Narcotics
Toxidromes
Diagnoses
Radiology
Lab Tests
100
Opiates are derived from which plant?
Poppy
100
The medication that is commonly used to treat opiate toxidrome
What is Naloxone (Narcan)
100
Pt is a 47 y/o female with no PMH. She presents with SOB, fever of 104F, and diffuse wheezing. What is the most likely diagnosis?
Pneumonia
100
Which imaging study is most appropriate for diagnosing constipation?
Abdominal KUB
100
What condition is marked by an elevated CPK?
Rhabdomyolysis
200
Which policy, proposed in 1995 by Dr. James Campbell, triggered the increase in opiate prescriptions from 87 million in 1995 to 219 million in 2011?
Pain as the 5th Vital Sign
200
How many different toxidromes are there?
Five
200
Pt is a 63 y/o male with a PMH of gout. He had an episode of right wrist pain three weeks ago, but joint aspiration did not reveal gout. His PCP referred him for a Cortisone shot into the wrist, which he received ten days ago. He presents today with fever and right wrist pain that is worse with ROM. The wrist is erythematous and warm to the touch. What is the most likely diagnosis?
Septic joint
200
What test would you order to assess for PE in an elderly patient with a hx of CKD?
VQ scan / NM lung perfusion scan
200
Sometimes the WBC is elevated due to a stress response. What other CBC result can you use to help determine if the WBC is related to infection?
Neutrophils
300
Which famous German drug company released both ASA and heroin (under the brand name diacetylmorphine) in the 1890's?
Bayer
300
What is piloerection?
Goosebumps
300
32 y/o male presents with RUQ abdominal pain that began approximately two hours ago. The patient is s/p chole. Associated sx include nausea, vomiting, and low-grade fever. Name two possible DDx.
Retained gallstone, colitis, diverticulitis, IBS, ulcer, pancreatitis, hepatitis, retrocecal appendicitis
300
Name this incidental x-ray finding.
Bladder stone
300
In patient's with DKA, you expect the pH and bicarb to be low, the glucose to be elevated, and the UA may also show ketones. What finding on CMP do you also expect to be elevated in DKA patients, which is typically the defining characteristic of ketoacidosis?
Elevated anion gap
400
Which demographic is most likely to be taking an opiate? (include gender and ethnic group)
White females
400
If you suspect Sympathomimetic toxidrome, which drug class would you expect to be positive on UDS?
Cocaine or Amphetamines
400
51 y/o female presents unresponsive. She has a PMH of CKD, mental retardation, and seizures (compliant with Keppra). She sustained a fall yesterday but refused transport to the ED. She was at her baseline until immediately PTA. Workup revealed no focal source of infection and head CT was unremarkable. Neurological function improved to baseline over an hour in the ED. What is the most likely cause of her unresponsiveness? BONUS: What electrolyte abnormality could have triggered it?
Unresponsiveness: post-ictal status BONUS: Hyponatremia
400
In a hip fracture, the leg is normally shortened and ______ rotated, whereas in a hip dislocation the leg is normally shortened and _____ rotated.
Externally; internally
400
Which TWO tests are important to order prior to imaging when assessing for PE in adult patients?
D-dimer and creatinine
500
19th century housewives most commonly used which of the following OTC medications, which is also known as opium tincture? A: Ergoapiol B: Norodin C: Nembutal D: Laudanum
Answer: Laudanum Ergoapiol is derived from a rye grain fungus, and was used to reduce postpartum bleeding or induce abortions in the early 1900's Norodin is brand-name methamphetamine that was marketed as a medication to reduce depression Nembutal is pentobarbitol, which was used as a child sedative in the 1930's
500
Blind as a bat, mad as a hatter, red as a beet, hot as Hades, dry as a bone, the bowel and bladder lose their tone, and the heart runs alone
What is anticholinergic
500
47 y/o female with no PMH presents with acute onset, atraumatic, constant, central back pain. She is tachycardic and markedly hypertensive at 200's / 100's. Her pain improved with a dose of Toradol, but she continued to be hypertensive despite adequate pain control. While musculoskeletal pain and kidney stone are options, which additional ddx is a surgical emergency that, left untreated, could be lethal?
Aortic dissection
500
Name this head CT finding, which would cause acute left-sided deficits and warrants emergent neurological intervention.
The hyperdense MCA sign refers to focal increased density of the middle cerebral artery on CT and is direct visualisation of thromboembolic material within the lumen
500
If the AST, ALT, and bilirubin are elevated in a chronic liver disease patient, what other test might you expect to find elevated?
INR
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