Rhythm and Blues
What are 4P causes of chest pain?
Pneumothorax
Pericarditis
Pneumonia
Pulmonary Embolism
If a patient presents with “Abnormal Flexion” on their motor exam what score will they receive on the Motor section of the GCS?
3
A three year old is brought in with URI and barky cough. What is the diagnosis?
Croup
A 65-year-old male with a history of atrial fibrillation presents with sudden onset severe abdominal pain that is out of proportion to exam findings.
Mesenteric ischemia
If a patient is brought in with a GCS of 7 RR of 6 and pinpoint pupils your first line treatment would be this
Naloxone
What rhythm abnormality is present on this ECG? (Be specific!)
Second Degree Type I AV Block (Wenckebach Type I). Image Source: https://litfl.com/av-block-2nd-degree-mobitz-i-wenckebach-phenomenon/
What are the 3 mechanisms of an ischemic stroke?
Thrombosis, Embolism, & Systemic Hypoperfusion
A two year old presents with sudden dypsnea and unilateral wheezes. What is the top of the differential?
Foreign body aspiration
A 55-year-old woman presents with RUQ abdominal pain which is sharp and localized to the right side of her abdomen. There is tenderness in RUQ and during palpation, she experiences pain and abruptly stops breathing. State the name and meaning of this sign and your next step.
Murphy’s sign acute cholecystitis. Next step can accept: ultrasound surgical intervention CBC
The first line treatment of a major acetaminophen overdose involves this
NAC (N-acetyl cysteine)
A patient presents with SOB, weight gain, edema, frothy white sputum, cough and vague chest pain. His BNP is 941 and Troponin is 57. What are the core treatments for this condition?
Nitrates
Diuretics
ASA
Non-invasive Positive Pressure Ventilation
A patient presents with nausea sweating blurry vision and muffled hearing followed by a fast-onset loss of consciousness with myoclonic jerks lasting 10 seconds. Following the episode the patient is oriented and alert. Is this more likely a presentation of syncope or seizure?
Syncope (There is a syncopal prodrome the episode is fast-onset and short-lasting and there is no post-ictal state as would be seen with a seizure. Myoclonic jerks can be seen in syncope and are often cause for this to be confused with seizure).
When attempting an endotracheal intubation this anatomical structure is considered the "gold standard" landmark to visualize before passing the tube.
vocal cords
A severely hemodynamically unstable patient presents to the emergency room. After stabilization evaluation and imaging from the ER doc an endoscope is performed and a TIPS procedure. What was the main cause of their instability and the underlying cause (be specific)?
Variceal upper GI bleeding due to portal hypertension
This calculated value is often elevated in cases of ethylene glycol methanol or isopropyl alcohol ingestion
Osmolar Gap
A 27 y/o otherwise healthy pt presents with sudden onset palpitations, SOB, light-headedness and a HR of 180. You ordered an ECG and are waiting for it to return. What arrythmia that can be managed conservatively is at the top of your ddx and what ECG findings would confirm your suspicion?
Supraventricular tachycardia (SVT). Narrow complex regular tachycardia.
What are two treatment options for the ACUTE STROKE
Endovascular thrombectomy and thrombolytics
This bedside tool provides a rapid non-invasive assessment of both oxygenation and ventilation by measuring end-tidal CO2
capnography
An 85 year old woman presents to the ED with vague generalized abdominal pain no vomiting or diarrhea. CRP of 8 WBC of 9 and Lactate of 1.1. What is the test you ll be ordering next?
Contrast-enhanced CT abdo/pelvis.
This antidote is used in alcohol dehydrogenase inhibition can be used to treat both methanol and ethylene glycol toxicity.
Fomepizole (or Ethanol)
What electrolyte abnormality is this?
Prominent U waves, flat T waves, ST segment depression, and PR prolongation. For a bonus point, name one condition that could lead to this electrolyte imbalance.
Hypokalemia
A patient presents with recurrent severe unilateral sharp headaches. On physical exam you also see unilateral lacrimation and rhinorrhea. What is the diagnosis?
Cluster Headache
A patient comes in with severe vomiting abdominal pain and a respiratory rate of 48. What is the presumptive diagnosis?
DKA
The "board-like abdomen" often seen in patients with free peritoneal air usually indicates this catastrophic condition
Perforation
What are the broad categories of "one pill kill" in young children?
Sodium channel blockers including calcium channel blockers
Methylxanthines
Sulfonylurea
Stimulants
Opioids