Musculoskeletal
This disease process is why the individual with severe low back pain and new onset incontinence is taken to a treatment area immediately in the ER
Cauda equina syndrome
Two meds we would expect to be ordered for a patient with bleeding esophageal varices
Vasopressin and octreotide
What is the mechanism of skin bronzing in primary Addison’s disease?
Increased ACTH leads to increased melanocyte-stimulating hormone
A patient in MICU last week, admitted for sepsis, was found to have a septic gallbladder as the source. What procedure would he most likely undergo?
Choledochostomy or percutaneous cholecystotomy
This deformity accounts for why someone who is 5'7" at the age of 27 may be 5'4" at the age of 77
Kyphosis
You have a patient with type 1 diabetes and bursitis. She received some treatment yesterday at the orthopedist and her blood sugars have been running in the 300s and 400s all day. What did she most likely receive, and what should she be checking other than her blood sugar?
Corticosteroids
Ketones
What are at least two blood tests involved in MELD scores?
INR, albumin, sodium, creatinine, bilirubin
A patient is admitted with a 4cm subdural hemorrhage with midline shift and vasogenic edema. The hourly urine outputs in five hours are 425ml, 775ml, 500ml, 350ml, and 525ml. What is the most likely complication this patient is experiencing?
Diabetes insipidus
The best way to prevent hepatitis A in someone who has not been vaccinated, but has likely been exposed
Hepatitis A immune globulin
This type of imaging diagnoses osteoporosis and produces what type of scores
DEXA scan
T scores
Intraoperative infusions of what medication have contributed to less postop anemia in total hip and knee replacements
Tranexamic acid/TXA
This decreases the risk of aspiration related to balloon tamponade/Sengstaken-Blakemore tube placement
Endotracheal intubation
You are taking care of a patient with an insulinoma. What symptoms are you looking out for?
A. Dry skin and weight loss B. Polyuria and polydipsia C. Diaphoresis and weakness relieved with fruit snacks D. Fruity breath odor and hyperventilation
C. Diaphoresis and weakness relieved with fruit snacks
This is a tumor that secretes excess insulin, and therefore causes hypoglycemia.
The canalith repositioning maneuver for benign paroxysmal positional vertigo is also known as...
The Epley maneuver
Your patient receiving induction chemotherapy for osteosarcoma had their BMP/mag/phos come back. Labs show a magnesium level of 1.8, phosphorus 4.2, potassium 5.1, glucose 229, sodium 146, creatinine 1.9, and calcium 12.9. What is the priority lab value and what will treat it?
Hypercalcemia
Zoledronic acid/Zometa
What is another term for peroneal nerve palsy?
Foot drop
The doctor has ordered lactulose 30 grams by mouth three times daily for your patient whose ammonia level is 115. What is your main concern with this order and what would you suggest as an alternative?
That it's ordered by mouth for someone who is not likely awake enough to take meds by mouth. Order lactulose via an NG tube or in enema form.
Your patient was diagnosed with hyperthyroidism in her 8th week of pregnancy. What is the most appropriate medication for her to take for her condition?
A. Radioactive iodine B. Synthroid C. Propylthiouracil D. Methimazole
C. Propylthiouricil
In the first trimester, you want to Protect the baby
A young male with pancreatitis is admitted to the inpatient unit. On day three, he develops shortness of breath and hypoxia. The nursing staff feels that this is drug-related because he had a urine toxicology test come up positive for opioids yesterday. Explain your thought process.
If we were concerned about tumor lysis syndrome for the patient whose labs were - magnesium level of 1.8, phosphorus 4.2, potassium 5.1, glucose 229, sodium 146, creatinine 1.9, and calcium 12.9 – what would be different, and what else would need to be drawn in addition to the BMP?
Calcium would be low, higher phosphorus, and we would need a uric acid level (high)
Your patient is of the Muslim faith and does not wish to take DVT prophylaxis of heparin or Lovenox. What is one synthetic blood thinner that can be given instead?
Fondaparinux/Arixtra
You are at an RRT for a patient with bleeding esophageal varices and the doctor has ordered mass transfusion protocol. The ICU nurse suggests using the rapid infuser, which infuses the blood up to 1000ml/minute. Do you agree or disagree with her actions, why or why not?
Disagree. Extremely high fluid infusion rates may contribute to increased portal hypertension, vessel shear, and bleeding
Pruritis in renal disease is to ___ as pruritis in liver disease is to ___
Uremia
Bile salts
The family member of a patient in acute liver failure expresses hope that liver dialysis will get them home for Thanksgiving. The nurse states what in response?
A. “I think you misunderstood, dialysis is for his kidneys” B. “I understand you want the best care for him. Getting a transplant will be the top priority and give us the best chance of getting him home for Thanksgiving” C. “I can see this is a very stressful time for you. We are doing everything we can, but sometimes hospice is a good option to support the whole family” D. “It doesn’t replace all the functions of the liver, but can remove toxins and buy us time”
D. “It doesn’t replace all the functions of the liver, but can remove toxins and buy us time”
Sir James Paget was responsible for identifying Paget’s disease of the bone. What is another disease process he discovered?
Paget’s disease of the nipple, Paget’s abscess, Paget-Schroetter disease