MCQ – TOPICS IN EMERGEMCY MEDICINE



MCQ – TOPICS IN EMERGEMCY MEDICINE SUSAN TUCKER

1.The percentage of blood in the venous circulation is

a) 90%

b) 80%

c) 70%

d) 60%

e) 50%

2.The normal circulating adult blood volume is?

a) 5%

b) 7%

c) 10%

d) for an obese person is calculated by their actual weight not their ideal weight

e) 8%

3.Which statement is true re an injury and its probable blood loss?

a) fractured shaft of femur = 1000ml

b) fractured shaft of femur = 1500 ml

c) fractured humerus = 500 ml

d) fractured tibia = 500 ml

e) fractured humerus 250ml

4.Which is the best marker of adequate tissue perfusion?

a) HR

b) BP

c) Pulse pressure

d) RR

e) Urine output

5.Which of the below does not limit the ability of the elderly pt to compensate for/cope with blood loss?

a) natural aging process produces a relative decrease in sympathetic activity

b) decreased cardiac compliance

c) atherosclerosis

d) often affected by drugs

e) increased incidence of varicose veins

6.In class III shock, which statement is incorrect?

a) it requires at least 30 % loss of BV

b) it can be adequately resuscitated with crystalloid alone

c) the pulse pressure is decreased

d) they present tachycardic and hypotensive

e) they are usually confused

7.If a 70kg man presents hypotensive from haemorrhage which statement is false?

a) he has probably lost a minimum of 1.5 L of blood

b) fluid resuscitation should begin with crystalloid fluid

c) the likely amount of crystalloid fluid that he will need to replace the deficit is 3.5L

d) he is likely to be tachypnoeic

e) all of the above are correct

8.Which statement is INCORRECT with regard to the MAST suit?

a) its application usually raises blood pressure in hemorrhagic shock?

b) In the presence of chest trauma its use may increase haemorrhage severity

c) Current evidence suggests that the MAST suit improves outcome in severe hemorrhage, not including pelvic fractures

d) It has a use in the stabilization of unstable pelvic fractures, tamponading retroperitoneal hemorrhage

e) Its use in a head injury is contraindicated as it raises ICP

9.Which would you not expect to find in a patient with neurogenic shock?

a) BP 85mmHg

b) PR 55

c) Warm peripheries

d) Sweating

e) CVP 5cm H20

10.What is not mandatory treatment in management of neurogenic shock?

a) IDC

b) NGT

c) Warm blankets

d) High dose methylprednisalone

e) H2 antagonists

11.Wich is incorrect with regards to acute spinal shock c/o C6 fracture?

a) you may see priapism

b) intubation may induce profound bradycardia

c) they will display diaphragmatic breathing

d) priapism must be reduced by needle aspiration of blood if it continues for more than 6 hours

e) aspiration of gastric contents occurs quietly without heaving due to decreased gastro-oesophageal tone

12.Which is an incorrect statement regarding anaphylactic shock?

a) 85% of all fatalities are due to iv penicillin

b) the pathology involves IgE specific degranulation of mast cells

c) history of a prior exposure is required

d) the rate of cross reaction of penicillin with 1st gen cephalosporins is higher than third

e) Hymenoptera stings are the second most fatal cause

13.Which is incorrect with regards to anaphylactoid reactions

a) they are immunoglobulin mediated

b) mediators are released from mast cells

c) they do not require a second exposure

d) they are managed the same as anaphylactic reactions

e) morphine and contrast media can work via this mechanism

14.What is the Glascow Coma Score of a patient who opens his eyes to pain, makes incomprehensible sounds and a decorticate response to a painful stimulus?

a) 5

b) 6

c) 7

d) 8

e) 9

15.Which of these is unlikely to suggest that the brainstem is functioning normally in a patient in COMA?

a) oculocephalic reflex where the eyes remain looking straight ahead /upright

b) oculovestibular reflex where the eyes deviate to the side of the injected water

c) midsize pupils that are reactive to light

d) left sided arm and leg weakness 4/5

e) conjugate gaze where the pupils cross the midline

16.What is decorticate posturing?

a) Flexed arms and elbows with flexed knees and hips

b) Flexed arms and elbow with extended legs

c) Extended arms with flexed hips and knees

d) Extended arms and legs

e) None of the above

17.Which statement is incorrect with regard to COMA?

a) yawning suggests an expanding posterior fossa lesion

b) for it to be due to cortical disease both cortices need to be involved

c) when caused by extradural hemorrhage it is due to pressure on the brainstem not a cortical aetology

d) the Reticular Activating System is in the brainstem and is responsible for wakefulness

e) If it is primarily a problem with the brainstem you would be less likely to find focal neurology than if it was a cortical aetiology

18.With regards to Septic shock which statement is incorrect?

a) sepsis without a focus should be treated empirically with Gentamicin and flucloxacillin

b) neutropenic pts with a WCC ................
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