Week 16 SAQ Electronic

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MODULE 16 short answer questions.

Below are 5 SAQs. Make sure you put your email in before you start so that you receive a copy of your answers. You have 30 minutes. Good luck!

Module 16 saQS

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SAQ 1.

A 36 year old woman with a history of chronic thyroid disease presents to the emergency room with confusion and a productive cough. Her vital signs are:

HR            65            /min
BP            87/70    mmHg
T                33.8        oC
RR            15            /min
Sats         99%        RA
GCS         7

Initial pathology is shown below.

Free T4                    0.12        pmol/L
TSH                            0.01        mU/L

Question 1. (3 marks)

What is the diagnosis? Give 2 complicating diagnoses which should be considered?

Question 1. (3 marks) What is the diagnosis? Give 2 complicating diagnoses which should be considered? *

Question 2. (4 marks)

Give 4 interventions you will undertake for this patient.

Question 2. (4 marks) Give 4 interventions you will undertake for this patient. *

Question 3. (3 marks)

Give 3 indications for ICU admission for this patient.

Question 3. (3 marks) Give 3 indications for ICU admission for this patient. *

SAQ 2.

A 10 year old patient presents with his mother with a reduced level of consciousness. He has developed respiratory distress over the course of the day, and she is convinced that his asthma has “flared up”.

His vital signs on arrival to the emergency department are:

HR 145 /min
BP 91/60 mmHg
RR 42 /min
Sats 99% RA
T 37.2 oC
GCS 10

Urgent arterial blood gas analysis is performed and the results are shown below.

pH                              7.02
PCO2                        17            mmHg
PO2                           112         mmHg
HCO3-                      6               mmol/L

Na+                            131         mmol/L
K+                               6.5           mmol/L
Cl-                              91            mmol/L

Glucose 21            mmol/L
Lactate                    1.1           mmol/L
Urea                          5.7           mmol/L
Creatinine 60            umol/L

Question 1. (3 marks)

What are the two major acid base abnormalities on the ABG? Which is the primary disturbance?

Question 1. (3 marks) What are the two major acid base abnormalities on the ABG? Which is the primary disturbance? *

Question 2. (2 marks)

Calculate a derived value that allows you to interpret the primary disturbance.

Question 2. (2 marks) Calculate a derived value that allows you to interpret the primary disturbance. *

Question 3. (1 mark)

What is the most likely diagnosis?

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

Question 4. (2 marks)

Correct the Na and K for the derangements in the ABG.

Question 4. (2 marks) Correct the Na and K for the derangements in the ABG. *

Question 5. What critical intervention will you institute to manage this patient? (2 marks)

Question 5. What critical intervention will you institute to manage this patient? (2 marks) *

SAQ 3

A 54 year old type two diabetic presents to your department after being found unconscious by his wife. She states that aside from the diabetes he has no major medical problems, but he has been complaining of dysuria for 2 days. On arrival his vital signs are:

HR            120         /min
BP            99/60    mmHg
RR            22            /min
Sats         94%        RA
T                39.3        oC
Cap refill 5            s

His bedside BSL reads “High”.

Question 1. (4 marks)

His initial electrolyte profile returns below:

Na+                            153         mmol/L
K+                               5.4           mmol/L
Cl-                              124         mmol/L
HCO3-                      19            mmol/L
Urea                          18            mmol/L
Creatinine 200         umol/L
Glucose 58            mmol/L

Give 4 major abnormalities present.

Give 4 major abnormalities present. *

Question 2. (3 marks)

Give 2 derived values from the electrolyte profile and the likely diagnosis.

Question 2. (3 marks) Give 2 derived values from the electrolyte profile and the likely diagnosis. *

Question 3. (6 marks)

Give 6 interventions you will undertake as part of your management.

Question 3. (6 marks) Give 6 interventions you will undertake as part of your management. *

SAQ 4

A 28 year old girl presents to your department with acute confusion. She had been complaining of acute anterior neck pain for the prior 4 days, and has no other medical history of note. She had attended the department the previous evening and had blood drawn. She was subsequently discharged with a diagnosis of “neck strain”. On arrival she has the following vital signs:

HR            150         /min
RR            26            /min
BP            85/58    mmHg
Sats         99%        RA
T 39.7        oC

Question 1. (3 marks)

Select results from the previous evening’s presentation are presented below.

Free T4 26 pmol/L
TSH 0.01 mU/L

What do they show, and what is the diagnosis on this presentation?

What do they show, and what is the diagnosis on this presentation? *

Question 2. (5 marks)

Give 5 interventions you will immediately apply

Question 2. (5 marks) Give 5 interventions you will immediately apply *

Question 3. (3 marks)

Give a brief outline of your approach to the quality control issues in this case.

Question 3. (3 marks) Give a brief outline of your approach to the quality control issues in this case. *

SAQ 5

Compare and contrast DKA and HHS using following attributes below.

Diabetes type

Diabetes type *

Blood glucose

Blood glucose *

Ketones

Ketones *

Fluid deficit

Fluid deficit *

Precipitant

Precipitant *

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