Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 2: Emergency and Critical Care
12 Medicine in austere environments MCQs
Davidson's Medicine - Part 2: Emergency and Critical Care · Davidson's Principles of Medicine · 10 practice questions
- Altitude illness
- Drowning
- Heat illness
- Frostbite
- Hypothermic arrest
- Heat illness prevention
- Hypothermia management
- Diving and immersion
1. A soldier collapses in a hot humid environment with neurological impairment, coarse tremor, absent sweating and core temperature 41 C. Which diagnosis, temperature site and cooling strategy fit?
- AHeat exhaustion, oral temperature, and cold drinks
- BHeat stroke, rectal temperature, and ice water immersion if possible or evaporative cooling with a fan if not
- CHeat oedema, axillary temperature, and dantrolene
- DHeat cramps, tympanic temperature, and ice packs alone
Show answer
B. Heat stroke, rectal temperature, and ice water immersion if possible or evaporative cooling with a fan if not Heat stroke is neurological impairment with core temperature 40 C or above with rectal temperature the gold standard; evaporative cooling is used when immersion is not possible; dantrolene has no evidence of benefit.
2. A hypothermic patient at 27 C arrests and after three shocks there is no response. Which adaptations apply?
- AGive adrenaline every 3 minutes
- BDelay further shocks until above 30 C, withhold adrenaline and amiodarone below 30 C and double intervals between 30 and 35 C
- CStop resuscitation
- DContinue stacked shocks
Show answer
B. Delay further shocks until above 30 C, withhold adrenaline and amiodarone below 30 C and double intervals between 30 and 35 C Signs of life are checked for 1 minute; additional shocks are delayed until core temperature exceeds 30 C and drug intervals doubled between 30 and 35 C.
3. A patient with mild hypothermia is packaged and warmed. Which statements are correct?
- ARubbing limbs is best, and IV fluids are harmful
- BImmersion is best, and IV fluids raise core by 3 C
- CHibler's method uses an insulating layer plus a vapour-tight outer layer, and warmed IV fluids prevent further cooling without active warming
- DHibler's method uses direct heat, and IV fluids rewarm quickly
Show answer
C. Hibler's method uses an insulating layer plus a vapour-tight outer layer, and warmed IV fluids prevent further cooling without active warming Warmed intravenous fluids provide no active warming but prevent further cooling; forced-air blankets raise core temperature by 0.1-3.4 C per hour.
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