Emergency & Toxicology — Prometric Style Questions, Set 2

What this deck covers

Emergency and Toxicology – Prometric Style Questions, Set 2 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. A minute that terrified the parents
2. The chest that went quiet
3. Two doses and still failing
4. Soot around the nose
5. A shifted windpipe after a fall
6. When the boluses stop helping
7. When the veins have run out
8. The hour after the pulse returns
9. Collapsed on the football pitch
10. The murmur that disappeared
11. Adding up the three parts
12. The drug with a three-hour window
13. A bruised belly after a fall
14. How long on the hard board
15. Measuring a scald
16. Grandmother’s heart tablets
17. Sugar that will not stay up
18. Blue despite all the oxygen
19. Sweets that were not sweets
20. A strange taste during stitches
21. When charcoal will not bind
22. Deciding on dialysis
23. Nobody knows what he drank
24. A reassuring level that was not
25. Rules for giving charcoal
26. Pulled from the frozen lake
27. The acid that would not clear
28. Cut down and feeling fine
29. Collapsed at the final whistle
30. After the firework went off
31. Sedating for a bent forearm
32. A trace that went flat
33. Choosing how to take the pain away
34. Before the drugs go in
35. Eleven admissions, nothing found
36. A scald with no splashes
37. The first person she told
38. Nothing dramatic, everything wrong
39. A bruise on a baby who cannot move
40. Bitten on the knuckle
41. Stung while paddling
42. Bitten by another child
43. A bite that may be dry
44. A rash after a bee sting
45. The urge to leave now
46. Thirty children at once
47. A mother asking to stay
48. Attending alone at fifteen
49. Back again after six hours
50. Everyone saw it, nobody acted

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: A febrile convulsion in an infant, Early intubation before the airway swells, Continue peripheral attempts until successful, A shunt occlusion, Diagnostic peritoneal lavage, Intravenous calcium chloride by slow injection, Flumazenil to reverse the sedation, Whether the patient is fully conscious, It works equally well at any time after ingestion, Discharge with community mental health follow-up, It reliably causes hypotension and bradycardia, Promise her that nothing will be told to anyone else, Close both wounds primarily with sutures, Give antivenom immediately for any snake bite.

Clinical pearls from this deck

• The frightening part of this is the parents’ memory, not the baby. Sort the risk group first, because it decides whether anything else is needed at all.
• A quiet chest in an asthmatic child is not improvement. It is the sound of air that is no longer moving.
• After the second dose fails, the answer is more adrenaline by a different route, not a different drug class.
• In a fire the pulse oximeter is a liar. Look at the nose, the voice and the cough, and act before the swelling does.
• Full neck veins with a silent chest is the combination that forbids both the X-ray and the ventilator. Put a needle in first.
• Feel the liver between boluses. It is the earliest sign that the next bolus will do harm rather than good.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all emergency and toxicology case decks · pediatric reference values.