Emergency for All

Question of the day

A 34-year-old pregnant woman presents to the Emergency Department (ED) after returning from Zambia. She has a four-day history of fever and dark urine.
She is confused upon arrival and has had a seizure.
Her GCS is 11 (Motor 5, Verbal 2, Eyes 4). Her capillary blood glucose is 2 mmol/L.

What’s your immediate management plan in the emergency department?

A) Secure airway, correct hypoglycaemia with IV dextrose, administer magnesium sulphate

B)Administer IV ceftriaxone and conservative fluid resuscitation to stabilise sepsis until malaria is diagnosed.

C) Secure airway, Manage hypoglycaemia using IV dextrose and undertake urgent blood work before antimalarial treatment.

D) Perform an urgent lumbar puncture to rule out central nervous system (CNS) infection before giving specific therapy.

E) Secure airway , correct hypoglycaemia with IV dextrose, and start IV artesunate immediately without waiting for confirmation.

Question of the day

A 10-year old child received two doses of IM adrenaline for anaphylaxis and now all symptoms resolve and child is at baseline.
Which of the following is not a risk factor of biphasic reaction?

A) Delay in adrenaline administration
B)Previous biphasic reaction
C) More than one dose of adrenaline required
D) Drug-induced anaphylaxis
E) Severe initial presentation

Question of the day

A 24-year-old woman presents multiple times to the ED. She tells you she follows you on social media and expresses that she "likes" you. She now presents with abdominal pain.

What is the best course of action?

A. Ask a colleague to examine her

B. Seek GMC advice

C. Take your colleague's opinion

D. Ask legal department advisor

E. Warn her if she doesn't keep the relationship professional, you will stop being her doctor

Quote of the day 😁

I think you can imagine while reading
Or May be you can add a little details like you can’t even fly without fuel or sth ( that’s worst case scenario)

A 30-year-old professional diver is treated for his second episode of a primary spontaneous pneumothorax on the right side. Both episodes were managed successfully with simple aspiration. He is otherwise fit and healthy and is keen to return to work.

According to BTS guidance, what advice should be given regarding his future diving career?

A. He can return to diving 4 weeks after his last X-ray is clear

B. He can return to diving only if he undergoes a CT scan showing no blebs

C. He is permanently disqualified from SCUBA diving unless he undergoes bilateral surgical pleurectomy

D. He can return to shallow-water diving (less than 10m) after 6 months

E. He can return to diving if he stops smoking and passes a lung function test

A 35-year-old man presents to the ED after being struck in the face with a baseball bat. You are assessing his facial fractures. You stand on his right side, place your left hand on his forehead to stabilise it, and with your right hand, hold the upper teeth and gently rock the hard palate. You observe that the hard palate and the nose move as a single unit, but his eyes do not move.
Which of the following is the most likely diagnosis?

A)Le Fort I fracture

B)Le Fort II fracture

C)Le Fort III fracture

D)Le Fort IV fracture

E)Isolated zygomaticomaxillary complex fracture