0 [{"id":509237,"quiz_id":"26020","answer_id":null,"answerType_id":"0","created_at":"2018-07-25 03:22:09","updated_at":"2018-07-25 03:22:20","questionName":"12818, 21283 \u2013 The usual urinary nitrogen loss following trauma is further increased when 1: the patient has adrenal insufficiency\u00a0","questionTimeSeconds":"0","questionTimeMinutes":"15","questionImagePath":null,"position":13,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null},{"id":509226,"quiz_id":"26020","answer_id":null,"answerType_id":"0","created_at":"2018-07-25 03:22:09","updated_at":"2018-07-25 03:22:20","questionName":"18237 \u2013 A previously fit 55 year old man has undergone an emergency right hemicolectomy for a perforated caecal carcinoma. On review 24 hours after the operation you note the following on his fluid balance sheet \u00adintravenous input 2L, nasogastric aspirate 2L, drain losses 700 ml, urine output 500 ml. Biochemistry shows Na+ 135 mmol\/L, K+ 3.0 mmol\/L, Cl-100 mmol\/L, HC03-27 mmol\/L. Which of the fluid balance regimens below would you order for the next 24 hr period?\u00a0","questionTimeSeconds":"0","questionTimeMinutes":"15","questionImagePath":null,"position":2,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null},{"id":509233,"quiz_id":"26020","answer_id":null,"answerType_id":"0","created_at":"2018-07-25 03:22:09","updated_at":"2018-07-25 03:22:20","questionName":"25845 \u2013 In an adult patient with haemorrhagic shock 1: systolic blood pressure of 60 mm suggests more than 1.5 litres blood loss\u00a0","questionTimeSeconds":"0","questionTimeMinutes":"15","questionImagePath":null,"position":9,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null},{"id":509230,"quiz_id":"26020","answer_id":null,"answerType_id":"0","created_at":"2018-07-25 03:22:09","updated_at":"2018-07-25 03:22:20","questionName":"25734 \u2013 Each of the following is an important component of the daily post\u00adoperative plan that should be formulated for surgical patients who are progressing satisfactorily, EXCEPT\u00a0","questionTimeSeconds":"0","questionTimeMinutes":"15","questionImagePath":null,"position":6,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null},{"id":509238,"quiz_id":"26020","answer_id":null,"answerType_id":"0","created_at":"2018-07-25 03:22:09","updated_at":"2018-07-25 03:22:20","questionName":"12818, 21283 \u2013 The usual urinary nitrogen loss following trauma is further increased when 2: parenteral sources of nitrogen are provided\u00a0","questionTimeSeconds":"0","questionTimeMinutes":"15","questionImagePath":null,"position":14,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null},{"id":509235,"quiz_id":"26020","answer_id":null,"answerType_id":"0","created_at":"2018-07-25 03:22:09","updated_at":"2018-07-25 03:22:20","questionName":"25845 \u2013 In an adult patient with haemorrhagic shock 3: urine output is a useful sign of tissue perfusion\u00a0","questionTimeSeconds":"0","questionTimeMinutes":"15","questionImagePath":null,"position":11,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null},{"id":509227,"quiz_id":"26020","answer_id":null,"answerType_id":"0","created_at":"2018-07-25 03:22:09","updated_at":"2018-07-25 03:22:20","questionName":"18292 \u2013 A 58-year-old man is admitted for elective surgery for a carcinoma of the gastric antrum. On admission, it is found that he has been taking aspirin 100 mg daily for the past five years. What should be done?\u00a0","questionTimeSeconds":"0","questionTimeMinutes":"15","questionImagePath":null,"position":3,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null},{"id":509224,"quiz_id":"26020","answer_id":null,"answerType_id":"0","created_at":"2018-07-25 03:22:09","updated_at":"2018-07-25 03:22:20","questionName":"25710 \u2013 A 15-year-old back seat passenger restrained by a lap-only seat belt in a car involved in a road traffic crash\u00a0","questionTimeSeconds":"0","questionTimeMinutes":"15","questionImagePath":null,"position":0,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null},{"id":509232,"quiz_id":"26020","answer_id":null,"answerType_id":"0","created_at":"2018-07-25 03:22:09","updated_at":"2018-07-25 03:22:20","questionName":"19204 \u2013 A 26 year old housewife underwent subtotal adrenalectomy for Cushing's disease 6 years previously and now complains of headache, excessively deepening pigmentation, but no loss of weight or appetite. 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He appears to be a little drowsy and, although he wakes easily when you talk to him, he keeps falling asleep during the conversation. His respiratory rate is 14 breaths\/min. 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Her respiratory rate is 16 breaths\/min. Which one of the following statements is most correct?\u00a0","questionTimeSeconds":"0","questionTimeMinutes":"15","questionImagePath":null,"position":4,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null},{"id":509234,"quiz_id":"26020","answer_id":null,"answerType_id":"0","created_at":"2018-07-25 03:22:09","updated_at":"2018-07-25 03:22:20","questionName":"25845 \u2013 In an adult patient with haemorrhagic shock 2: an isolated closed femoral fracture is unlikely to be the cause of a fall in systolic blood pressure\u00a0","questionTimeSeconds":"0","questionTimeMinutes":"15","questionImagePath":null,"position":10,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null}]

