EMERGENCY MEDICINE QUESTIONS (EMQS)
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COORDINATORS: JAMES GAGG AND GAVIN LLOYD
Theme: Infectious diseases
QUESTION 1
Which of the following statements are true in relation to the diagnosis and treatment of necrotising fasciitis?
- Non-steroidal anti-inflammatory drugs should be administered in addition to opiates to achieve adequate analgesia.
- The presence of gas on radiological imaging is very sensitive, but not very specific in determining the diagnosis.
- A tense, erythematous, dusky area of skin is a late manifestation of the disease.
- High dose clindamycin (900 mg/day) should be administered as a first line antibiotic.
QUESTION 2
Which of the following statements regarding the management of a patient with severe sepsis are true?
- Septic shock is sepsis plus tissue hypoperfusion—defined as hypotension (systolic <90 mm Hg) resistant to fluid resuscitation (at least 1 litre crystalloid bolus) or blood lactate concentration greater than 4 mmol/l.
- Initial fluid resuscitation in the adult with septic shock should be with crystalloid rather than colloid.
- An anatomical source of sepsis should be identified
. . . [Full text of this article]
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Emerg. Med. J. 2008 25: 783.[Extract] [Full Text] [PDF]
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