A&E Formative

Question 1

What is the intial management of Colles fracture?

Answer 1

Closed reduction and casting

Question 2

What are the indications for X-ray in ankle sprain?

Answer 2

Inability to bear weight both mediated and in A&E for 4 steps

Tenderness along lateral malleolus or medial malleolus

Question 3

What to do for non displaced clavicle fracture?

Answer 3

Simple clavicular fracture management

Question 4

What is an immediate concern in posterior knee dislocation; arterial injury or immediate dislocation reduction

Answer 4

Management of arterial injury
-> popliteal artery is at high risk in knee dislocation causing compromised blood flow to lower libms

Question 5

What is the earliest lab finding for fat embolism?

Answer 5

Fat droplets in blood smear?

Question 6

What is the earliest indication of volkmann’s ishcaemia?

Answer 6

Earliest sign of any vascular compromise is persistent Pain worse on passive extension

Question 7

What is a contraindications for internal fixation of fracture?

Answer 7

Active infection
-> active infection means it is uncontrolled

Question 8

What are the features of plaster of Paris?

Answer 8

Made by heating gypsum (calcium sulfate dihydrate) to about 150°C, which removes water and forms calcium sulfate hemihydrate.

It sets at room temp to become hard and brittle

Question 9

What is the most common injury following humeral fracture; radial nerve injury or shoulder dislocation?

Answer 9

Shoulder dislocation is not a complication of a fracture; they result from different events

Question 10

How to manage complete non displaced humeral fracture?

Answer 10

Conservative with immobilisation and physiotherapy

Question 11

When is he I Arthropathy done for humeral fractures?

Answer 11

Communities fracture
Compromised blood supply to humeral head

Question 12

When is reverse total shoulder replacement done?

Answer 12

Elderly patients with complex fractures, especially if rotator cuff is compromised

Question 13

What is a bennet fracture?

Answer 13

fracture at the base of the first metacarpal that extends into the carpometacarpal (CMC) joint. It is typically intra-articular and occurs due to axial force on a flexed thumb

Question 14

Which structures is invovles in Bennett fracture?

Answer 14

The abductor pollicis longus (APL) pulls the shaft of the first metacarpal dorsally, proximally, and laterally, resulting in dislocation/subluxation at the CMC joint

Question 15

How is Bennett fracture managed?

Answer 15

Orthopaedic referral and surgical fixation

Question 16

What is the most earliest sign of compartment syndrome?

Answer 16

Disproportionate pain

Question 17

What is a common complication of colles fracture?

Answer 17

Carpal tunnel syndrome, from direct trauma, post-reduction swelling or malignment casing compression of median nerve

Question 18

What must be present for medial meniscus tear?

Answer 18

Joint line tenderness

Question 19

What causes Anterior knee pain, worse on jumping or squatting?

Answer 19

Patellar tendinae they

Question 20

What causes localised swelling over patella?

Answer 20

Pre-patellar bursitis

Question 21

What is a Chandra’s loose body?

Answer 21

Free floating cartilage fragment causing pain or clicking of knee due to trauma or degenerative bone disease.

Question 22

What is the best management of acute Achilles tendon rupture in young healthy patinets?

Answer 22

Surgical repair with rehabilitation

Question 23

What is a prerequisite before formal testing for brainstem death?

Answer 23

Normothermic
Normotensive
Free from reversible causes or metabolic disturbances

Question 24

What is a concerning diastolic BP for shock?

Answer 24

Below 50mmHg

Question 25

What is the ECCG features of TCA?

Answer 25

Widened QT -> prolonged QRS is present but not most specific

Question 26

What are the shockable rhythms that is pulseless?

Answer 26

Pulseless ventricular tachycardia

Question 27

What is the shockable rhythms?

Answer 27

Pulses Vt Ventricular fibrillation

Question 28

Should you provide fluid or packed red cells in blood loss?

Answer 28

Begin with IV fluids Follow with trnasufison of blood products at 1:1 ratio

Question 29

What is the target for Hb in shock?

Answer 29

Over 70

Question 30

Which drug can be continued on day of surgery?

Answer 30

Beta blockers

Question 31

How to manage Metformin on morning of surgery?

Answer 31

Omit only lunchtime dose if eGFR is greater than 60 and low risk of AKI -> otherwise omit morning if reduced kidney fucntion

Question 32

What is the appropriate step down from IV morphine for now 4/10 pain in patient with suspected head injury?

Answer 32

Oral ibuprofen and paracetomol -> codeine has risk of constipation sedation and respiratory depression

Question 33

What is the investigation for DVT in pregnancy?

Answer 33

V/Q scan

Question 34

What causes hemiparesis with suspected aortic dissection?

Answer 34

Occlusion of cerebral ischaemia as a side effect of

Question 36

Should you start fluids or antibiotics first for infection?

Answer 36

Immediate fluid resuscitation to restore perfusion and prevent progression to multi-organ failure