block

12818, 21283 – The usual urinary nitrogen loss following trauma is further increased when 1: the patient has adrenal insufficiency 

Select the correct answer(s).  

(0/0)

---

False

True

none

18237 – A previously fit 55 year old man has undergone an emergency right hemicolectomy for a perforated caecal carcinoma. On review 24 hours after the operation you note the following on his fluid balance sheet ­intravenous input 2L, nasogastric aspirate 2L, drain losses 700 ml, urine output 500 ml. Biochemistry shows Na+ 135 mmol/L, K+ 3.0 mmol/L, Cl-100 mmol/L, HC03-27 mmol/L. Which of the fluid balance regimens below would you order for the next 24 hr period? 

Select the correct answer(s).  

(0/0)

---

E. 1L N. saline + 1L dextrose 5% + 100 mmol KCl 

A. 2L N. saline + 3L dextrose 5% + 50 mmol KCl

B. 2L N. saline + 1L dextrose 5% + 50 mmol KCl

C. 1L N. saline + 3L dextrose 5% + 100 mmol KCl

D. 3L N. saline + 2L dextrose 5% + 100 mmol KCl 

none

25845 – In an adult patient with haemorrhagic shock 1: systolic blood pressure of 60 mm suggests more than 1.5 litres blood loss 

Select the correct answer(s).  

(0/0)

---

False

True

none

25734 – Each of the following is an important component of the daily post­operative plan that should be formulated for surgical patients who are progressing satisfactorily, EXCEPT 

Select the correct answer(s).  

(0/0)

---

B. monitoring nutritional requirements

C. determining the appropriate level of care

D. considering likely discharge timing 

A. inspecting drains and considering time of their removal

E. commencing DVT prophylaxis 

none

12818, 21283 – The usual urinary nitrogen loss following trauma is further increased when 2: parenteral sources of nitrogen are provided 

Select the correct answer(s).  

(0/0)

---

True

False

none

25845 – In an adult patient with haemorrhagic shock 3: urine output is a useful sign of tissue perfusion 

Select the correct answer(s).  

(0/0)

---

False

True

none

18292 – A 58-year-old man is admitted for elective surgery for a carcinoma of the gastric antrum. On admission, it is found that he has been taking aspirin 100 mg daily for the past five years. What should be done? 

Select the correct answer(s).  

(0/0)

---

C. Give protamine sulphate with the premedication

D. Stop aspirin and delay surgery for one week 

A. Proceed to surgery forthwith

B. Give vitamin k 10 gm intravenously with the premedication

E. Halve dose of aspirin and delay surgery for one week 

none

25710 – A 15-year-old back seat passenger restrained by a lap-only seat belt in a car involved in a road traffic crash 

Select the correct answer(s).  

