Brain Food is a project to drip feed clinical knowledge (in the form of mock SAQs) to satisfy those hungry neurons. Sources are SA/NT Trial Exam 2021.2 and Monash 2022.1. Answers are prone to ageing. Leave a comment if you don't understand or something doesn't seem right...
PS we don't use the mock questions uploaded to ACEMs official mocks
She has a past medical history of breast cancer with a right sided mastectomy and on apixaban for paroxysmal atrial fibrillation.
Her observations are:
PR 100 bpm
BP 110/80 mmHg
SaO2 92% RA
RR 28 bpm
3. State two (2) medications including route and dose that could be given.
- CT angiogram
- Laboratory Ix especially apixaban/Xa levels/coagulation/cross match
- Bedside such as ECG/echo less useful
- Bronchoscopy unlikely to occur prior to intubation
PR 140 bpm
BP 80/60 mmHg
Sao2 90 % 15 litres O2
- Lateral decubitus with suspected bleeding side down, prepare for intubation
- Resuscitation with blood products and correction of bleeding diathesis eg temp/Ca/plts and further prothrombinex if given 25/kg before
- Intubation, consider advancing tube into non bleeding lung for single lung ventilation or double lumen tube
- Urgent interventional radiology if bleeding source identified or balloon tamponade once intubated