Esopha-goose
2 y.o. male swallows a button battery seen on xray in the proximal esophagus. What is the next best step?
Emergent EGD
What is the ultrasound measurement of gallbladder wall thickness concerning for developing cholecystitis?
>3mm
Per ACLS, in pulseless VFib/VTach, after how many shocks is epinephrine given?
2
This is the hemoglobin value, in g/dL, below which PRBCs are transfused in a hemodynamically stable patient.
What is 7.0 g/dL?
At what distance can the balloon on a transvenous pacemaker be safely inflated when beginning to float?
20 cm
72 y.o. M has chest tightness after eating pulled pork, and now cannot tolerate liquids or food by mouth. He is stable but spitting up constantly. What is the most effective/definitive management for this condition?
EGD
What is the most common cause of large bowel obstruction?
Colorectal cancer
Per ACLS, in pulseless VFib/VTach, after how many shocks is Amiodarone or Lidocaine given?
3
Occurring within 6 hours, this reaction causes non-cardiogenic pulmonary edema with bilateral infiltrates and hypoxemia — and diuretics are specifically avoided.
What is TRALI
What is the most common cause of esophageal perforations?
Iatrogenic perforations
A 70 y.o. female presents with abdominal pain after finishing a 14-day course of antibiotics for cellulitis. On exam, she is ill-appearing, tachycardia, hypotensive, febrile, with diffuse abdominal tenderness. CT imaging shows inflammation, dilation, and edema of the transverse colon without perforation. What two antibiotics AND their routes are indicated at this time?
Oral Vancomycin and IV metronidazole
55 y.o. male presents with altered mental status. On exam, he is diaphoretic, AxO x2, HR 180, BP 82/66, O2 98% on room air. What is your next best step?
Synchronized cardioversion
Beginning within minutes of starting the transfusion, this ABO-incompatibility reaction presents with fever, flank/back pain, hypotension, and hemoglobinuria, and requires stopping the transfusion immediately
What is an Acute Hemolytic Transfusion Reaction
What is the name of the characteristic finding on xray of a flat, circular foreign body in the esophagus that distinguishes a button battery from a coin (i.e. name the sign)
Double ring sign
4 y.o. girl presents ill appearing with bloody diarrhea, abdominal pain, and anuria for 2 days. BP 190/104, T 101.4F, HR 130, RR 30. Labs: K5.4, BUN 65, Creat 4.1, WBC 18, Hgb 6.6. What bacteria is the most likely cause?
Escherichia coli 0157:H7
Aside from Amiodarone, per ACLS, for stable, wide complex tachycardia, what other medication can be given?
Procainamide or Soltalol
This is the 1:1:1 ratio of these three blood products delivered during a massive transfusion protocol.
What are PRBCs, FFP, and Platelets
Where do most esophageal foreign objects become lodged in pediatric patients?
Level of the cricopharyngeus muscle of proximal esophagus
33 y.o. pregnant patient presents with severe epigastric pain radiating to her back with vomiting. Nursing staff noted that when drawing blood, there appears to be milky layer on top of the blood when settled. Bedside RUQ ultrasound is unremarkable. What is the diagnosis and cause?
Pancreatitis: hypertriglyceridemia
33 y.o. male presents with altered mental status and chest pain with HR of 38 bpm. Per ACLS, what infusion (besides epinephrine) can be started, and what is the starting dose?
Dopamine 5 mcg/kg/min (range 5-20 mcg/kg/min)
Because citrate in stored blood products chelates it, this electrolyte must be monitored during large-volume transfusion.
What is calcium