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MODULE 8 short answer questions.

Below are 5 SAQs. You have 30 minutes. Good luck!

    Module 8 SAQS

    SAQ 1.

    An excerpt of the Australian resuscitation council guideline for advanced life support is shown below.
    Picture
    Question 1. (4 marks)

    What is the difference between a “shockable” and “non-shockable” rhythm? Give 2 examples of a shockable rhythm.


    Question 2. (1mark)

    What is the ratio of compressions to breaths for CPR?

    Question 3. (4 marks)

    What doses and when should drugs be given for a “shockable rhythm”?

    Question 4. (2 marks)

    What dose of adrenaline should be given when in a non-shockable rhythm? (1 mark)


    Question 5. (1 mark)

    What is the ratio of compressions to ventilations in children?

    Question 6. (6 marks)

    Give 6 reversible causes of non-shockable arrests in adults.

    saq 2. (FOLLOWS ON INTO SAQ 3).

    A 78 year old man presents to your emergency department  with the ambulance after an episode of syncope. On arrival his vital signs are
     
    HR                  54                   /min
    BP                  112/65           mmHg
    RR                  18                   /min
    T                     37.1                oC
     
    His ECG on arrival is shown below.
    Picture
    Question 1. (5 marks)

    What give three abnormalities seen on the ECG, the underlying diagnosis and are the implications for this patient's presentation?

    Question 2.
    The patient suffers an episode of syncope in the department. His vital signs are retaken:
     
    HR                  35                   /min
    BP                  72/38             /min

    A repeat ECG is shown below. Give two abnormalities shown by the ECG and the diagnosis.

    Picture
    Question 3. (4 marks)
     
    Give 2 medications you could administer in this situation and the appropriate doses?

    saq 3. (FOLLOWS FROM SAQ 2.)

    The patient from SAQ 2 has does not respond to the drugs you administer.
    Question 1.

    What treatment will you now administer? (1 mark)

    Question 2.

    Describe your method for doing this. (5 marks)

    Question 3. (7 marks)

    Select pathology results for the patient are shown below. Give 3 major abnormalities and give 2 treatments you will commence.
     
    Na+                140     mmol/L
    K+                   6.1      mmol/L
    Cl-                  100     mmol/L
     
    Urea               13.6    mmol/L
    Creatinine     146     mmol/L                     
     
    digoxin          12       ng/ml

    SAQ 4

    ​A 17 year old male presents after an episode of syncope on the soccer pitch. He has no medical history of note. On presentation to the emergency department his vital signs are:
     
    HR      67                   /min
    BP      110/65           mmHg
    RR      18                   /min
    Sats    99%               RA
    T         37.2                oC
     
    He is placed in the subacute area and an ECG is taken.
    Picture
    Question 1. (3 marks)
    What is the major abnormality seen on the ECG and what diagnosis is suggested?

    Question 2. (1 mark)

    The nurse looking after the patient reports another episode of syncope in the department, and tells you he has run a repeat ECG which is shown below. What does the ECG show?

    Picture
    Question 3. (2 marks)

    The patient is awake, with a blood pressure of 110 systolic. What treatment will you administer?

    Question 4. (5 marks)
     
    Shortly after treating this patient, the ambulance brings in a 56 year old patient who has ROSC after a cardiac arrest in the community. He has had 5 minutes of CPR and responded to a 200J for ventricular fibrillation. The patient has been intubated on scene. On arrival he is sedated, paralyzed and his vital signs are:

     
    HR      104     /min
    BP      95/60 mmHg
    RR      16
    Sats    100% 100% O2
    T         37.4    oC
     
    Give 5 treatment priorities you now have for this new patient?

    SAQ 5

    A 68 year old woman presents with a high fever and dyspnoea. She describes having a productive cough for the preceding 3 days. She has a history of rheumatoid arthritis treated with methotrexate.
     
    On arrival her vital signs are:
     
    HR      119     /min
    BP      86/42  mmHg
    RR      36       /min
    Sats    92%    6L O2
     
    Question 1. (4 marks)

    How will you clinically assess the volume status of this patient?

    A venous gas is taken in the resuscitation room and the results are shown below.

    pH         7.25
    pCO2    32  mmHg
    HCO3-  16  mmol/L
    BE          -8

    Na+       132  mmol/L
    K+          5.5  mmol/L
    Cl-         100 mmol/L

    Urea     12.5  mmol/L
    Cr           130   umol/L

    Lactate  4.6  mmol/L

    Question 2. (3 marks)

    Give 3 acid/base disturbances that are present.

    Question 3. (2 marks)

    Provide 2 calculations to support your answer.

    Question 4.  (3 marks)

    Give 3 other abnormalities seen on the blood gas.

    Question 5. (2 marks)

    Clinically the patient is anuric. Provide an explanation for this based on the VBG and a calculation to support your answer.
     
    Question 6. (3 marks)

    What initial management will you institute?

    Question 7. (2 marks)

    After your initial treatment remains hypotensive with a blood pressure of 82 systolic. What further management will you institute?

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