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Exam A: - Answers

Published online by Cambridge University Press:  21 January 2017

Keith Davies ,
Christopher Gough ,
Emma King ,
Benjamin Plumb  and
Benjamin Walton
Keith Davies
Affiliation:
Severn Deanery, Bristol
Christopher Gough
Affiliation:
Severn Deanery, Bristol
Emma King
Affiliation:
Severn Deanery, Bristol
Benjamin Plumb
Affiliation:
Severn Deanery, Bristol
Benjamin Walton
Affiliation:
North Bristol NHS Trust
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Summary

A trauma patient is brought into the resuscitation room with an obviously unstable pelvis. Despite ongoing fluid resuscitation with blood products the patient remains haemodynamically unstable, has profound metabolic acidosis and continues to deteriorate. Focused assessment with sonography in trauma (FAST) scan is positive.

Type
Chapter
Information
Single Best Answer Questions for the Final FFICM , pp. 9 - 45
Publisher: Cambridge University Press
Print publication year: 2016

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References

References

Holcomb, JB, Tilley, BC, Baraniuk, S, et al. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA. 2015;313(5):471–482.Google Scholar
Magnone, S, Coccolini, F, Manfredi, R, et al. Management of hemodynamically unstable pelvic trauma: results of the first Italian consensus conference. World J Emerg Surg. 2014;9(1):18.CrossRefGoogle ScholarPubMed
Spahn, DR, Bouillon, B, Cerny, V, et al. Management of bleeding and coagulopathy following major trauma: an updated European guideline. Crit Care. 2013;17(2):R76.Google Scholar

References

The American Institute for Ultrasound in Medicine (AIUM). AIUM Practice Guidelines for the Use of Ultrasound to Guide Vascular Access Procedures. Laurel, MD: AIUM, April 2012.Google Scholar
National Institute for Health and Care Excellence (NICE). Guidance on the use of ultrasound locating devices for placing central venous catheters (Technology Appraisal Guidance 49). London: NICE, 2002.Google Scholar

References

Goddard, J, Turner, AN, Cumming, AD, Stewart, LH. Kidney and urinary tract disease. In Boon, NA, Colledge, NR, Walker BR, , Hunter, JAA. Davidson's Principles and Practice of Medicine. 20th edition. Edinburgh: Churchill Livingstone Elsevier, 2006: p. 486.Google Scholar
Kidney Disease: Improving Global Outcomes. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3(1).Google Scholar
The UK Renal Association website. http://www.renal.org/ (last accessed April 2015).Google Scholar

Reference

Davis, PD, Kenny, GNC. Basic Physics and Measurement in Anaesthesia. 5th edition. London: Elsevier, 2003.Google Scholar

References

Kahi, CJ, Rex, DK. Bowel obstruction and pseudo-obstruction. Gastroenterol Clin North Am. 2003;32(4):1229–1247.Google Scholar
Marini, JJ, Wheeler, AP. Critical Care Medicine: The essentials. 4th edition. Philadelphia: Lippincott, Williams & Wilkins, 2009, p 226.Google Scholar

References

Smith, T. Chapter 6: Hypnotics and intravenous anaesthetic agents. In Smith, T, Pinnock, C, Lin, T. Fundamentals of Anaesthesia. 3rd edition. Cambridge: Cambridge University Press, 2009, pp 569–584.CrossRefGoogle Scholar
Chapter 8: General anaesthetic agents, Chapter 9: Analgesics, and Chapter 11: Muscle relaxants and anticholinesterases, in Section 2: Core drugs in anaesthetic practice. In Peck, T, Hill, S, Williams, . Pharmacology for Anaesthesia and Intensive Care. 3rd edition. Cambridge: Cambridge University Press, 2008.Google Scholar

Reference

Moore, KL, Agur, AMR, Dalley, AF. Essential Clinical Anatomy. 5th edition. Baltimore, MD: Lippincott Williams & Wilkins, 2014.Google Scholar

References

Joint Formulary Committee. British National Formulary (online). London: BMJ Group and Pharmaceutical Press. http://www.evidence.nhs.uk/formulary/bnf/current/5-infections/52-antifungal-drugs/treatment-of-fungal-infections (accessed July 2015).Google Scholar
Lewis, RE. Current concepts in antifungal pharmacology. Mayo Clin Proc. 2011;86(8):805–817.Google Scholar
Sherif, R, Segal, BH. Pulmonary aspergillosis: clinical presentation, diagnostic tests, management and complications. Curr Opin Pulm Med. 2010;16(3):242–250.Google Scholar
Taccone, FS, Abeele, Van den, Bulpa, P, et al. Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes. Crit Care. 2015;19:7.Google Scholar

