Medical Emergencies & BNF Therapeutics for ORE Part 1
Essential guide to Resuscitation Council UK CPR algorithms, emergency drugs (Adrenaline, GTN, Midazolam), and DPF prescribing.
Key Syllabus Concepts Tested in Medical Emergencies & BNF Therapeutics
- Resus Council UK adult CPR compression-to-ventilation ratio (30:2) and 15L/min high-flow oxygen
- Emergency drugs: Anaphylaxis IM Adrenaline 0.5mg (1:1000), Angina sublingual GTN 400mcg, Seizures buccal midazolam 10mg
- Hypoglycemia: 15-20g oral sugar if conscious, IM Glucagon 1mg if unconscious
- BNF Dental Formulary: Amoxicillin 500mg TDS for 5 days first-line, Clarithromycin/Metronidazole in penicillin allergy
Sample SBA Practice Questions
Sample Question 1 (Paper B)
A patient suddenly develops acute anaphylaxis following LA injection. What is the immediate first-line drug and dose?
- IV adrenaline 0.5 mg (1:10,000) into a large forearm vein
- IM adrenaline 0.3 mg (1:10,000) into the anterolateral thigh
- IM adrenaline 0.5 mg (1:1000) into the anterolateral thigh
- IM chlorphenamine 10 mg into the deltoid muscle
✅ Correct Answer: IM adrenaline 0.5 mg (1:1000) into the anterolateral thigh
Explanation: Anaphylaxis first-line treatment is immediate IM Adrenaline 0.5mg (1:1000) into anterolateral thigh.
Clinical Pearl: IM Adrenaline 0.5mg 1:1000 is first-line emergency drug for acute anaphylaxis.
Sample Question 2 (Paper B)
A patient with a history of angina experiences crushing retrosternal chest pain during treatment. What is the initial drug of choice?
- High-flow oxygen, 15 litres per minute
- Chewable aspirin tablet, 300 milligrams
- Sublingual glyceryl trinitrate spray, 400 micrograms
- Sublingual nifedipine capsule, 5 milligrams
✅ Correct Answer: Sublingual glyceryl trinitrate spray, 400 micrograms
Explanation: Sublingual GTN spray (1-2 puffs) dilates coronary arteries and relieves angina pectoris symptoms.
Clinical Pearl: Sublingual GTN spray 400mcg (1-2 puffs) is first-line for acute angina pectoris.
Sample Question 3 (Paper B)
An asthmatic patient suffers an acute bronchospasm attack in the dental chair. Which inhaler should be administered immediately?
- Beclometasone (brown inhaler) 200 mcg/puff, up to 4 puffs via spacer
- Salmeterol (green inhaler) 25 mcg/puff, up to 2 puffs via spacer
- Ipratropium bromide (grey inhaler) 20 mcg/puff, up to 4 puffs via spacer
- Salbutamol (blue inhaler) 100 mcg/puff, up to 10 puffs via spacer
✅ Correct Answer: Salbutamol (blue inhaler) 100 mcg/puff, up to 10 puffs via spacer
Explanation: Salbutamol is a short-acting beta-2 agonist administered via spacer (up to 10 puffs) during acute asthma attacks.
Clinical Pearl: Acute asthma bronchospasm is treated immediately with Salbutamol inhaler via spacer.
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