Ultimate Finals List - DR WHO

DR WHO

• ALS & defib, VT, reversible causes

• Mx of anaphylactic reaction to antibiotic infusion

• Dr WHO - ABCDE Pt with Meningitis - Emergency medicine. Run-through scenario with a resus-Annie type thing but you talk through what you would do (DR ABCDE Look Listen Feel Measure Treat routine) The patient was "A" in AVPU, in shock with warm peripheries and you were shown a picture of his legs which had meningococcal rash questions on the management of which filled in the remaining 2 mins - of course he was allergic to penicillin as all patients in finals suddenly turn out to be...

• Airway station with anaesthetist – alcoholic comes in… gurgling sounds – ABC, talk through airway adjuncts (Guedel->Nasopharyngeal etc and asked how would use and measure for each) Shown obs chart sats still low – high flow 02 etc etc – doesn’t improve – bag valve

• DRWHO - DKA

• Dr ABCDE- a patient acute chest pain. Go through airway-breathing-circulation, look/feel/listen/measure/treat for each as appropriate. Shown an ECG which conforms to thrombolysis criteria, expected to talk through basic management.

• DR WHO - a UCL thing. Diagnosis hypoglycaemia. Said would give IV dextrose. Then made idiot of myself. Examiner said 'if patient was conscious what could you give him?' I said a sugary drink. He said 'or...' I said 'a Mars Bar' He said 'or..' I said 'Or a Snickers' (Why was I naming chocolate bars!!!???) He then spoke to me like I was very simple and said 'Yes, but we're doctors and doctors like to use drugs so what could you prescribe?' Answer (which I got what felt like 8 hours later was IM glucagon!!!) - hypostop gel (oral), 50mls 50% iv dextrose, im glucagon.

• Airway Management- fairly straightforward scenario regarding a patient on the ward who’s obs had dropped. Seemed to be anaphylaxis as swollen tongue etc. Had to site a nasopharyngeal airway. Examiner then told you the pt has now stopped breathing. I had a moment of panic at this point and wanted to start cpr until examiner kindly informed me the patient had a pulse!!!! I suddenly looked at the equipment in front of me and had a flash of inspiration and told the examiner I would use the bag-valve-mask. She was very happy about this and said most people had struggled with remembering the bag-valve-mask!