Major Haemorrhage Management Quiz

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Questions and Answers

What is the primary mechanism by which the body attempts to maintain blood pressure during major haemorrhage?

Increased production of erythrocytes to compensate for blood loss.

Activation of the intrinsic coagulation cascade to form clots and reduce bleeding.

Release of hormones to trigger vasoconstriction and increase vascular resistance. (correct)

Increased production of plasma to dilute and increase volume.

Which of the following factors contribute to the development of coagulopathy in major haemorrhage?

Increased levels of plasminogen, leading to excessive clot breakdown.

Excessive use of crystalloid fluids, diluting clotting factors.

Loss of erythrocytes and clotting factors from the circulation. (correct)

Activation of the extrinsic coagulation cascade, leading to uncontrolled clotting.

Which of the following statements about the lethal triad in major haemorrhage is TRUE?

Metabolic acidosis results from the accumulation of oxygen in the blood.

The lethal triad is characterized by a combination of coagulopathy, hypothermia, and metabolic acidosis. (correct)

Hypothermia can enhance the activity of clotting factors, improving coagulation.

Coagulopathy is primarily caused by the depletion of platelets, leading to poor clotting.

What is the primary reason for avoiding excessive use of crystalloid fluids in major haemorrhage?

Crystalloids can dilute blood components, impairing clotting and oxygen carrying capacity. (C) Signup and view all the answers

Why is it important to monitor calcium levels during massive blood transfusion?

Calcium in donated blood binds to plasminogen, inhibiting clotting. (D) Signup and view all the answers

Which of the following is a characteristic of the extrinsic pathway of coagulation?

Triggered by external trauma, tissue damage, or inflammation. (C) Signup and view all the answers

How does TXA (tranexamic acid) help manage major haemorrhage?

TXA inhibits the action of plasmin, reducing the breakdown of clots. (B) Signup and view all the answers

Which blood product is specifically used to provide a concentrated source of fibrinogen in major haemorrhage management?

Cryoprecipitate (D) Signup and view all the answers

Why is it essential to maintain a core body temperature above 32°C during major haemorrhage?

Hypothermia can impair the function of clotting factors and platelets, worsening coagulopathy. (A) Signup and view all the answers

What is a potential complication of administering large volumes of FFP in major haemorrhage?

Transfusion-Associated Circulatory Overload (TACO), leading to fluid overload. (B) Signup and view all the answers

What is the appropriate treatment for laryngospasm in a patient with COPD?

Salbutamol 250mcg IV slowly (B), Aminophylline 250-500mg IV (C) Signup and view all the answers

Which medication is classified as an emergency treatment for bradycardia?

Adrenaline (D) Signup and view all the answers

What is NOT a treatment option for malignant hyperthermia?

Increasing oxygen consumption (A) Signup and view all the answers

In the case of anaphylaxis, which of the following statements is true regarding immediate treatment?

IV adrenaline should be administered (A) Signup and view all the answers

What is the role of amiodarone in emergency situations?

It stabilizes arrhythmias for shockable ventricular fibrillation (C) Signup and view all the answers

What is the primary immunoglobulin involved in the allergic response to allergens?

IgE (B) Signup and view all the answers

During anaphylaxis, what immediate effect does the large release of histamine have on blood pressure?

Decreases blood pressure (B) Signup and view all the answers

What treatment is typically administered for severe anaphylaxis, such as Grade 3?

IM Adrenaline (1:1000) (B) Signup and view all the answers

In which grade of anaphylaxis would a patient primarily exhibit GI symptoms such as vomiting and diarrhea?

Grade 2 (A) Signup and view all the answers

What physiological response occurs following the degranulation of mast cells during an allergic reaction?

Release of inflammatory mediators (D) Signup and view all the answers

What is a likely consequence of capillary permeability during severe anaphylaxis?

Loss of blood volume and hypovolemia (B) Signup and view all the answers

What physiological change results from excessive calcium release in malignant hyperthermia?

Persistent muscle contraction (A) Signup and view all the answers

Which condition is a direct consequence of rhabdomyolysis?

Myoglobinuria (D) Signup and view all the answers

What is the primary mechanism by which dantrolene alleviates malignant hyperthermia?

Blocks calcium from binding to troponin (D) Signup and view all the answers

Which laboratory finding is most indicative of hyperkalaemia following a prolonged muscle contraction?

Elevated potassium concentrations (A) Signup and view all the answers

What is the most critical initial treatment for suspected malignant hyperthermia?

Provide 100% oxygen (B) Signup and view all the answers

What is the primary consequence of excessive lactic acid production in the body?

Shift to anaerobic respiration (A) Signup and view all the answers

Which of the following mechanisms is essential for spontaneous breathing to occur post-anaesthesia?

CO₂ retention within the patient (D) Signup and view all the answers

How does Boyle's law relate to lung mechanics?

Increase in thoracic cavity size reduces pressure (D) Signup and view all the answers

Which statement correctly describes the impact of high resistance in breathing?

