Cards
Misc
Pulm
MSK
Misc
100
The two fundamental approaches to manage atrial fibrillation
What are
a. rhythm control
b. rate control
100
The most common cause of laryngotracheobronchitis (aka croup)
Parainfluenza
100
Pneumonia is most commonly acquired via
A. hematogenous spread from elsewhere in the body
B. Direct introduction of organisms into pleura or lungs
C. Aspiration from oropharynx
D. Other
What is
B. Aspiration from oropharynx
100
The primary cause of death from a pelvic fracture is
A. Associated injuries
B. Blood loss
C. Ruptured diaphragm
D. Sepsis
What is
B. blood loss
100
How do I determine BP goals in a stroke patient?
1. Ischemia or bleed?
-Bleed: <140mmHg systolic
-Ischemia ->
-Using TPA?: goal <180mmHg systolic
-No TPA?: Don't do anything unless >220mmHg
200
I should do this if I think my patient is hemodynamically unstable BECAUSE OF their rapid afib.
What is electrically Cardiovert?
I recommend a small dose of etomidate if you can.
Then SYNCHRONIZE.
Then 200J. -> 300J if that doesn't work.
200
60M PMH ESRD on nightly peritoneal dialysis presaents with fever and abdominal pain. What is the likely dx and what do you do?
What is
Sample the dialysate fluid to investigate probable SBP. Go ahead and treat with ABx through PD catheter.
200
ARDS is associated most strongly with...
A. Aspiration
B. Trauma
C. Sepsis
D. Massive blood transfusion
What is
C. Sepsis
200
86F PMH HF, afib on eliquis presents after she fell in her kitchen. Head CT was normal in the ED. She was admitted for HF exacerbation that caused her fall. She has L hip pain but her x-ray is negative. She is unable to walk due to the pain. What do you do?
A. Encourage OOB with PT to give better chance of mobility.
B. CT Pelvis to investigate occult fx
C. Call Ortho to see if CT is necessary
D. DVT U/S
200
What is the classic triad of lab findings in a patient was adrenal insufficiency (adrenal crisis)?
1. hyponatremia
2. hyperkalemia
3. hypoglycemia* most important clue, characteristic
300
These medications help provide RATE control for afib.
(Exception would be WPW but we are keeping it simple.)
What are
-calcium channel blockers (dilt & verapamil)
-beta blockers (metoprolol, esmolol, carvedilol)
-Dig
-Amio (might cardiovert though!)
-Don't forget Magnesium!
300
True or False
For a pregnant asthmatic patient, great caution should be used when giving steroids.
False
The risk of not treating the asthma is more dangerous for mom & baby. Give the steroids unless the exacerbation is very mild.
300
These patients get vaccinated for pneumococcal PNA.
Who are...
Alcoholics, cigarette smokers, COPD, HF, DM, immunocompromised, asplenic, >65 years old
300
Which has a worse prognosis, femoral neck hip fracture or intertrochanteric hip fracture and why?
What is femoral neck fracture?
The break is within the hip joint capsule. You have a greater chance of avascular necrosis.
300
Which of the following does not correspond to DIC.
A. Increased fibrinogen level
B. Decreased platelets
C. Schisotocytes
D. Anemia
E. Increased fibrin split products (AKA.... ?)
What is
A. Increased fibrinogen level- this would actually be low
400
These medications provide RHYTHM control.
What is
-Amio (go to)
-flecainide
-procainamide
400
What incidental BP reading warrants ED referral?
<90mmHg systolic
400
Variables considered when classifying severity of a patient's asthma.
What are
-daily symptoms
-nocturnal awakenings
-frequency of using short acting beta agonist
-activity limitations
-lung capacity volumes
400
Which joint is the most commonly affected by septic arthritis in the following populations:
-IV drug users
-Kids
-Everyone else (most cases)
What is...
IVDU: sacroiliac, sternoclavicular, intervertebral
Peds: knee and hip
Everyone else: knee
400
All of the following are classic for primary HIV EXCEPT...
A. Positive HIV ELISA
B. Fever
C. Sore Throat
D. High viral load
What is
A. Positive HIV ELISA
500
The usual treatment for incidentally found asymptomatic PVC's
What is nothing?
(Lyte derangements & hypoxia can cause PVC's & those should be addressed if the patient is sick.)
500
Severe salicylate poisoning (>100mg/dL) requires what intervention straight away regardless of symptoms?
A. N- acetylcysteine
B. Acidification of urine
C. Administration of a chelator
D. Hemodialysis
D. Hemodialysis
500
Most true about TB Skin Test:
A. It is positive in 100% of patients w/ TB meningitis.
B. Positive TBST = infection with Mycobacterium tuberculosis but not necessarily active disease
C. It is positive in 100% of patients infected w/ Mycobacterium tuberculosis
D. Criteria for interpreting a test as positive are universal for patients regardless of background/PMH
What is...
B. Positive TBST = infection with Mycobacterium tuberculosis but not necessarily active disease
500
How do we diagnose septic arthritis?
What is
Arthrocentesis
WBC 5K- 50K (Usually >40K, 75% PMNs)
500
An elderly man from a nursing home is sent to the ED for abd distension & discomfort. Urinary retention is diagnosed & Foley is placed. He puts out 2L initially and then 900cc over the next 3hr. Next steps:
A. Discharge to ECF
B. Removal of catheter for void trial
C. Admit for IV hydration and lyte monitoring
D. Other
What is...
C. Admit for IV hydration & lyte monitoring for post obstructive diuresis