MCQ Paper No.519th May 2017 by admin Please select True or False for the following questions. 1. Regarding HITa. Argatroban, danaparoid and fondaparinux can be safely used True False b. Platelets typically fall in the first 3 days after exposure to heparin True False c. Is due to heparin dependent IgM antibodies binding to heparin/platelet factor 4 True False d. The Warkentin probability scale is used to estimate the probability of HIT True False e. Functional assays, e.g. serotonin release assay, have >95% sensitivity and specificity for HIT True False 2. Regarding atrial flutter a. Type I antiarrhythmics can be used (e.g. flecanide, lidocaine and propafenone) True False b. Digoxin can be safely used True False c. Sotalol can be used if atrial flutter recurs True False d. Atrioventricular block rarely occurs True False e. The atrial rate is usually 300bpm True False 3. Regarding elderly patients: a. Patients over 80 must have an APACHE II of at least 6 True False b. Mortality for a patient over 70 undergoing emergency laparotomy is 30% True False c. Mortality for patients with fractured neck of femur is 10% at one month True False d. Elderly patients are often less responsive to catecholamines True False e. The use of benzodiazepines, cyclizine and atropine increase the risk of post-operative delirium True False 4. Regarding diabetic ketoacidosis in children a. Cerebral oedema has a mortality of around 40% True False b. Dry mucous membranes, sunken eyes, reduced skin turgor and poor capillary refill time suggests approximately 3% dehydration True False c. Fluid deficit should be replaced over 48 hours True False d. The shocked child should be given 10ml/kg fluid bolus True False e. A fixed rate insulin infusion should be started one hour after intravenous fluids were started True False 5. With regards to AKI: a. It is defined by an increase in serum creatinine of ≥ 1.5 times over 48 hours True False b. Furosemide may induce acute interstitial nephritis True False c. Protein intake should be restricted in all patients with AKI True False d. IV NAC should be given with IV fluid therapy to prevent contrast induced nephropathy in high risk patients True False e. Use of low dose, hyper-osmolar contrast solutions reduce the risk of AKI True False Time's up
Log in to Reply Anil Bhalla 5th July 2017 at 10:01 pm 4d. Shocked kid 20ml/kg fluid boils. 10ml/kg is trauma guideline
Log in to Reply admin Post author 6th July 2017 at 2:09 pm agree, this might be a little controversial anil. APLS say 20m;/kg for the shocked child but the BSPED guidelines specifically state 10ml/kg in DKA. That seems logical in view of the risk of fluid shifts and cerebral oedema in kids with DKA. http://www.bsped.org.uk/clinical/docs/DKAguideline.pdf
Log in to Reply Jess Maycock 6th July 2017 at 11:55 am Q3 Elderley patients shoud be given prophylactic antibiotics – for what?
Log in to Reply admin Post author 6th July 2017 at 2:08 pm that was the wrong stem thanks Jess, have changed
4d. Shocked kid 20ml/kg fluid boils. 10ml/kg is trauma guideline
agree, this might be a little controversial anil. APLS say 20m;/kg for the shocked child but the BSPED guidelines specifically state 10ml/kg in DKA. That seems logical in view of the risk of fluid shifts and cerebral oedema in kids with DKA.
http://www.bsped.org.uk/clinical/docs/DKAguideline.pdf
Q3 Elderley patients shoud be given prophylactic antibiotics – for what?
that was the wrong stem thanks Jess, have changed