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The moderators of do not endorse/sanction said channel or bear any responsibility for any happenings within said channel. For moderation issues that arise there contact the moderators of the channel and not the moderators of. Basic Full Safety Reminder We do not provide official answers or professional judgement. As always, speak to your healthcare professional for answers specific to your condition. 1) 27 y/o m brought to ED 30 mins after MVA.
Unconscious at scene, Glasgow 10. Temp 98, RR 36, HR 130, BP 90/60. Breath sounds dec on Right; crepitus to palpation over right hemithorax. X-ray shows right hemopneumothorax. X-ray shows unstable pelvic fracture. Right thoracostomy tube yields 300 mL of blood. Given 3L of crystalloid but still tachy/hypotensive.
What's next step?. a) epinephrine. b) hetastarch.
c) recombinant factor vii. d) FFP. e) packed RBC's I picked A because I dunno still hypotensive. But I'm guessing he needs blood? 2) Study is proposed to assess effectiveness of a new HIV vaccine. Vaccine has been successfully tested on animals. Study will include members of a prison population.
Those who participate will be considered for early parole. Prisoners will be randomly assigned to receive vaccine or placebo. Which is biggest concern?. a) coercion of a vulnerable population. b) conflict of interest. c) failure to use an appropriate placebo. d) inadequate informed consent.
e) lack of generalizability I picked E because it reminded me of a UWorld question lol. I'm sure this is simple for many of you but I suck at these questions. 3) 23 y/o man brought by his mom because his wife died in a MVA 1 week ago and he's been having auditory hallucinations. Mother reports he was unable to make decisions for his wife's funeral and has been confused and disorganized since (no shit). Normal PE, AAO x3. Sad affect, appears preoccupied and has difficulty concentrating. States that he hears his brother's voice saying everything will be ok, but mom says his brother lives in a different state.
a) bereavement. b) brief psychotic disorder. c) PTSD. d) schizoaffective. e) schizophrenia I picked A b/c I thought auditory hallucinations were part of bereavement? FFP is for when you need to replenish clotting factors, so: Factor deficiencies (like V or VIII) Iatrogenic clotting deficiencies (warfarin overdosage/reversal) It's also used as therapy for TTP Massive transfusions (4+ units pRBCs) This patient is likely going to need a massive transfusion, they may very well need FFP given at some time (since they aren't just bleeding out their RBCs, they'd losing their clotting factors and platelets, too).
But you need to start with the blood, and the patient in question 1 hasn't been given any yet. That's why pRBCs is the best option. Edit: wrong factors, fixed, added TTP.