EMQs in Clinical Medicine.pdf - Peshawar Medical College

Medical emergencies 227
98 Medical emergencies
A
B
C
D
E
F
G
endotracheal intubation
Burr hole
100 per cent O 2 , intravenous
heparin
oral diazepam
tracheostomy
100 per cent O 2 , intravenous
diazepam
intravenous atropine
H
I
J
K
L
M
pericardiocentesis
100 per cent O 2 , oral
temazepam
non-invasive positive pressure
ventilation
DC (direct current) cardioversion
intravenous dobutamine
cricothyroidotomy
Suggest the most appropriate emergency management from the options above.
Each option may be used only once.
1 A 40 year old rescued from a factory fire presents with stridor and cyanosis.
Endotracheal intubation is unsuccessful.
2 A 21-year-old man presents with status epilepticus.
3 A 35-year-old builder is brought to A&E after suffering a blow to the side of the
head at work. He did not lose consciousness but 4 hours afterwards complained
of a severe headache. He became very confused and his conscious level is
deteriorating. On examination he has a dilated right pupil. Pulse 50 beats/min,
BP 168/100 mmHg.
4 A 30-year-old woman is rushed to A&E after a stab wound to the chest. On
examination her heart sounds are muffled and the jugular venous pressure (JVP)
rises on inspiration. BP 75/40 mmHg.
5 A 34-year-old woman collapses at the airport arrivals lounge with sudden
dyspnoea. BP 90/42 mmHg, PaO 2 6.0 kPa.
Answers: see page 244.