INFECTIOUS DISEASE
What is the most common bacterial pathogen seen in surgical site infections?
S. aureus (MSSA/MRSA)
What are the three main components of parenteral nutrition?
Dextrose, amino acids, lipids
What is a common side effect of Mucomyst (acetylcysteine) resulting in the recommendation to be administered with a bronchodilator?
Bronchospasm
What is the reversal agent for heparin?
Protamine sulfate
Why is calcium chloride administered during MTP in trauma patients?
Citrate found in transfused blood products results in the chelation of calcium and can lead to decreased myocardial contractility and coagulopathies
IDSA recommends ________ as the first line therapy for Clostridium difficile when resources are available
Fidaxomicin
What electrolyte abnormalities are characteristic of refeeding syndrome, and which is the most dangerous?
Hypophosphatemia (most critical), hypokalemia, hypomagnesemia; occurs with rapid reintroduction of nutrition in malnourished patients.
Name of current definition/criteria for ARDS
What is the Berlin Definition (2012)
Landmark trial to assess the use of the use of TXA in acute bleeding
CRASH Trial
Antibiotics for penetrating abdominal trauma should cover what kind of pathogens?
Gram negative and anaerobic pathogens
These agents have activity against MRSA (list at least 4)
Vancomycin, linezolid, daptomycin, doxycycline, clindamycin, sulfamethoxazole/trimethoprim, ceftaroline
What is the most significant complication of parenteral nutrition?
Central line-associated bloodstream infection (CLABSI)
Recommended treatment course (days) for VAP
What is 7 days
An inactivated combination of factors II, IX, and X, with variable amounts of factor VII. Recommended in the setting of life-threatening bleeds primarily Warfarin toxicity.
Prothrombin complex concentrate (PCC) (KCentra)
When should post-splenectomy vaccines be given to a patient who had their spleen removed?
At day 14 or discharge from the hospital (patient must be in stable condition)
These agents have activity against pseudomonas (list at least 4)
Zosyn, Meropenem, Imipenem, Cefepime, Aztreonam, Ceftazidine, Ciprofloxacin, Levofloxacin
ASPEN guidelines recommend _______ before and during parenteral nutrition for patients at risk of refeeding syndrome
Thiamine 100–300 mg/day IV for the first 3–5 days
Which anti-arrhythmic medication is most notorious for causing pulmonary toxicity?
Amiodarone
What are the main three pathways in the clotting cascade? (3)
intrinsic pathway, extrinsic pathway, common pathway
Name one contraindication to succinylcholine for RSI in trauma patients
Spinal cord injury >24–48 hours old, major burns (>24–48 hours post-injury), crush injuries, prolonged immobilization, neuromuscular diseases (e.g., Guillain-Barré, ALS)
This class of antifungals are primarily used to target treatment for candida species resistant to azole antifungals (e.g. fluconazole)
Echinocandins (micafungin, caspofungin, anidulafungin)
This trace element should be avoided in patients with cholestatic liver disease receiving PN
Manganese
Which landmark trial concluded the following: Among patients with moderate-to-severe ARDS who were treated with a strategy involving a high PEEP, there was no significant difference in mortality at 90 days between patients who received an early and continuous cisatracurium (NIMBEX) infusion and those who were treated with a usual-care approach with lighter sedation targets.
ROSE trial
What is the reversal agent for dabigatran?
Idarucizumab (Praxbind)
Name 4 classes of ICP-lowering medications for traumatic brain injuries:
Osmotic agents: hypertonic saline or mannitol
Sedatives: propofol, midazolam, etc.
Barbiturates
Paralytics