New content quiz December 2014

Colloids other than albumin have not shown to have any benefit over crystalloid solutions in initial resuscitation, have a higher risk of allergic reaction and are considerably more expensive than colloids. Other adverse effects include impairment of fibrin polymerisation, decreased clot elasticity, decreased clot weight, reduced von Willebrand factor levels. (link)

Erythema nodosum is a nodular panniculitis which is a type of type IV hypersensitivity reaction that mostly involves inflammation of the subcutaneous fat. It most commonly occurs in 20-45 year olds and is much more common in women than men  after puberty. (link)

Consensus decision making is the preferred method of decision making. It is also known as unanimous (or near unanimous) agreement or consent. It is when all members accept/support the decision, however it does not mean it is each member’s preferred outcome, nor that all agree with it, but they can live with it. (link)

Hypothermia (33-36 C) is of benefit following severe perinatal asphyxia by improving functional outcome, not mortality. Although it may lead to improved outcome from coma secondary to cardiac arrest, temperature control to 36C appears to be as effective as 33C. It is of no proven benefit following traumatic brain injury in adults or children and is associated with cerebral oedema on rewarming. It is not of benefit, and probably harmful, in severe bacterial meningitis. (link)

To remember the order of appearance of the ossification centres of the carpal bones, use the right hand and move anti-clockwise from the Capitate. The sequence is: Capitate before 1year; Hamate before 2 years; Triquetrum before 3 years; Lunate before 4 years; Scaphoid before 5 years; Trapezium before 6 years; Trapezoid before 7 years; the Pisiform does not fit the pattern and appears before 10 years. (link)

The tibial shaft appears at 7 weeks in utero with and the fibula shaft appearing one week later at 8 weeks in utero. The calcaneal body appears at 3 months in utero and the talar body appears at 6 months in utero.The distal tibia appears at 4-12 months of age and the distal fibula appears at 6-12 months of age. The medial malleolus forms from the distal tibial epiphyses at 7-10 years of age.  (link)

The estimated tidal volume (6mL/kg) for a 173cm tall woman of average build is 385mL (415 for a similar sized man).

The estimated tidal volume (6mL/kg) for a 183cm tall man of average build is 470mL. (link)

In this situation you should first try increasing the PEEP to 8cm H20, rather than increasing the TV or FiO2. (link)