SAQ 955 – Environmental – endurance event collapse with seizure and abnormal blood results

You are the doctor for a well-equipped mobile clinic at a 5-day ultra-endurance event in the West MacDonald Ranges near Alice Springs.

On day 3, a 30-year-old female competitor is brought in after collapsing. She is confused, agitated and complaining of headache.

Test	Result	Reference range
pH	7.25
pCO2	42
pO2	25.2
HCO3	18
Hb	147	120-160
K+	5.2	3.2-5.2
Na+	114	135-145
Glucose	6.9	3.9-5.8
Lactate	6.2	0.5-2.0
Creatinine	115	45-90

List three key history features and three key examination features in your initial assessment.

(Marked out of 6.0)
</p> <table class="saq-prop-table" style="width: 100%; max-width: 100%; table-layout: fixed; border-collapse: collapse;"> <thead> <tr> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Category</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Key features</th> </tr> </thead> <tbody> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">History</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Examination</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> </tbody> </table> <p>

/ 6

List four differential diagnoses for this presentation.

(Marked out of 4.0)

/ 4

Her GCS deteriorates and she has a prolonged generalised seizure. The venous blood results are shown. List two drugs you would use urgently, including dose and route.

(Marked out of 6.0)
</p> <table class="saq-prop-table" style="width: 100%; max-width: 100%; table-layout: fixed; border-collapse: collapse;"> <thead> <tr> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Drug</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Dose</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Route</th> </tr> </thead> <tbody> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Drug 1</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Drug 2</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> </tbody> </table> <p>

/ 6

Her rectal temperature is 42 degrees C. List five complications of exertional heat stroke.

(Marked out of 5.0)

/ 5

Total Score: 0 / 21

Percentage: 0%