References

BMJ Best Practice – Assessment of Jaundice. Available at http://bestpractice.bmj.com/best-practice/monograph/511.html (accessed August 2015).Google Scholar
Roche, SP, Kobos, R. Jaundice in the adult patient. Am Fam Physician 2004;69(2):99–304.Google Scholar

References

Diprose, P, Pierce, JMT. Anaesthesia for patients with pacemakers and similar devices. Brit J Anaesthes CEPD Rev, 2001;1(6):166–170.Google Scholar
Hampton, JR. The ECG Made Easy. 6th edition. Edinburgh: Churchill Livingstone, 2003.Google Scholar

References

Davis, P, Kenny, G. Basic Physics and Measurement in Anaesthesia. 5th edition. London: Butterworth Heinemann Elsevier, 2005, Chapter 17, pp 187–198.Google Scholar
Sturgess, D, Morgan, T. Haemodynamic monitoring. In Bersten, AD, Soni, N. Oh's Intensive Care Manual. 6th edition. Oxford: Butterworth Heinemann Elsevier, 2009, Chapter 12, pp 105–122.Google Scholar

References

Konstantinides, SV, Torbicki, A, Agnelli, G, et al. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Endorsed by the European Respiratory Society (ERS). Eur Heart J. 2014;35(43):3033–3073.Google Scholar
National Institute for Health and Care Excellence (NICE). CG144: Venous thromboembolic diseases: the management of venous thromboembolic diseases and the role of thrombophilia testing. London: NICE, 2012. http://www.nice.org.uk/guidance/cg144 (accessed November 2014).Google Scholar
National Institute for Health and Care Excellence (NICE). TA287: Rivaroxaban for treating pulmonary embolism and preventing recurrent venous thromboembolism. London: NICE, 2013. http://www.nice.org.uk/guidance/ta287/ (accessed November 2014).Google Scholar

References

Bamford, J, Sandercock, P, Dennis, M, et al. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet. 1991; 337(8756):1521–1526.CrossRefGoogle ScholarPubMed
Thanvi, B, Munshi, SK, Dawson, S, Robinson, T. Carotid and vertebral artery dissection syndromes. Postgrad Med J. 2005;81(956):383–388.Google Scholar
Treadwell, SD, Thanvi, B. Malignant middle cerebral artery (MCA) infarction: pathophysiology, diagnosis and management. Postgrad Med J. 2010;86(1014):235–242.Google Scholar

References

Galiè, N, Hoeper, MM, Humbert, M, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J. 2009:30(20);2493–2537.Google Scholar
Matthews, JC, McLaughlin, V. Acute right ventricular failure in the setting of acute pulmonary embolism or chronic pulmonary hypertension: a detailed review of the pathophysiology, diagnosis, and management. Curr Cardiol Rev. 2008;4(1):49–59.Google Scholar

References

Carson, JL, Brooks, MM, Abbott, JD, et al. Liberal versus restrictive transfusion thresholds for patients with symptomatic coronary artery disease. Am Heart J. 2013; 165(6):964–971.CrossRefGoogle ScholarPubMed
Herbert, PC, Wells, G, Blajchman, MA, et al. A multicentre, randomized controlled clinical trial of transfusion requirements in critical care. N Engl J Med. 1999;340(6):409–417.Google Scholar
Holst, LB, Haase, N, Wetterslev, J, et al. Lower versus higher hemoglobin threshold for transfusion in septic shock. N Engl J Med. 2014;371(15):1381–1391.Google Scholar
Spahn, DR, Bouillon, B, et al. Management of bleeding and coagulopathy following major trauma: an updated European guideline. Crit Care. 2013; 17(2):R76.Google Scholar
Villanueva, C, Colomo, A, Bosch, A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med. 2013; 368(1):11–21.CrossRefGoogle ScholarPubMed

Reference

Howard, SC, Jones, DP, , Pui C-H. The tumour lysis syndrome. N Engl J Med 2011:364(19):1844–1854.Google Scholar

References

Public Health England. Updated guidance on the management and treatment of Clostridium difficile. infection. 2013. http://www.dhsspsni.gov.uk/updated-guidance.pdf (accessed February 2015).Google Scholar

