 | 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 |
38-year-old male is brought in by ambulance to emergency following a mountain bike accident whilst riding down steep bushland. He reports severe neck pain and he is unable to move his hands. He has not mobilised since the accident but is able to move his lower limbs.
Vital signs are:
Temp 36.9 degrees C
HR 110 bpm
RR 22 bpm
BP 145/83 mmHg
GCS 14
You have both CT and MRI are available at your hospital.
Vital signs are:
Temp 36.9 degrees C
HR 110 bpm
RR 22 bpm
BP 145/83 mmHg
GCS 14
You have both CT and MRI are available at your hospital.
1. State three (3) differing pros for each imaging modality for this patient.
1. CT:
MRI:
- Bony structures are better detailed
- Usually readily available cf MRI
- Scan itself is quick cf MRI
- Less expensive
- No risk to medical implants/metal
- No noise / claustrophobia issues
- Faster reporting / EPs more comfortable to report themselves
MRI:
- Better at providing detail of non bony structures
- No radiation exposure
- Very few side effects with MRI contrast
- Can detect subtle bony damage ...in this patient will provide more answers than if CT was first line
- Usually required for surgical planning
Further assessment reveals that the patient has a spinal cord syndrome.
2. State which spinal cord syndrome this patient has and list two (2) other
characteristic features?
2. State which spinal cord syndrome this patient has and list two (2) other
characteristic features?
Characteristic features:
- Motor impairment> sensory,
- UL >LL,
- Distal >proximal,
- Bladder dysfunction
3. Other than complete cord transection, list two (2) other spinal cord syndromes and
with two (2) clinical features for each.
with two (2) clinical features for each.
4. Your registrar is concerned that this patient may require intubation. List three (3) indications for intubation.
- Concurrent Head injury, Agitation
- Respiratory failure
- Associated chest injury
- Aspiration
- Cord injury >C6
- Airway obstruction due to expanding haematoma or laryngeal injury
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