MCQ Paper No.519th May 2017 by admin Please select True or False for the following questions. 1. Regarding HIT a. Argatroban, danaparoid and fondaparinux can be safely usedTrueFalseb. Platelets typically fall in the first 3 days after exposure to heparinTrueFalsec. Is due to heparin dependent IgM antibodies binding to heparin/platelet factor 4TrueFalsed. The Warkentin probability scale is used to estimate the probability of HITTrueFalsee. Functional assays, e.g. serotonin release assay, have >95% sensitivity and specificity for HITTrueFalse2. Regarding atrial flutter a. Type I antiarrhythmics can be used (e.g. flecanide, lidocaine and propafenone)TrueFalseb. Digoxin can be safely usedTrueFalsec. Sotalol can be used if atrial flutter recursTrueFalsed. Atrioventricular block rarely occursTrueFalsee. The atrial rate is usually 300bpmTrueFalse3. Regarding elderly patients: a. Patients over 80 must have an APACHE II of at least 6TrueFalseb. Mortality for a patient over 70 undergoing emergency laparotomy is 30%TrueFalsec. Mortality for patients with fractured neck of femur is 10% at one monthTrueFalsed. Elderly patients are often less responsive to catecholaminesTrueFalsee. The use of benzodiazepines, cyclizine and atropine increase the risk of post-operative deliriumTrueFalse 4. Regarding diabetic ketoacidosis in children a. Cerebral oedema has a mortality of around 40% TrueFalseb. Dry mucous membranes, sunken eyes, reduced skin turgor and poor capillary refill time suggests approximately 3% dehydrationTrueFalsec. Fluid deficit should be replaced over 48 hoursTrueFalsed. The shocked child should be given 10ml/kg fluid bolusTrueFalsee. A fixed rate insulin infusion should be started one hour after intravenous fluids were startedTrueFalse5. With regards to AKI: a. It is defined by an increase in serum creatinine of ≥ 1.5 times over 48 hoursTrueFalseb. Furosemide may induce acute interstitial nephritisTrueFalsec. Protein intake should be restricted in all patients with AKITrueFalsed. IV NAC should be given with IV fluid therapy to prevent contrast induced nephropathy in high risk patientsTrueFalsee. Use of low dose, hyper-osmolar contrast solutions reduce the risk of AKITrueFalseTime is 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