Higher pressure is needed to inflate the lungs (B) Signup and view all the answers

What occurs when compliance in the lungs decreases?

Difficulty in lung inflation (A) Signup and view all the answers

What function does the SA node serve in cardiac physiology?

It serves as the primary pacemaker of the heart. (C) Signup and view all the answers

Which wave in an ECG indicates the electrical activity of the ventricles?

QRS complex (A) Signup and view all the answers

During the depolarization phase of a cardiac action potential, which ion primarily enters the cell?

Sodium (Na⁺) (A) Signup and view all the answers

Which statement accurately describes the cardiac cell at rest?

It possesses a negative resting membrane potential. (C) Signup and view all the answers

What happens during the early repolarization phase of the action potential?

Sodium channels close and some potassium channels open. (A) Signup and view all the answers

What is indicated by the PR interval on an ECG?

Duration between atrial depolarization and ventricular depolarization. (A) Signup and view all the answers

Which zone of burn injury is characterized by maximum damage and cell death?

Zone of coagulation (D) Signup and view all the answers

What is the primary ion movement associated with the repolarization phase of a cardiac action potential?

Potassium (K⁺) exiting the cell. (B) Signup and view all the answers

What metabolic change occurs as a result of severe burns?

Hypermetabolism leading to increased metabolic demand (D) Signup and view all the answers

Which of the following statements accurately describes the systemic response following burns exceeding 30% of tissue areas?

Systemic hypotension and end organ hypo-perfusion (B) Signup and view all the answers

Which phase of the cardiac action potential marks the cell returning to resting conditions?

Rest phase (D) Signup and view all the answers

Which ion concentration is actually higher outside of the cardiac cell at rest?

Sodium (Na⁺) (A) Signup and view all the answers

Which type of burn is characterized by fluid loss, blisters, and pain, but does not damage the dermis?

2nd degree superficial burn (C) Signup and view all the answers

What is the primary physiological response in the respiratory system due to burns?

Bronchospasm causing increased resistance (C) Signup and view all the answers

What occurs immediately after sodium channels open during depolarization?

Potassium channels begin to open. (C) Signup and view all the answers

Which of the following measures is essential for managing circulation in burn patients?

Using the Parkland formula for fluid replacement (C) Signup and view all the answers

In cases of burns affecting the mouth area, what is a crucial concern?

Swelling potentially leading to airway obstruction (C) Signup and view all the answers

Why does a burn injury lead to insulin resistance?

Elevated adrenaline levels preventing insulin binding (A) Signup and view all the answers

Study Notes

Pathophysiology of Breathing

Equation for energy = O₂ + glucose → ATP + CO₂ + H₂O
Aerobic Respiration
Release of lactic acid from lack of oxygen.
Too much is bad for the body (Anaerobic Respiration)
Muscles: Intercostal Muscles, Accessory Muscles, Sternocleidomastoid, and Pectoral.

The Lungs

Space between the outer surface of lungs + inner thoracic wall- pleural space.
The lungs undergo expansion or reduction in size according to the pressure.
Small changes in size affects the amount of space available.
Tension pneumothorax: Fluid or air in the pleural space.
Bigger surface area = less pressure (Boyle's law)
Smaller surface area = high pressure.
How?
Diaphragm + respiratory centre (Medulla Oblongata)
Central chemoreceptors located in the medulla.
Respond to partial pressure of CO₂→ Phrenic nerve → diaphragm → contracts.
Pressure in lungs must be lower than atmospheric pressure in order for air to get in.

Resistance

When there is not enough space in a cavity (high resistance).
COPD
Bronchospasm/Asthma
Oedema
Adrenaline → Bronchodilator (lower dose)
If resistance is high, the pressure needed to inflate lung needs to be higher.
Effort of breathing increased.
May lead to no oxygen being able to diffuse.
May lead to collapse or lower away, reducing compliance.

Compliance

How easy expansion takes place.
A decrease in compliance occurs with restrictive lung disease (inflates pressure).
As lung inflates pressure increases due to an inability to expand.
Inadequate oxygen.
Atelectasis can reduce compliance.

Positions

Supine: Increases airway pressure.
Lateral: Ventilates the upper lung but lower lung is better perfused.
Trendelenburg: Resembles diaphragm/compress the lungs.
Prone: Mechanical ventilation may improve ventilation due to even distribution.

Drugs Affecting Breathing

Opiates→ Depth of anaesthesia → Respiratory system cannot respond to oxygen requirements, changes.
Muscle relaxants→ Prevent oxygen requirements changes.
Spontaneous breathing→ Emergence from anaesthesia (Anaesthetist will allow some CO₂ into pt when breathing).

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Description

Test your knowledge on the mechanisms and management strategies for major haemorrhage. This quiz covers topics such as coagulopathy, the lethal triad, and the importance of monitoring during massive blood transfusion. Understand the critical interventions that can save lives in emergency situations.