Cardiovascular Crisis
Pulmonary Perils
Neurogenic nightmares
Metabolic Mayhem
100
A 67-year-old male with a history of hypertension presents with sudden-onset chest pain radiating to the back. Blood pressure is 190/110 in both arms. CXR shows a widened mediastinum.
What is Aortic Dissection?
100
A 45-year-old female with a history of smoking presents with acute dyspnea and pleuritic chest pain after a long-haul flight.
What is Pulmonary Embolism
100
A 78-year-old female with atrial fibrillation presents with acute right-sided weakness and aphasia.
What is an ischemic stroke affecting the left MCA
100
A 23-year-old type 1 diabetic presents with nausea, vomiting, and Kussmaul respirations. Labs reveal glucose 540, pH 7.22, and serum ketones
What is diabetic ketoacidosis (DKA)
200
A 72-year-old male with a history of hypertension and heart failure presents with palpitations, dyspnea, and dizziness. His pulse is irregularly irregular at 140 bpm, and his BP is 110/70 mmHg. ECG shows
What is atrial fibrillation with rapid ventricular response (Afib with RVR)
200
A 68-year-old male with CHF presents with worsening dyspnea, frothy sputum, and bilateral crackles
What is acute pulmonary edema
200
A 64-year-old male with a history of uncontrolled hypertension presents with a thunderclap headache, vomiting, and nuchal rigidity.
What is a subarachnoid hemorrhage
200
A 72-year-old male with cirrhosis presents with altered mental status. Ammonia levels are elevated.
What is hepatic encephalopathy
300
A 72-year-old male collapses in the hospital. His labs reveal low potassium and magnesium.
EKG shows
What is torsades de pointes
300
A 64-year-old male with COPD presents with confusion and lethargy. ABG shows pH 7.28, pCO2 65, and pO2 50 on 2L oxygen.
What is acute hypercapnic respiratory failure
300
A 34-year-old female presents with fever, confusion, and seizures. CSF shows elevated WBCs and RBCs with normal glucose.
What is herpes encephalitis
300
A 48-year-old male with CKD presents with muscle weakness and ECG showing peaked T waves.
What is hyperkalemia
400
A 56-year-old male presents with shortness of breath and hypotension three days after an MI. Echo shows a new holosystolic murmur at the left sternal border and a left-to-right shunt.
What is a ventricular septal rupture post-MI
400
A 55-year-old male on mechanical ventilation becomes hypotensive and develops asymmetric breath sounds. CXR shows lung collapse with tracheal deviation.
What is a tension pneumothorax
400
A 60-year-old male with a history of alcoholism is found unresponsive. His pupils are mid-position and nonreactive. He has a Cushing’s reflex (hypertension, bradycardia, irregular respirations)
What is herniation due to increased intracranial pressure
400
A 38-year-old female presents with altered mental status, tachycardia, hyperreflexia, and fever. She recently stopped taking her thyroid medication.
What is thyroid storm
500
A 60-year-old male with a history of metastatic lung cancer presents with progressive dyspnea, fatigue, and lightheadedness over several days. On exam, he is hypotensive (BP 85/50 mmHg), tachycardic (HR 110 bpm), and has distended neck veins. Muffled heart sounds are heard on auscultation. ECG shows
What is cardiac tamponade
500
A 30-year-old male with pneumonia becomes suddenly hypotensive and develops a pleural effusion on CXR
What is Septic shock secondary to pneumonia
500
24-year-old female with a history of epilepsy presents with a seizure lasting >5 minutes and no recovery between episodes
What is Status Epilepticus
500
A 65-year-old alcoholic presents with confusion, ataxia, and nystagmus.
What is Wernicke's encephalopathy