This prophylactic medication for migraines is contraindicated in pregnancy due to teratogenicity but is highly effective for chronic migraine prevention.
What is topiramate (or valproate)?
This blood pressure threshold should NOT be lowered in acute ischemic stroke unless the patient is receiving thrombolytics.
What is 220/120 mmHg?
This potentially fatal syndrome presents with confusion, autonomic instability, and neuromuscular abnormalities when combining serotonergic agents.
What is serotonin syndrome?
A posterior hip dislocation requires emergent reduction within this time frame to minimize avascular necrosis risk.
What is 6 hours?
Central retinal artery occlusion presents with this fundoscopic finding of retinal whitening with a cherry-red spot.
What is a cherry-red spot at the fovea?
Migraine with aura lasting more than 60 minutes or associated with motor weakness should raise concern for this complication.
What is migrainous infarction (or stroke)?
Atrial fibrillation-related stroke prevention requires this CHA₂DS₂-VASc score to initiate anticoagulation in men.
What is ≥2 (or ≥1 in some guidelines)?
Lithium toxicity risk increases with this common class of antihypertensive medications that affects renal clearance.
What are thiazide diuretics (or ACE inhibitors/NSAIDs)?
Scaphoid fracture with proximal pole involvement has higher risk of this complication due to retrograde blood supply.
What is avascular necrosis (or nonunion)?
Acute angle-closure glaucoma requires immediate treatment with these three medication classes to lower intraocular pressure.
What are topical beta-blockers, alpha-agonists, and carbonic anhydrase inhibitors (plus pilocarpine)?
New daily persistent headache in an obese woman of childbearing age with papilledema requires evaluation for this condition.
Young stroke patients with patent foramen ovale and no other identifiable cause may have this mechanism of stroke.
What is paradoxical embolism?
This atypical antipsychotic requires regular absolute neutrophil count monitoring due to agranulocytosis risk.
What is clozapine?
This fracture pattern involves the radial head, ulnar shaft, and distal radioulnar joint disruption.
What is a Monteggia fracture (or Essex-Lopresti injury for radial head)?
Guillain-Barré syndrome classically presents with ascending paralysis and this characteristic CSF finding of elevated protein with normal cell count.
What is albuminocytologic dissociation?
An ESR greater than 50 mm/hr in suspected giant cell arteritis warrants immediate initiation of this treatment before biopsy confirmation.
What are high-dose corticosteroids (prednisone 40-60 mg daily)?
Carotid endarterectomy is indicated for symptomatic carotid stenosis of this percentage or greater.
What is 70% (or 50-69% in select cases)?
Treatment-resistant depression may respond to this NMDA antagonist given via intranasal route or IV infusion.
What is ketamine (or esketamine)?
Knee dislocation requires immediate evaluation for this vascular injury, which occurs in up to 40% of cases.
What is popliteal artery injury?
This complication of acute otitis media presents with postauricular swelling, ear protrusion, and requires IV antibiotics and possible mastoidectomy.
What is acute mastoiditis?
Trigeminal autonomic cephalalgias respond to this medication, which requires monitoring for hyponatremia and bone marrow suppression.
What is verapamil (for cluster headache prophylaxis)?
Mechanical thrombectomy can be performed up to this time window in patients with large vessel occlusion who meet specific imaging criteria.
What is 24 hours (in selected patients with favorable imaging)?
Status epilepticus refractory to benzodiazepines and phenytoin should be treated with this continuous IV anesthetic requiring EEG monitoring.
What is propofol (or midazolam/pentobarbital)?
This clinical decision rule uses age, mechanism, and ability to bear weight to determine need for knee imaging after trauma.
What are the Ottawa knee rules?
Multiple sclerosis diagnosis requires dissemination in space and time, with this MRI finding being pathognomonic when present.
What are Dawson fingers (periventricular lesions perpendicular to ventricles)?