Week 3 SAQ

Sentry Page Protection

MODULE three short answer questions.

saq 1.

An 18 year old man presents to the emergency department after being struck in the left eye by a squash ball. There was no associated loss of consciousness, and no symtpoms of acute head injury. A clinical image of the eye is showing below.

Question 1. What are the important findings in the image? (3 marks)

Question 2. What injuries are associated with this presentation (2 marks)

Question 3. What specific features relating to this presentation and the associated injuries will you examine for and why? (5 marks)

saq 2.

A 65 year old woman presents to your department with an acutely painful left eye. The pain is extreme, and associated with vomiting. She describes blurred vision on the left, and the sensation of seeing halos around objects. She has no medical history of note, but does admit to wearing contacts.

Question 1. Give a differential diagnosis for this situation (3 marks)

Question 2. A clinical image of the patient’s eye is shown below. What are the important positive and negative findings? (2 marks)

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

Question 4. What treatment will you administer to relieve this condition? (4 marks)

saq 3.

A 17 year old male presents with severe onset left testicular pain, of 4 hours duration. He has no history of the pain previously, and no urinary symptoms of note. He is severely distressed by the pain, and is currently vomiting.

His vital signs are:

HR 110 /min
BP 118/79 mmHg
RR 22 /min
Sats 98% RA
T 37.2 oC

Question 1. What is your differential diagnosis? (2 marks)

Question 2. What features will you look for to on examination to confirm the likely diagnosis? (4 marks)

Question 3. You are asked by the on-call surgical registrar to perform an ultrasound of the testicle, as she is caught in theatre with an expected delay of more than 2 hours. Is this acceptable? Why or why not? (3 marks)

Question 4. Describe your next actions. (1 mark)

saq 4.

A 55 year old male presents with left sided flank pain radiating down into his right testicle. It is intermittent in nature and leaves him severely distressed. He has a history of renal colic, and states that this pain closely resembles his previous episodes.

Question 1. Discuss CT versus ultrasound this patient with regard to sensitivity, harm and overall diagnostic utility. (6 marks)

Question 2. A CT KUB is performed and the image is below. What are the important positive and negative findings? (4 marks)

saq 5.

An 83 year old man is brought in from a local nursing home with a fever and increasing confusion. He has multiple medical conditions, including Alzheimer’s dementia, type two diabetes, benign prostatic hyperplasia and ischaemic heart disease.

His vital signs are:

HR 140 /min
BP 92/60 mmHg
RR 31 /min
O2 sats 99% RA
T 39.6 oC

Question 1. A venous blood gas is taken on arrival. Interpret the results. (4 marks)

FiO2      21%
pH             7.09
pCO2         22 mmHg
pO2             66 mmHg
HCO3-         9 mmol/L

Na+             140 mmol/L
K+                 4.5 mmol/L
Cl-                 103 mmol/L

lactate 9.8 mmol/L

Question 2. A clinical photograph of your examination findings is included below. Describe the photograph and give a diagnosis. (2 marks)

Question 3. Outline your management (4 marks)