Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
How can a cephalhaematoma be told apart from caput succedaneum?
A woman at 32 weeks with type 1 diabetes has nausea, vomiting, abdominal pain, rapid breathing and a glucose of 16 mmol/L (about 290 mg/dL). Which complication should be suspected?
A child weighing 26 kg is prescribed 5 mg/kg of a drug. The stock solution contains 50 mg/mL. Draw up the dose: what volume V do you give?
The prescription is 4900 units of a drug that comes as 10000 units/mL. Draw up the dose in the 1 mL syringe: what volume V do you give?
Infuse 250 mL over 8 hours with a giving set of 60 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.
500 mL was ordered over 6 hours. After 3 hours you find that 280 mL is still in the bag, and the order must still finish on time. By what percentage Δ must the original pump rate be increased?
Answer: A · A cephalhaematoma does not cross the suture lines
Caput is oedema of the scalp, present at birth, crossing sutures and resolving within days. A cephalhaematoma is a subperiosteal bleed limited by the sutures; it appears after birth, lasts weeks and can increase jaundice.
Answer: D · Diabetic ketoacidosis
Diabetic ketoacidosis can develop quickly in pregnancy, even at moderately raised glucose, and carries a high risk of fetal death. Ketones and blood gases are checked urgently, and fluids and insulin are started.
Answer: V = 2.6 mL
Drawing up a dose: volume = (prescribed dose/stock strength) × stock volume. Convert to the same units first, then check that the volume fits the syringe and lands on one of its graduations.
On this 10 mL syringe every small line is 0.2 mL.
Answer: V = 0.49 mL
Drawing up a dose: volume = (prescribed dose/stock strength) × stock volume. Convert to the same units first, then check that the volume fits the syringe and lands on one of its graduations.
On this 1 mL syringe every small line is 0.01 mL.
Answer: R = 31 gtt/min
Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.
At the bedside you round to the nearest whole drop: 31 gtt/min.
Answer: Δ = 12 %
Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.
Many hospitals allow such an adjustment up to 25% without a new order; check local policy.
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