10/28/21

Question 1

What is the classic antidote for neuroleptic malignant syndrome?

Answer 1

Dantrolene.

Question 2

Bacterial Endocarditis is most commonly caused by and which valve (IVDA vs Native)

Answer 2

IVDA: Staphylococcus aureus, tricuspid

Native valve: Staphylococcus aureus, viridans streptococci (most common in previously diseased), mitral

Question 3

How to correct hypoglycaemia in PEDs, rule of 50

Answer 3

Under 1 yr: 5 ml/kg of 10% Dextrose (10×5=50)

1-8 yr: 2 ml/kg of 25% Dextrose (25×2=50)

> 8 yr: 1 ml/kg of 50% Dextrose (50×1=50)

Question 4

Toxoplasmosis RX

Answer 4

Treatment is pyrimethamine, sulfadiazine, folinic acid (prefered)

can use bactrim too

Question 5

The ________ supplies the inferior wall of the left ventricle in the majority of patients.

Answer 5

right coronary artery

ECG findings of an inferior wall myocardial infarction include ST elevation in II, III and aVF.

Question 6

_____________ on ekg is most concerning for occlusion of the left main coronary artery.

Answer 6

ST segment elevation in aVR greater than 1 mm

or

greater than the ST elevation seen in V1

Question 7

Why should intubation and mechanical ventilation be considered prior to or concomitantly with prostaglandin E1 administration?

Answer 7

Prostaglandin E1 administration is frequently associated with apnea.

Question 8

Correct sequence of the seven cardinal movements of labor?

Answer 8

• Engagement
• descent
• flexion
• internal rotation
• extension
• external rotation
• expulsion

Question 9

Examination of the umbilical cord anatomy upon delivery of the placenta should reveal what three vessels?

Answer 9

Two arteries and one vein.

Question 10

Fracture of what carpal bone is associated with ulnar nerve injury?

Answer 10

Hamate. The ulnar nerve courses under the hook of the hamate and fractures can lead to ulnar injury.

Question 11

Peripheral Neuropathies

Sciatic

Answer 11

buttock injury, hip dislocation
↓ knee flexion, foot drop
Rx: analgesics, physical therapy

Question 12

The hallmark features of DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome include

Answer 12

• rash
• liver enzyme elevation (> 90%)
• eosinophilia (> 60%)
• elevated ESR/ CRP (> 60%)

Question 13

Peripheral Neuropathies

Common peroneal

Answer 13

proximal fibula injury, foot drop

Rx: ankle splint

Question 14

symptom that would help differentiate severe bacterial tracheitis from epiglottitis

Answer 14

epiglottitis= drooling

croup/ bacterial tracheitis are usually able to swallow their oral secretions

Question 15

Peripheral Neuropathies
Radial
Ulnar: elbow injury, ↓ finger adduction or thumb grasp, fourth or fifth digit paresthesias
Lateral femoral cutaneous: inguinal ligament entrapment, upper thigh dysesthesia or numbness

Answer 15

sat night palsy/ crutches
wrist or finger drop
Rx: wrist splint

Question 16

Wood’s lamp and Candida

Answer 16

Candida produces a superficial irritation rash that will fluoresce under Wood’s lamp

Question 17

Peripheral Neuropathies

Ulnar

Answer 17

elbow injury

↓ finger adduction or thumb grasp, fourth or fifth digit paresthesias

Question 18

Peripheral Neuropathies

Lateral femoral cutaneous

Answer 18

inguinal ligament entrapment

upper thigh dysesthesia or numbness

Question 19

Hyphema Treatment

Answer 19

For not sickle cell, treatment is with eye protection, limitation of activity, and head elevation of 30–45 degrees

Question 20

Fungal Pneumonia

Histoplasmosis

Answer 20

Ohio and Mississippi river valleys

bird and bat droppings

Question 21

Fungal Pneumonia

Coccidioidomycosis

Answer 21

southwest

arthritis, erythema nodosum

Question 22

Fungal Pneumonia

Blastomycosis

Answer 22

northeast

budding yeast, bone lesions