BMAS Safety MCQ

NB: Please DO NOT use this Web site questionnaire for your COBC submission. The real COBC questionnaire is available from the office as part of the COBC pack.


1) What anatomical feature would make deep puncture with an acupuncture needle at CV17 potentially fatal?

One answer only.

Pectus excavatum
Pectus carinatum
Sternal foramen
Dextrocardia


2) What is the prevalence of this feature?

One answer only.

Less than 1 in 100,000
Less than 1 in 100
Greater than 1 in 100


3) Is this feature generally detectable by external examination?

One answer only.

Yes
No


4) What anatomical structure is potentially at risk from needling at GB21?

One answer only.

Vertebral Artery
Lung / pleura
Brachial plexus
Subclavian artery


5) What is the main risk associated with needling GB21 or any other point over the rib cage?

One answer only.

Fit
Faint
Funny turn
Pneumothorax


6) What needle angulation should be used at GB21 to minimise risk?

One answer only.

Perpendicular to the skin
Vertical
Tangential to the rib cage


7) Up to how long after needling over the rib cage can the symptoms of a pneumothorax develop?

One answer only.

2 hours
2 days
2 weeks


8) Which three techniques can be employed when needling over the rib cage to minimise the risk of pneumothorax?

Choose 3 of the following options.

Tangential to the rib cage
Superficial
Lift and thrust
Vigorous twirling
Onto a rib
Sensing the flow of Chi in the lung meridian
Monitoring the "lung" at the radial pulse


9) What is the most important immediate therapeutic action that should be applied to a patient with a tension pneumothorax?

One answer only.

Wrap them up in a warm blanket
Relieve the pressure
Give them a shot of brandy
Take the brandy yourself
Rig up a water-seal chest drain with the brandy bottle, some flexible tubing and a bic pen


10) Which of the following medical conditions is an absolute contraindication to the use of indwelling needles?

One answer only.

Cauliflower ear
Hypertrophic obstructive cardiomyopathy
Ischaemic heart disease
Valvular heart disease
Mitral valve prolapse
Sub-endocardial infarction


11) What is the risk of using indwelling needles in this condition?

One answer only.

Subacute Bacterial Endocarditis
Septicaemia
Bacteriaemia
Uraemia
Insomnia


12) Indwelling needles should be used with caution in debilitated patients. What potentially fatal condition are they more at risk of developing?

One answer only.

SBE
Septicaemia
Bacteriaemia
Uraemia
Insomnia


13) The use of which type of needle will minimise the risk of blood borne infection?

One answer only.

Reusable
Disposable
Indwelling


14) Which acupuncture point can be used in any trimester without risk to the pregnancy, and what is the reason for our confidence in its safety?

One answer only.

CV1 because of its convenient anatomical location
CV22 because of its safe anatomical location
PC6 because of its frequent use in pregnancy
GV20 because it is used for everything


15) In which two areas of the body should electroacupuncture be used with particular caution?

Choose 2 of the following options.

Face
Cervical spine
Anterior triangle of the neck
Thoracic spine
Across the chest
Lumbar spine
Abdomen


16) Which two medical conditions might lead you to avoid the use of electroacupuncture?

Choose 2 of the following options.

Diabetes
Narcolepsy
Epilepsy
Cataplexy
Valvular heart disease
Dysrhythmias controlled with a demand pacemaker
Hypnagogic hallucinations
Hypnopompic hallucinations


17) If you choose to treat a patient who is taking warfarin, in which two areas of the leg would you avoid vigorous needling, and why?

Choose 2 of the following options.

Into joint spaces because of the increased risk of haemarthrosis
The enclosed fascial compartments of the lower leg because of the risk of compartment syndrome
Points near the nail beds because of the risk of subungual haematomas
GB30 because of the proximity of the sciatic nerve


18) Bleeding diatheses are not an absolute contraindication to acupuncture, but in which one of the following cases should needling be avoided?

One answer only.

Platelet count of 50 x109/l
Spontaneous bruising
INR of 3.5


19) Which potentially beneficial side effect of acupuncture should you always discuss with a patient at their first session? Why??

One answer only.

Sedation because of the increased risk of an accident occurring on the way home
Bruising on the neck because of possible social embarrassment
Euphoria because it may result in an unnecessary spending spree


20) Which position should you instruct your patient to assume for their first acupuncture treatment?

One answer only.

Lying or sitting on an examination couch
Sitting in an armchair
Kneeling among scatter cushions


21) If you leave a patient alone in a treatment room with needles retained, what should always be left within their reach?

One answer only.

A cotton wool ball
An alcohol swab
An alcoholic drink
A warm blanket
Some means of attracting your attention
Spare needles in case one falls out


22) Name four visible pathological lesions that should be avoided when needling into or through an area of skin?

Choose 4 of the following options.

Ulcers
Tumours
Depigmented areas
Freckles
Varicose veins
Areas of superficial infection
Areas of hyperhidrosis
Tattoos