Waterloo
Lets Get Physical
HELLP
Shock You Like A Hurricane
Under Pressors
100
How many Meq of Sodium in 0.9% Saline?
154
100
How do you perform Castell's sign
- Percuss the 8th or 9th left intercostal space in the anterior axillary line
- The space should sound resonant during full inspiration
- If the sound changes from resonant to dull during full inspiration, the sign is positive
100
What do you call these?
Schistocytes
100
What is Beck's Triad?
Hypotension, JVD, Muffled Heart Sounds
100
What is the first-line pressor in Septic shock?
Norepinephrine
200
The PLUS trial compared Normal Saline to what balance crystalloid?
Plasma-Lyte
200
What Ethnicity/Ancestry is Dupytrene's contracture most associated with?
Irish or Northern European
200
What does a hemolytic Workup entail?
Peripheral Blood smear, unconjugated bilirubin, LDH, Haptoglobin, Reticulocyte count, Direct coombs test
200
Name 4 different causes of Distributive shock?
Sepsis, Anaphylaxis, Spinal Trauma, Anesthesia, Addison's
200
What is the first line pressor in cardiogenic shock?
Norepinephrine
300
In what situation does Ringer's Lactate have a significantly higher mortality rate than Normal Saline
Traumatic Brain Injury
300
Name 4 physical Exam Maneuvers to detect ascites
1. Fluid wave
2. Shifting Dullness
3. Bulging Flanks
4. Puddle Sign
300
What does HELLP stand for?
Hemolysis, Elevated Liver Enzymes and Low platelets
300
What are the SIRS criteria?
Temperature < 36 or > 38
HR > 90 BPM
RR > 20 breaths/min
WBC < 4, > 12, or > 10% immature (band) forms
300
Describe the MOA of alpha 1, Beta 1, and Beta 2 receptor agonists
alpha 1 - vasoconstrict
B1 - inotropy/chronotropy
B2 - vasodilation
400
What were the RCT study names that compared Ringer's Lactate to Normal Saline? What were the main findings?
SALT ED and SMART. Favour administering intravenous balanced crystalloids over saline to decrease a composite outcome of death, new renal replacement therapy or persistent renal dysfunction
400
Name the 5 hand physical exam findings of cirrhosis
Terry's nails
Clubbing
Asterixis
Palmar Erythema
Dupytrene's contracture
400
Name 4 causes of Microangiopathic hemolytic anemia?
DIC, TTP, HUS, Mechanical heart valves, March hemoglinuria, Malignant HTN, SLE, Scl renal crisis, catastophic antiphospholipid syndrome, HELLP
400
Describe the Difference between Sepsis, Severe Sepsis and Septic Shock
Sepsis: 2/4 SIRS with source
Severe Sepsis: sepsis + ↑lactic acid (>2) or ↓MAP
Septic shock: Severe Sepsis + unresponsive to fluids
400
Name 6 pressors
Norepinephrine
Dopamine
Milrinone
Dobutamine
Vasopressin
Phenylephrine
Epinephrine
500
Waterloo by ABBA is a song about which famous general's last battle?
Napoleon Bonaparte
500
What famous singer whose name is often used as a trivia team name wrote the song "Physical"
Olivia Newton-John
500
Who are these guys?
The Beatles - John, Paul, George, and Ringo
500
The band that wrote "Rock you like a hurricane" shares a name with a cause of pancreatitis, what's there name?
Scorpions
500
Under Pressure by Queen and David Bowie was plagiarized by Vanilla Ice in what famous song?
Ice Ice Baby