SBA Revise 2

A 63-year-old female presents to the Emergency Department complaining of a right-sided headache associated with piercing pain in her right eye and blurred vision. She is vomiting at triage. She cannot see the Snellen chart at all with her right eye and can only appreciate hand movements. Her eyes are as shown in the image below. Her right pupil is mid-dilated and non-reactive. She has no known medical history.

What is the most likely diagnosis?

A 5-year-old attends with a sore arm. You suspect a nursemaid’s elbow. Which is the best method for reducing this dislocation?

A 20-year-old woman attends the ED with bilateral pelvic pain, pain during intercourse and vaginal discharge for one week. Her pain has gradually worsened and is constant. She has no bowel or urinary symptoms.

Her observations are:
Temp: 38.50C
HR: 120 beats per minute
BP: 105/50

Abdominal examination shows marked tenderness across the lower abdomen, without signs of peritonitis or palpable mass.

Which is the likeliest organism to be causing her symptoms (in the UK)?

You see a 1-week-old in the Emergency Paediatric Department with her mother and father. She was born at 32 weeks with a Ventricular Septal Defect (VSD) but is growing well and appears healthy.

They are concerned regarding a protrusion they have noticed around her umbilicus. You examine her and find a defect in her abdominal fascia that is approximately 1cm in diameter. It is fully reducible and does not seem to cause her any discomfort. She is otherwise well.

Which of the following is the most significant risk factor for an umbilical hernia?

A 7-year-old child presents to the Paediatric Emergency Department, with his father, 2 hours after falling off his bike directly on to the handlebars. His Father was concerned as he has been complaining of abdominal pain. On examination he is clinically stable with no A – D concerns. He is tender in his upper abdomen with abdominal wall ecchymosis.

Which of the following would be the most appropriate definitive investigation in this patient?

You see Zain in the paediatric emergency department with a head wound from a fall.

He needs wound cleaning and closure. You need him to stay still.

Zain is 16 today. Which option is best for distracting him during the procedure?

A 7-year-old child presents to the Paediatric Emergency Department after falling forward from his scooter onto outstretched hands. His wrist is swollen and painful. The following x-rays are taken.

What is the most likely diagnosis?

Rob is a 15-day-old bottle fed pre-term neonate who has some blood in his nappy. He looks unwell.

Which of these is the most likely diagnosis?

A 24-year-old man presents with a number of wounds on his right forearm. He tells you that his neighbour’s dog bit him twelve hours ago when he picked up one of her pups. The wounds are superficial and he says it only bled for a few seconds. He has no medical history. The patient says that he only came to the ED because his neighbour told him he would need antibiotics and a tetanus booster.

With regard to antibiotics, which of the following is the most appropriate advice for this patient?

Arwa is a nine month old baby, who has come in a bit wheezy and short of breath.

She was born at term, with no problems, and has been well since. She has no siblings. There is no other family history. Mum is a smoker.

Her observations are:

RR 28, SpO2 95%, dipping occasionally to 93%, HR 148, Cap refil < 2 seconds. She has fed as much as normal, and has had lots of wet nappies. How much oxygen should Arwa be placed on, and through what delivery device?