1. A & E POSTING (5th Rotation)
1. In emergency:
A. Pulsus paradoxus is defined as alternation of weak and strong beat pulse
B. Shock is when the blood pressure drops 40 mmHg
C. Neurogenic shock shows Parasympathetic overdrive
D. Formula to calculate MAP is: 2/3 Diastolic BP + 1/3 systolic BP.
E. Shock index is HR/MAP
2. Triaging in A & E
A. Revised trauma score consists of systolic BP, GCS and respiratory rate.
B. Unstable patient should be put in yellow zone
C. Patient with Triple A should be directly sent red zone
D. Primary survey includes full examination from head to toe
E. A medical assistant is qualified to pronounce death
3. Acute coronary syndrome:
A. Non- STEMI differs from Unstable angina based on their ECG changes
B. In STEMI, ST elevations are seen in V1-V3 for lateral MI
C. Q wave formation is seen within weeks
D. Troponin T is useful to detect reinfarction
E. Heart block is a contraindication for administration of Beta blockers
4. All are true regarding head injury except
A. Head injury can be divided into primary and secondary
B. Head injury almost always are closed injury
C. Based on Canto 1986 classification, grade 2 is LOC <5 min, PTA >30min &
amnesia
D. Penetrating skull injury include linear skull fracture, depressed skull fracture &
basilar skull fracture
E. Epidural haematoma is not serious and not required surgery
5. Regarding concussion
A. Concussion is defined as temporary loss of function due to trauma
B. Post concussion syndrome are memory problems, dizziness & depression
C. Most common seen in adult & elderly
D. Result from acceleration moment of the brain only
E. Grade IV is loss of consciousness >10 minutes

2. 6. Acute management in head injury
A. First A, B, C, D & E
B. In circulation, maintain adequate cerebral perfusion pressure
C. Fluid resuscitation is not needed
D. Secondary survey includes pupil size, GCS & motor function
E. Put cervical collar if cervical head injury is suspected
7. Stage of shock
A. In early reversible stage, HR is increased as well as MAP
B. In progressive stage, heart only become hypoxic
C. In refractory stage, cellular death cause organ failure which may lead to death
D. Restoration of BP & fluid volume cannot restore homeostasis of tissue
E. Acidosis with hyperkalaemia occurs in intermediate stage
8. Type of shock
A. Exogenous blood loss is an example of hypovolaemic shock
B. Features of hypovolaemic shock are tachycardia & sweating
C. Cardiogenic shock will cause decrease in cardiac output thus low BP
D. In restrictive shock, pulsus paradoxus & muffled heart sound may present
E. Shock index indicator is ratio of heart rate to systolic BP
9. Poisoning
A. Complication of Multiple Dosages of Activated Charcoal (MDAC) includes
pulmonary aspiration & electrolytes imbalance
B. MDAC can be used in barbiturates poisoning
C. Position the patient in lateral position with lower leg straight & upper leg flexed

3. D. Intubation is contraindicated in poisoning cases
E. Emesis can be done in children only
10. Regarding diabetic emergencies :
A. Infection is the precipitant in over 37% of cases of Diabetic Ketoacidosis
B. Sepsis, increased age and pre-existing cardiovascular or renal disease are
predictors of high mortality in DKA
C. Patients with HHS had increased risk of arterial and venous thrombosis
D. DKA and HHS are not life-threatening conditions
E. HHS is cause by absence of insulin in the body
11. All are true regarding diabetic hypoglycemia except :
A. Most commonly occurs in DM type 1
B. Ethanol ingestion is one of the precipitant
C. Treatment is oral glucose in conscious patients
D. Cerebral edema must be suspected if patient not regained consciousness after
IV glucose was given
E. Treatment for cerebral edema is mannitol
12. These statements are true regarding DKA:
A. Ketone stick only can detect acetone and acetoacetate in the urine
B. Serum osmolality is > 350 mmol/L
C. Blood glucose usually > 30 mmol/L
D. 0.9% saline was used when serum Na+ was >145mmol/L
E. Rapid colloid or crystalloid infusion is needed for hypotension or shock
13. Basic Life Support:
A. The steps are known as the ‘chain of survival’
B. First step is check for the dangers
C. CPR can immediately be done if you are alone at that place
D. ‘Call fast’ in cases of patients suspected of choking or drowning
E. ‘Call first’ if patient suspected had ventricular fibrillation

4. 14. All are true regarding thermal burn:
A. There were no pains in 3rd and 4th degree burns
B. 3rd degree burn only involved part of the dermis
C. Present of blisters indicated 2nd degree burn
D. Superficial burn was same as 2nd degree burn
E. Lund and Browder chart follow the rule of nine
15. Management of thermal burn includes:
A. Immerse the major burn part in cool water
B. IV morphine was used for pain control in moderate and major burn
C. Fluid replacement was given based on Parkland formula
D. Isotonic solution was used in 1st 24 hours of fluid replacement
E. 24 hours of fluid replacement finished after 24 hours patient arrive in hospital
16. Regarding inhalation burn:
A. Respiratory complications account for most deaths from bun injury
B. One of complication is atelectasis
C. Direct thermal injury below larynx is common
D. It triggers the release of thromboxane and results in increased pulmonary
arterial pressure
E. Management includes give 100% of oxygen