Week 4 SAQ electronic

MODULE 4 short answer questions.

Below are the module SAQs. You have 30 minutes. Good luck!

Module 4 saQS

SAQ 1.

A 72 year old man presents to the emergency department with brisk bleeding from the right nostril. He is applying pressure at the bridge (superior junction of the nose and face) of his nose without any improvement in the bleeding. He is warfarinized for atrial fibrillation, but otherwise has no medical history. He has no airway compromise, and his vital signs are:

HR       90            /min
BP       135/82    mmHg
RR       16    /min
Sats    99%        RA
Temp 37.2     oC

Question 1. Give one intervention you will immediately apply and one investigation you will undertake. (2 marks)

Question 1. Give one intervention you will immediately apply and one investigation you will undertake. (2 marks) *

Question 2. The patient’s bleeding does not settle with your initial management. What therapeutic actions will you take now? (6 marks)

Question 2. The patient’s bleeding does not settle with your initial management. What therapeutic actions will you take now? (6 marks) *

Question 3. The patient continues to have a significant ooze of blood from his nose after your interventions. His INR returns at 10.3. What actions will you take? (2 marks)

Question 3. The patient continues to have a significant ooze of blood from his nose after your interventions. His INR returns at 10.3. What actions will you take? (2 marks) *

SAQ 2.

A 38 year old injecting drug user presents complaining of dyspnoea and lassitude. He also has right sided neck pain.

His vital signs are:

HR    110    /min
BP    90/45 mmHg
RR    28    /min
Sats    99%    RA
Temp    39.6    oC

Question 1. What specific features will you enquire about on history to assess this man’s airway? (3 marks)

Question 1. What specific features will you enquire about on history to assess this man’s airway? (3 marks) *

Question 2. A routine chest xray is performed, and is shown below. What does it show?(2 marks)

Question 2. A routine chest xray is performed, and is shown below. What does it show?(2 marks) *

Question 3. The patient goes on to have a CT of the neck performed, and an image is shown below. Give 2 major abnormalities and the likely diagnosis. (3 marks)

Question 3. The patient goes on to have a CT of the neck performed, and an image is shown below. Give 2 major abnormalities and the likely diagnosis. (3 marks) *

Question 4. Give 2 actions you will undertake to manage this patient. (2 marks)

Question 4. Give 2 actions you will undertake to manage this patient. (2 marks) *

SAQ 3

A 4 year old boy presents with his mother complaining of severe neck pain and an inability to turn the neck. His mother states he has been complaining of a sore throat for the past 3 days, but he has otherwise no medical history of note. On presentation he has visible drooling.

His vital signs are:

HR        125      /min
BP        91/66    /min
RR        38      /min
Sats    99%    RA
T           39.1    oC

Your resident has ordered a plain film of the child’s neck which is shown below.

Question 1. What is the major abnormality and the likely diagnosis? (2 marks)

Question 1. What is the major abnormality and the likely diagnosis? (2 marks) *

Question 2. Give four features you will examine for as part of you assessment of this child’s airway. (4 marks)

Question 2. Give four features you will examine for as part of you assessment of this child’s airway. (4 marks) *

Question 3. Give four management steps you will immediately undertake. (4 marks)

Question 3. Give four management steps you will immediately undertake. (4 marks) *

SAQ 4

A 19 year old female presents with a painful throat. She states she is unable to swallow food and water, and is feeling quite unwell. She also complains of difficulty in opening her mouth.

Her vital signs are:
HR        110    /min
BP        115/80mmHg
RR        20    /min
T        38.6    oC

After analgesia you are able to examine the patient’s throat. A clinical image of the patient is shown below.

Question 1. Give three abnormalities and 2 differential diagnoses? (5 marks)

Question 1. Give three abnormalities and 2 differential diagnoses? (5 marks) *

Question 2. Give 5 management steps you will institute. (5 marks)

Question 2. Give 5 management steps you will institute. (5 marks) *

SAQ 5

A 27 year old patient presents with a painful left ear. He has no medical history of note. He describes waking up to find green pus staining his pillow.

His vital signs are:

HR        79    /min
BP        120/78mmHg
RR        16    /min
T        37.6    oC

A clinical image of the patient’s examination findings is shown below.

Question 1. Give 2 abnormalities and the diagnosis (3 marks)

Question 1. Give 2 abnormalities and the diagnosis (3 marks) *

Question 2. How will you manage this patient. (4 marks)

Question 2. How will you manage this patient. (4 marks) *

Question 3. The patient returns to ED a week later, having not been compliant with the therapy you prescribed above. He is complaining of severe ear pain that extends behind his ear.

A CT scan of the patient’s head is performed. Give 2 abnormalities and the diagnosis. (3 marks)

A CT scan of the patient’s head is performed. Give 2 abnormalities and the diagnosis. (3 marks) *

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