2 investigations will you perform on this patient to evaluate these possibilities?
Question 3. (2 marks) Given your differential diagnoses, give 2 investigations will you perform on this patient to evaluate these possibilities?
*
Question 4. (3 marks)
Briefly describe your procedure for arthrocentesis of the knee.
Question 4. (3 marks) Briefly describe your procedure for arthrocentesis of the knee.
*
SAQ 5
A 66 year old female with a history of rheumatoid arthritis presents feeling generally unwell. She complains of some moderate abdominal pain, but has no surgical signs on examination. Her usual medications include prednisone 10mg daily and methotrexate weekly. She has no other medical history of note. Her vital signs are:
HR 115 /min
BP 85/68 mmHg
RR 28 /min
Sats 98% RA
T 38.1 oC
A venous blood gas is performed and the results are shown below.
pH 7.18
PO2 46 mmHg
PCO2 32 mmHg
HCO3- 16 mmol/L
Na+ 126 mmol/L
K+ 6.5 mmol/L
Cl- 105 mmol/L
Lactate 1.2 mmol/L
Question 1. (4 marks)
What are the major abnormalities on the blood gas, and what is the likely cause?
Question 1. (4 marks) What are the major abnormalities on the blood gas, and what is the likely cause?
*
Question 2. (4 marks)
Give 4 investigations you will perform.
Question 2. (4 marks) Give 4 investigations you will perform.
*
Question 3. (4 marks)
List 4 interventions you will perform.
Question 3. (4 marks) List 4 interventions you will perform.
*
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Sample Course Syllabus
EXAMPLE OF A WEEK
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