QUESTION NO 1 : List of options: 0.9 % Saline solution 5% Dextrose solution Albumin Blood (Red cells) Cryoprecipitate Fresh frozen plasma (FFP) Hartmann’s solution / Ringer Lactate Immunoglobulin Platelets Prothrombin complex What is the most appropriate next step resuscitation fluid or blood product which can be used in each of the following patients? You may choose each option once, more than once or not at all. A) A patient with a Haemoglobin of 6 after a massive upper GI bleed from oesophageal varices, who is currently only receiving IV saline                      ---Please Select--- 0.9 % Saline solution 5% Dextrose solution Albumin Blood (Red cells) Cryoprecipitate Fresh frozen plasma (FFP) Hartmann’s solution / Ringer Lactate Immunoglobulin Platelets Prothrombin complex    B) A patient who is on Warfarin for anticoagulation for AF with an INR of 8 who has a massive PR bleed                      ---Please Select--- 0.9 % Saline solution 5% Dextrose solution Albumin Blood (Red cells) Cryoprecipitate Fresh frozen plasma (FFP) Hartmann’s solution / Ringer Lactate Immunoglobulin Platelets Prothrombin complex    C) A patient with hyperchloremic metabolic acidosis                      ---Please Select--- 0.9 % Saline solution 5% Dextrose solution Albumin Blood (Red cells) Cryoprecipitate Fresh frozen plasma (FFP) Hartmann’s solution / Ringer Lactate Immunoglobulin Platelets Prothrombin complex    D) A nurse who suffers a needle stick injury from a Hepatitis B positive patient                      ---Please Select--- 0.9 % Saline solution 5% Dextrose solution Albumin Blood (Red cells) Cryoprecipitate Fresh frozen plasma (FFP) Hartmann’s solution / Ringer Lactate Immunoglobulin Platelets Prothrombin complex    E) The fluid of choice for a patient on a sliding scale as treatment for Diabetic Ketoacidosis where the BM is now 10mmol/L                      ---Please Select--- 0.9 % Saline solution 5% Dextrose solution Albumin Blood (Red cells) Cryoprecipitate Fresh frozen plasma (FFP) Hartmann’s solution / Ringer Lactate Immunoglobulin Platelets Prothrombin complex    F) A patient who has received multiple blood transfusions during resuscitation after major trauma requires fresh frozen plasma and.....                      ---Please Select--- 0.9 % Saline solution 5% Dextrose solution Albumin Blood (Red cells) Cryoprecipitate Fresh frozen plasma (FFP) Hartmann’s solution / Ringer Lactate Immunoglobulin Platelets Prothrombin complex

Question By Mr. Kasun Wanigasooriya MBCHB, MRCS.