References

Peek, G, Elbourne, D, Mugford, M, et al. Randomised controlled trial and parallel economic evaluation of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR). Health Technol Assess. 2010;14(35):1–74.Google Scholar
Royal Brompton & Harefield NHS Trust ECMO advice. http://www.rbht.nhs.uk/healthprofessionals/clinical-departments/critical-care/ecmo/ecmo-referrals (accessed April 2015).Google Scholar

References

Difficult Airway Society. Intubation guidelines. https://www.das.uk.com/guidelines (accessed May 2015).Google Scholar
Langeron, O, Masso, E, Huraux, C, et al. Prediction of difficult mask ventilation. Anesthesiology. 2000;92(5):1229–1236.Google Scholar

References

National Institute of Clinical Excellence (NICE). Chronic obstructive pulmonary disease [CG101]. London: NICE, 2010.Google Scholar
Naughton, MT, Tuxen, DV. Acute respiratory failure in chronic obstructive pulmonary disease. In Bersten, AD, Soni, N. Oh's Intensive Care Manual. 6th edition. Edinburgh: Butterworth Heinemann, 2009.Google Scholar

References

Chatterjee, K. The Swan-Ganz catheters: past, present, and future. Circulation 2009;119(1):147–152.Google Scholar
Gomez, CMH, Palazzo, MGA. Pulmonary artery catheterization in anaesthesia and intensive care. Br J Anaesthes. 1998;81(6):945–956.Google Scholar

Reference

Joint United Kingdom (UK). Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee. Transfusion Handbook Chapter 2: The ABO system. http://www.transfusionguidelines.org/transfusion-handbook/2-basics-of-blood-groups-and-antibodies/2-4-the-abo-system (accessed April 2015).Google Scholar

Reference

Capodanno, D, Angiolillo, DJ. Contemporary reviews in cardiovascular medicine. Antithrombotic therapy in patients with chronic kidney disease. Circulation. 2012;125:2649–2661.Google Scholar

References

National Institute for Health and Clinical Excellence (NICE). Appendix F: Protocols for treating convulsive status epilepticus in adults and children; adults (CG137). London: NICE, 2012.Google Scholar
Smith, T. Hypnotics and intravenous anaesthetic agents. In Smith, T, Pinnock, C, and Lin, T. Fundamentals of Anaesthesia. 3rd edition. Cambridge: Cambridge University Press; pp 572–576.Google Scholar

References

ARDS Definition Task Force, Ranieri, VM, Rubenfeld, GD, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307(23):2526–2533.Google Scholar
Fanelli, V, Vlachou, A, Ghannadian, S, et al. Acute respiratory distress syndrome: new definition, current and future therapeutic options. J Thorac Dis. 2013;5(3):326–334.Google Scholar

References

Gennari, FJ, Weise, WJ. Acid-base disturbances in gastrointestinal disease. Clin J Am Soc Nephrol. 2008;3:1861–1868.Google Scholar
Jolliffe, DM. Practical gastric physiology. Contin Educ Anaesthes Crit Care Pain. 2009;9(6):173–177.CrossRefGoogle Scholar

References

Gines, P, Angeli, P, Lenz, K, et al. Clinical Practice Guidelines: EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53:397–417.Google Scholar
Wiest, R, Krag, A, Gerbes, A. Spontaneous bacterial peritonitis: recent guidelines and beyond. Gut. 2012;61:297–310.Google Scholar

References

Clarke, RT, Warnick, J, Stretton, K, Littlewood, TJ. Improving the immediate management of neutropenic sepsis in the UK: Lessons from a national audit. Br J Haematol. 2011;153(6):773–779.Google Scholar
National Institute for Health and Care Excellence (NICE). Neutropenic sepsis: prevention and management of neutropenic sepsis in cancer patients (CG151). London: NICE, 2012.Google Scholar

References

Hochman, JS. Cardiogenic shock complicating acute myocardial infarction: expanding the paradigm. Circulation. 2003;107:2998–3002.Google Scholar
Steg, PG, James, SK, Atar, D, et al. ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012;33(20):2569–2619.Google Scholar
Thiele, H, Zeymer, U, Neumann, FJ, et al. Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial. Lancet. 2013;382(13):1638–1645.Google Scholar

Reference

British guideline on the management of asthma – a national clinical guideline. British Thoracic Society, Scottish Intercollegiate Guidelines Network (SIGN 141, October 2014). Thorax. 2014;69:i1.Google Scholar

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