QuestionSBA
QuestionChoice
This patient is very unwell, likely due to biliary sepsis. This question requires you to identify that this patient needs urgent fluid resuscitation - this includes giving a 500ml bolus of fluid in less than 15 minutes. 45 minutes would take too long to give the fluid in this type of scenario.
50230
e
A fluid bolus of 500ml should be prescribed and given over 45 minutes
QuestionChoice
This patient is very unwell, likely due to biliary sepsis. This question requires you to identify that this patient needs urgent fluid resuscitation - this includes giving a 500ml bolus of fluid in less than 15 minutes. 30 minutes would take too long to give the fluid in this type of scenario. A 250ml bolus is also not enough, this would typically be used in patients with pre-existing heart failure.
50229
d
A fluid bolus of 250ml should be prescribed and given over 30 minutes
QuestionChoice
This patient is very unwell, likely due to biliary sepsis. This question requires you to identify that this patient needs urgent fluid resuscitation - this includes giving a 500ml bolus of fluid in less than 15 minutes. 30 minutes would take too long to give the fluid in this type of scenario.
50228
c
A fluid bolus of 500ml should be prescribed and given over 30 minutes
QuestionChoice
This patient is very unwell, likely due to biliary sepsis. This question requires you to identify that this patient needs urgent fluid resuscitation - this includes giving a 500ml bolus of fluid in less than 15 minutes.
50226
a
A fluid bolus of 500ml should be prescribed and given over <15 minutes
QuestionChoice
This patient is very unwell, likely due to biliary sepsis. This question requires you to identify that this patient needs urgent fluid resuscitation - this includes giving a 500ml bolus of fluid in less than 15 minutes. Giving a 250ml bolus is preferred if the patient has pre-existing heart failure.
50227
b
A fluid bolus of 250ml should be prescribed and given over <15 minutes
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3623
Replacing fluid in a patient who is in shock
Topic
13
Neurosurgery
10093
Case Presentation: A 34-year-old gentleman is admitted to ED with generalised abdominal pain.




 **PMH** Nil


 **DH** Nil


 **Investigations**


Observations: HR 112 bpm, RR 21, blood pressure 84/44 mmHg, temperature 38.4, O2 saturations 93% on RA


Abdominal examination: tender to palpation in RUQ, bowel sounds present.


Bloods: CRP 211 mg/L (<5 mg/L), WCC 18.9 x 10<sup>9</sup>)L (3.6 – 11.0 x 10<sup>9</sup>)L)


Question: Select the most appropriate decision option based on this data
a