10/1/21 bonus

Question 1

True or false: resolution of pneumonia on chest radiograph lags behind clinical symptoms.

Answer 1

True.

Question 2

A type I hypersensitivity reaction is an ___________ mediated reaction

Answer 2

IgE-mediated

ex: urticaria, anaphylaxis

Question 3

A type III hypersensitivity (C) reaction is an ___________ mediated reaction

Answer 3

antigen-antibody complexes deposit in tissues and activate complement damaging the local tissue.

ex: serum sickness, vasculitis, or drug fever

Question 4

Type IV hypersensitivity reaction is _________ mediated

Answer 4

T-cell mediated

does not involve antibodies, rather it is produced by a delayed response.

Contact dermatitis is an example

Question 5

Type II hypersensitivity reaction involves

Answer 5

preformed IgM and IgG antibodies that bind specific membrane receptors on specific cell types, leading to the destruction of these cells by macrophages or neutrophils.

Often these reactions target blood cells and produce anemia, neutropenia, or thrombocytopenia.

Question 6

What is the differential diagnosis for a high anion gap metabolic acidosis?

Answer 6

MUDPILES:

• Methanol
• Uremia
• DKA (as well as alcoholic and starvation ketoacidosis)
• Propylene glycol/paracetamol (acetaminophen)
• Iron/isoniazid
• Lactate
• ethylene glycol
• salicylates.

Question 7

Is any alcohol use a contraindication for discharging AMA?

Answer 7

No, just acute alcohol intoxication.

Question 8

stable cervical spine fractures

Answer 8

• Clay-shoveler fracture (avulsion of the spinous process of C6 or C7)
• unilateral facet dislocation
• type I odontoid fracture (tip of the odontoid is broken off)

Question 9

The mnemonic for unstable cervical spine fractures and dislocations is

Answer 9

Jefferson bit off a hangman’s thumb

Jefferson burst fracture

• bilateral facet
• odontoid type II and type III fractures,
• hangman fracture
• teardrop fracture

Question 10

The NEXUS criteria

Answer 10

no focal neurologic deficits
normal alertness
no evidence of intoxication
no distracting injuries
no posterior midline cervical tenderness

Question 11

What treatment, besides Deferoxamine, should you consider for Iron Toxicity?

Answer 11

Gastric decontamination via whole bowel irrigation using a polyethylene glycol-electrolyte solution

prevents further absorption

should be done when > 20 mg/kg has been ingested
or
there are findings of radiopaque tablets on imaging.

Question 12

ST-Segment Elevation Myocardial Infarction (STEMI)

Lateral wall ST elevation in leads _________

Answer 12

I, AVL, V5, and V6

Question 13

ST-Segment Elevation Myocardial Infarction (STEMI)

Posterior wall ST depressions in leads ____________

Answer 13

V1 through V3

elevations in V8 and V9

Question 14

ST-Segment Elevation Myocardial Infarction (STEMI)

Inferior wall ST elevation in leads ____________

Answer 14

II, III, and AVF

Question 15

ST-Segment Elevation Myocardial Infarction (STEMI)

Anterior wall ST elevation in leads _______

Answer 15

V1 through V4

Question 16

SALTER mnemonic

Answer 16

I: Slipped epiphysis
II: Above physis, most common
III: Below physis
IV: Through physis
V: ERasure of the growth plate

Management:
I/II: nonoperative
IV/V: surgery required

Question 17

A patient is considered orthostatic when

Answer 17

• decrease in systolic greater than 20 mm Hg

- decrease in diastolic blood greater than 10 mm Hg

Question 18

A fall from greater than what height is considered a severe mechanism in pediatric head trauma of patients >2 years of age?

Answer 18

Greater than 5 feet.