Pulm/Crit
This noninvasive ventilation modality is commonly used first-line in acute COPD exacerbation with hypercapnia
What is BiPAP?
This is the first imaging study performed in a hemodynamically unstable trauma patient to evaluate for intra-abdominal bleeding
What is a FAST exam (Focused Assessment with Sonography for Trauma)?
This cause of chest pain after a viral illness can progress to cardiogenic shock with global hypokinesis on echo
What is fulminant myocarditis?
Pregnant patient that is past 20 weeks gestation presents with hypertension. Define 2 features that characterizes pre-eclampsia without severe features.
1. Sustained hypertension (>140/>90)
2. Kidney injury/proteinuria (>300mg/dL)
This lab abnormality—elevated carboxyhemoglobin—is seen in this type of poisoning from enclosed-space fires
What is carbon monoxide poisoning?
This transfusion complication presents with acute hypoxemia and bilateral infiltrates within 6 hours
What is TRALI?
This life-threatening soft tissue infection requires immediate surgical debridement and presents with pain out of proportion
What is necrotizing fasciitis?
This reversible cause of sudden cardiac death in young athletes is due to asymmetric septal hypertrophy
What is hypertrophic cardiomyopathy?
This postpartum pituitary infarction presents with failure to lactate after severe hemorrhage
What is Sheehan syndrome?
This mitochondrial toxin exposure, commonly found in anti-freeze, causes severe lactic acidosis and optic neuropathy in chronic alcohol users
What is methanol toxicity?
This autoimmune disease commonly causes a pulmonary-renal syndrome with manifestations of hemoptysis, shortness of breath, fatigue, anemia, hematuria, acute kidney disease. Name at least 1 serology would you order to help with your diagnosis?
What is anti-GBM (anti-glomerular basement membrane) or C3 (complement 3 level)?
A fat embolism syndrome is a rare complication of pancreatitis or long bone/pelvic bone traumas that causes a sudden TRIAD of symptoms 24-72 hours after injury. What is that TRIAD of symptoms?
1. Hypoxia
2. Petechial rash
3. AMS, neurological decline
Patients presenting with an inferior MI/right ventricular infarction AND hypotension, what is the one specific class of medication we should avoid?
What is Nitrates?
This postpartum headache with seizures is diagnosed with MR venography
What is cerebral venous sinus thrombosis?
This antidote is used for acetaminophen overdose and works by replenishing glutathione
What is N-acetylcysteine (NAC)?
This rare complication of severe infection presents with bilateral adrenal hemorrhage and refractory shock
What is Waterhouse–Friderichsen syndrome?
This catastrophic vascular emergency presents with severe periumbilical pain out of proportion to abdominal exam findings, late onset hematochezia, and rapidly progressive metabolic acidosis. Name the diagnostic test that must be completed.
CTA/MRA abdomen/pelvis
--> Mesenteric angiography can be done if diagnosis is still unclear
Cardiac tamponade is a rare but reversible cause of a PEA arrest, sometimes occurring after central line placement. What is an ECHO finding that would confirm this?
This autoimmune encephalitis presents with psychosis, seizures, and ovarian teratoma in young women
What is anti-NMDA receptor encephalitis?
Elderly patients that are taking amitriptyline are at risk for TCA toxicity, which presents with anticholinergic effects (dry skin, dilated pupils, fever), hypotension, cardiac toxicity (prolonged QTc or arrhythmias), and AMS. Name an important diagnostic test that should be ordered.
What is an EKG, CMP, tests to rule out other co-intoxications (RUDS, acetaminophen levels, salicylate levels), +/- head CT non-con
This rare cause of recurrent flash pulmonary edema is due to bilateral renal artery stenosis and RAAS hyperactivation
What is Pickering syndrome?
This severe DVT complication presents with cyanotic, painful limb and impending compartment syndrome
What is phlegmasia cerulea dolens?
This life-threatening arrhythmia occurs in patients with structurally normal hearts and polymorphic VT triggered by emotional stress or exercise
What is catecholaminergic polymorphic ventricular tachycardia (CPVT)?
Name ONE teratogenic medication that should be avoided during pregnancy for the each of the following medical conditions:
1. Hypertension
2. Seizures
3. Antibiotics
4. Lupus
1. For hypertension, avoid ACEi/ARBs, lisinopril, losartan
2. For seizures, avoid Valproate sodium, Phenytoin, Phenobarbital, Carbamazepine, Topiramate.
3. For antibiotics, avoid Bactrim, aminoglycosides (streptomycin, gentamicin), tetracyclines (doxycycline), fluoroquinolones (ciprofloxacin, levofloxacin )
4. For Lupus, avoid methotrexate
This rare cause of chronic acetaminophen use leads to elevated 5-oxoproline and normal anion gap metabolic acidosis
What is pyroglutamic acidosis?