Advanced Clinical Care
A 62-year-old with atrial fibrillation presents with acute onset right arm weakness and aphasia <4.5 hrs after onset. Next step?
Answer: What is administer IV alteplase?
Best initial test for suspected DVT in a stable patient?
Answer: What is compression ultrasonography?.
Type I error measures what probability?
Answer: What is false positive rate (α)?
CCS: Patient with DKA arrives; initial order for metabolic stabilization?
Answer: What is IV fluids + insulin drip?
Antibiotic of choice for hospital-acquired pneumonia with risk for Pseudomonas?
Answer: What is piperacillin–tazobactam (or meropenem)?
A patient with STEMI has persistent chest pain despite aspirin and nitroglycerin. ECG shows inferior ST elevation. Next best intervention?
Answer: What is emergent percutaneous coronary intervention?
Answer: What is emergent percutaneous coronary intervention?
In suspected subarachnoid hemorrhage with negative CT within 6 hrs, next best test?
Answer: What is lumbar puncture for xanthochromia?
A patient refuses life-saving blood transfusion due to religious beliefs; capacity intact. Ethical principle guiding respect?
Answer: What is autonomy?
CCS: CHF patient with acute pulmonary edema; next priority after oxygen?
Answer: What is IV diuretics (furosemide)?
Initial management for suspected pulmonary embolism with hypotension?
Answer: What is emergent thrombolysis?
A 50-year-old with new-onset diabetes and weight loss has a palpable non-tender gallbladder. Most likely diagnosis?
Answer: What is pancreatic adenocarcinoma (Courvoisier sign)?
A patient with acute abdomen and free air under diaphragm on upright film. Most likely cause?
Answer: What is perforated viscus?
You perform a study with p = 0.03. Interpret this?
Answer: What is there is a 3% probability that the observed effect is due to chance if the null is true?
CCS: Severe asthma exacerbation tiring and hypoxic despite albuterol; next escalate?
Answer: What is IV magnesium and consider non-invasive ventilation?
An elderly with suspected temporal arteritis and vision changes; next best step before biopsy?
Answer: What is high-dose steroids?
A patient with suspected bacterial meningitis cannot receive LP before antibiotics due to signs of increased intracranial pressure. Immediate next step?
Answer: What is start empiric broad-spectrum antibiotics and steroids?.
A melanoma-suspected skin lesion biopsy technique?
Answer: What is excisional biopsy with narrow margins?
Confidential patient info is mistakenly posted online. What is required?
Answer: What is HIPAA breach notification and mitigation?
CCS: Suspected sepsis with HR 120, hypotension after fluids; first vasopressor?
Answer: What is norepinephrine infusion?
A patient with hypercalcemia and EKG changes (short QT, arrhythmia); immediate treatment?
Answer: What is IV fluids + calcitonin?
A 27-year-old with shortness of breath and elevated D-dimer has borderline creatinine limiting CT contrast. Next diagnostic step?
Answer: What is ventilation–perfusion (V/Q) scan?
febrile neutropenic patient with persistent fever despite IV antibiotics; next imaging?
Answer: What is chest CT for invasive fungal disease?
You design a trial comparing 3 therapies and want to control for multiple comparisons. Appropriate method?
Answer: What is Bonferroni correction?
CCS: Upper GI bleed with hemodynamic instability; first action before blood products?
Answer: What is airway protection + fluid resuscitation + type and cross?
Young patient with acute ischemic stroke arrives just outside thrombolytic window but with small core infarct and large penumbra on MRI; next action?
Answer: What is mechanical thrombectomy if within time criteria?