Pathology EMQ template

 

Your Name: Tahira Choudry

Theme: Chemical pathology – Poisoning

 

OPTION LIST

 

A

Haemodialysis

I

Serum iron concentration

B

Contact the regional poisons information centre

J

Activated charcoal by nasogastric tube.

C

IV N-acetylcysteine

K

Brief observation in hospital.

D

IV Flumazenil

L

Blood levels of salicyclates.

E

Gastric lavage

M

Liver transplantation

F

Urine drug screen

N

IV desferrioxamine

G

Prepare a lecture on the evils of drug taking.

O

Alkalinization of urine with bicarbonate.

H

Nothing

P

Active cooling

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. At 69 years of age Rufus was found at home semi-conscious with a suicide note drenched in alcohol. His recent divorce proceedings were alluded to by his sister, with the finding of a dubious packet of powder alongside his belongings. On arrival to A&E Rufus had dilated pupils, hypertension, tachycardia and a fever. How would you investigate the cause of his current state?

 

 

2. A 29 year old female thespian was rushed to hospital after a night of entertaining guests.  She is vomiting and her plasma paracetamol concentration is 1.30mmol/L at 6am. Her maid informs you that she is being counselled for an eating disorder and concurrent alcohol problem. Amid the media furore, which next step do you undertake?

 

 

3. An 8 year old boy is admitted to the emergency room unconscious. His father informs you that he has full custody and had left him with his wife for the weekend. He mentions seeing him playing with his wife’s iron tablets and cheekily looking at the brightly coloured array. He sobs intermittently, informing you that his boy had passed some black stools this morning. What do you do next?

 

 

4. A 46 year old female manic depressant was found in a state of stupor by her mother. She is hypertonic and her limbs are rigid. Her mother cries out that she had only left her unattended for 5 minutes. What do you do next?

 

 

5. A 13 year old girl with convulsions was given diazepam. She is sweating with a temperature of 41.5.  Her mother reluctantly tells you that she is a cocaine addict and is meticulously careful not to involve the children. What is your next step?

 

 

 

ANSWERS

1. F

2. C

3. N

4. E

5. P