Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 2: Emergency and Critical Care
09 Acute medicine and critical illness MCQs
Davidson's Medicine - Part 2: Emergency and Critical Care · Davidson's Principles of Medicine · 12 practice questions
- Organ donation
- Critical illness
- Breathlessness
- Levels of care
- Investigation strategy
- ICU management
- Acute abdomen
- Cardiac arrest
1. A patient in coma has an unknown cause and a normal CT head; brainstem stroke is suspected. Which investigations are appropriate?
- AOnly EEG
- BLumbar puncture, and repeat CT
- CUrgent sodium and glucose, and CT angiography of the circle of Willis
- DOnly MRI
Show answer
C. Urgent sodium and glucose, and CT angiography of the circle of Willis Hyponatraemia and hypoglycaemia are easily corrected causes of irreversible injury; non-contrast CT is frequently negative in brainstem stroke.
2. A patient in cardiac arrest with a shockable rhythm receives ALS, and after return of circulation another needs cerebral perfusion optimised. Which statements are correct?
- AAdrenaline once and amiodarone after 1 shock; MAP under 50
- BAtropine every 5 minutes; MAP above 120
- CAdrenaline every 3-5 minutes and amiodarone after 3 shocks; maintain MAP above 70 mmHg
- DAdrenaline every minute; MAP 60 exactly
Show answer
C. Adrenaline every 3-5 minutes and amiodarone after 3 shocks; maintain MAP above 70 mmHg The ALS algorithm gives adrenaline every 3-5 minutes and amiodarone after 3 shocks; post-arrest MAP above 70 mmHg should be maintained.
3. A patient has monthly unexplained blackouts with a normal 24-hour ECG, and another has a headache reaching maximum intensity within 5 minutes. Which are the appropriate next steps?
- ATilt test, and lumbar puncture only
- BRepeat 24-hour ECG, and observation
- CExercise ECG, and MRI in a week
- DAn implantable loop recorder, and rapid assessment for subarachnoid haemorrhage
Show answer
D. An implantable loop recorder, and rapid assessment for subarachnoid haemorrhage Implantable ECG recorders continuously record; a thunderclap headache needs rapid assessment for subarachnoid haemorrhage.
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