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Question 1
Incorrect
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A young woman presents to the clinic with massive hematemesis. The episodes continue to occur despite initial measures. She is a chronic alcoholic. Which of the following steps would be the most important regarding the management of this patient?
Your Answer: IV fluids
Correct Answer: Emergency banding
Explanation:Acute upper gastrointestinal bleeding is a common medical emergency which carries a hospital mortality in excess of 10%. The most important causes are peptic ulcer and varices. Varices are treated by endoscopic band ligation or injection sclerotherapy and management of the underlying liver disease.
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This question is part of the following fields:
- Emergency
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Question 2
Incorrect
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A 12-year-old boy with emesis, dehydration, cold peripheries and deep breathing, has a blood glucose of 28mmol/l. What would be the next best step in management?
Your Answer: 0.45% normal saline plus 5% dextrose
Correct Answer: Give normal saline 0.9%
Explanation:Normally blood glucose is filtered out by the kidneys, however as glucose levels exceed 180 mg/dL, the renal tubules become saturated and additional reabsorption is not possible. Glucose remains in the renal tubules, causing additional water and electrolytes to diffuse into the renal system and be excreted as urine (also known as osmotic diuresis). Excessive urine production results in electrolyte loss, and dehydration. Thus an important part of managing these patients is fluid replacement. Initially a litre of 0.9% NaCl over the 1st hour is given which may followed by either 0.45 or 0.9% NaCl, depending on the corrected serum sodium and the hemodynamic status of the patient.
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This question is part of the following fields:
- Emergency
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Question 3
Incorrect
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A 26-year-old patient without a known medical history presents to casualty unconscious. What should be done as soon as possible?
Your Answer: CT Scan
Correct Answer: Blood Glucose
Explanation:Blood glucose should be evaluated immediately in order to investigate for diabetic coma triggered by hyperglycaemia or hypoglycaemia.
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This question is part of the following fields:
- Emergency
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Question 4
Incorrect
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A 25-year-old patient with no prior medical history is admitted unconscious. Which should be done as an initial investigation?
Your Answer: ABG
Correct Answer: Blood glucose
Explanation:The patient’s blood glucose should be evaluated in order to rule out a reversible diabetic come due to high or low blood glucose.
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This question is part of the following fields:
- Emergency
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