(0/0)

---

C. should have a diagnostic peritoneal lavage if pancreatic injury is suspected

B. would have hypotension as a likely early consequence of intra-abdominal bowel injury

D. with an elevated plasma or peritoneal lavage amylase almost certainly has a pancreatic injury 

E. should have a lumbar spine x-ray looking for a Chance hyper-flexion fracture 

A. is likely to suffer a lumbar spine compression fracture

none

19204 – A 26 year old housewife underwent subtotal adrenalectomy for Cushing's disease 6 years previously and now complains of headache, excessively deepening pigmentation, but no loss of weight or appetite. You might reasonably expect 

Select the correct answer(s).  

(0/0)

---

D. an adenoma developing in the remaining adrenal tissue

A. normal diurnal variation of plasma cortisol

B. normally suppressible plasma ACTH activity

E. hypotension, hyperkalemia, and low plasma cortisol 

C. bitemporal hemianopia and erosion of the posterior clinoids 

none

18243 – In the management of acute postoperative pain, which one of the following is incorrect? 

Select the correct answer(s).  

(0/0)

---

E. intramuscular narcotic should not be given more frequently than every four hours 

D. people over the age of 70 years often require a lower dose to achieve comfort 

A. morphine is generally a better analgesic than pethidine

B. the best dosing is on a mg per kg basis

C. subcutaneous administration is less reliable than intramuscular

none

25845 – In an adult patient with haemorrhagic shock 4: an acute 1 litre blood loss requires 3-4 litres of crystalloid for resuscitation 

Select the correct answer(s).  

(0/0)

---

True

False

none

18337 – A 45-year-patient has been receiving 10 mg morphine subcutaneously every 2 to 3 hours for pain relief following open reduction and internal fixation of a fractured ankle. He appears to be a little drowsy and, although he wakes easily when you talk to him, he keeps falling asleep during the conversation. His respiratory rate is 14 breaths/min. Which one of the following statements is most correct? 

Select the correct answer(s).  

(0/0)

---

A. He does not have respiratory depression

E. He will not require further morphine for at least 24 hours 

C. The next dose of morphine should be decreased and effect on pain relief noted 

B. The same dose of morphine can be repeated if needed

D. If he is still complaining of severe pain subsequent doses of morphine can be increased

none

25698 – In a trauma patient with a crush pelvic fracture, a large retroperitoneal haematoma and shock 

Select the correct answer(s).  

(0/0)

---

B. low urine output precludes the use of contrast for radiological studies

D. myoglobinuria secondary to rhabdomyolysis is unlikely to occur in the first 12 hours after injury

A. complete anuria would imply lower urinary tract obstruction until proved otherwise 

C. renal dose dopamine, diuretics and mannitol are useful first line of treatment agents to prevent the development of renal failure

E. hyperkalaemia > 6 mMoI/I with ECG signs of toxicity would be an indication for immediate treatment with ion exchange resins (eg resonium) 

none

18343 – A 37-year-old patient is noted to be difficult to rouse one hour after a subcutaneous injection of 12.5 mg morphine. Her respiratory rate is 16 breaths/min. Which one of the following statements is most correct? 

Select the correct answer(s).  

(0/0)

---

B. She does not have respiratory depression

C. She may have respiratory depression and should be given supplemental oxygen and 1000 ?g naloxone iv prn

A. No immediate action is required but the amount of morphine she is given next time should be reduced

E. She should be given supplemental oxygen and nalorphine 

D. She may have respiratory depression and should be given supplemental oxygen and 100 ?g naloxone iv prn 

none

25845 – In an adult patient with haemorrhagic shock 2: an isolated closed femoral fracture is unlikely to be the cause of a fall in systolic blood pressure 

Select the correct answer(s).  

(0/0)

---

True

False