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CBS 1 - Set 2 - EPIC 2 Spring 2025
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Question No. 1
i) What is the diagnosis?
Acute cyanide intoxication
ii) How do you treat?
100% O2
Amyl nitrate/ Sodium nitrite
Sodium thiosulphate
Hydroxocobalamin
Decontamination
Question No. 2
i) What is the likely diagnosis?
Sick euthyroid syndrome
ii) How to confirm?
Increased reverse T3
Question No. 3
i) What is your interpretation?
Rhabdomyolysis
AKI
ii) How do you treat?
Normal saline, 200-1,000 mL/hr, is recommended if no contraindications for volume load
Administration of bicarbonate and mannitol will reduce the incidence of renal failure
Question No. 4
i) What is the most likely cause of anaemia based on the above report?
Megaloblastic anaemia due to folate deficiency
ii) Can you name 3 other causes for this type of anaemia?
Alcoholism, Malabsorption syndrome, Methotrexate overdose
Question No. 5
i) What is seen in this ventilatory trend?
Isolated increase in PIP
ii) What is the most likely cause?
It is most likely due to increasing airway resistance (obstruction, bronchospasm)
Question No. 6
i) How will you manage? Please justify.
Rule out any obstruction/secretion
Optimize ventilator (↑FiO2, PEEP)
Switch to VCV
Accept Raised ETCO2 (Permissive Hypercapnia)
Consider prone ventilation/Inverse ratio/ECMO
Question No. 7
i) Interpret the ECG – what is your suspected diagnosis?
RV overload/strain pattern
Pulmonary embolism
Question No. 8
i) Interpret the following graphics
Block in arterial access and drop in blood return to system
Question No. 9
i) What's your diagnosis?
Non convulsive status epilepticus
Question No. 10
i) Comment on the CVP tracing
Large A wave due to junctional rhythm
Changes to normal with return of sinus rhythm