The Sugar Diabetes
Front Hall Probs
BizzBuzz
I Been Runnin Off
Vision Quest
100
Patient with history of metastatic cancer p/w AMS, generalized weakness, nausea, and this EKG. Dx and first tx?
Hypercalcemia. Fluids.
100
Pt p/w abd pain, joint pain, and palpable rash on BLE. Dx?
HSP (IgA vasculitis)
100
AAA +/- repair with GI bleed
Aortoenteric fistula
100
How many PMNs (neutrophils) in ascitic fluid is diagnostic of SBP?
> 250
100
Location of this foreign body? Treatment?
Esophagus. Call GI for endoscopic removal.
“En face” = esophagus; profile = trachea
200
Sodium/Potassium levels in adrenal crisis?
Hyponatremia and hyperkalemia
200
Dx? Likely age of pt?
SCFE, young teen (13)
200
Myoclonus
Serotonin syndrome
200
Which treatment is associated with reduced mortality risk in cirrhotic patients with GI bleeds?
Ceftriaxone
200
Diagnosis? Biggest risk factor?
NEC (necrotizing enterocolitis). Prematurity.
First few days of life, abd bloating + abd wall erythema + bloody diarrhea, pneumatosis intestinalis
300
List the concentration and weight-based volume of dextrose repletion in a 5 month vs 5 year vs 50 year old.
Infants: 5 cc/kg of D10
Kids: 2 cc/kg of D25
Adults: 1 cc/kg of D50
300
1 = steeple sign = croup
2 = RPA
3= Thumbprint sign = epiglottitis
300
Bilious emesis in <1 year old
Midgut volvulus
300
List Charcot's triad. For which disease process is this triad common?
Fever, RUQ pain, jaundice. Cholangitis.
Add hypotension and AMS for Reynold's pentad = ascending cholangitis
300
Diagnosis and treatment?
Pneumomediastinum, CTS consult, broad-spectrum abx
Usually after forceful vomiting, mediastinal crunch (Hamman sign)
400
List the correct order of treatment for thyroid storm.
Propranolol, PTU/MMI, iodide, hydrocortisone
400
Name the 5 cyanotic congenital heart disorders.
Transposition, Tetraology, truncus, tricuspid atresia, total anomalous pulmonary venous return
400
Answer both:
Respiratory alkalosis + metabolic acidosis
Hypochloremic, hypokalemic metabolic alkalosis
Salicylate overdose
Pyloric stenosis
400
Which organ is most commonly injured with a GSW to the abdomen? KSW?
GSW = small bowel
KSW = liver
400
Name the diagnosis and treatment.
Sigmoid volvulus. Sigmoid decompression (call surgery or GI).
"Bent innertube" on AXR, old pt (NH/bedridden)
500
35 yo M with no PMH p/w 4-month h/o recurrent episodes of palpitations, HA, & diaphoresis. Episodes occur randomly, 4-5 times per week. HR will be in the 130’s and SBP > 170. CT scan of the abdomen and pelvis will likely reveal a mass located where (be specific)? What is the classic treatment?
Adrenal medulla. Phentolamine.
500
Grandma's house + AMS + pinpoint pupils. Dx and tx?
Clonidine overdose. Narcan.
500
Diarrhea + seizures in peds patient
Shigella
Causes hyponatremia due to SIADH
500
Bloody diarrhea, RLQ pain, contact w/ farm animals
Yersinia
500
Dx and tx?
Intussusception, surgery consult + air enema
