10/29/21 Bonus

Question 1

What type of regional nerve block will provide anesthesia to the upper central incisor?

Answer 1

Infraorbital nerve block.

An inferior alveolar nerve block will provide anesthesia to the lower central incisors.

Question 2

How often are transfusions associated with an adverse reaction?

Answer 2

Approximately 20% of the time.

Question 3

Hemolytic transfusion reactions

Answer 3

• host immune response vs donor cells–> cell lysis/ cytotoxic release
• ABO incompatibility is the most common cause
• transfusion should be stopped immediately
• Rx: supportive/ ICU admit

Question 4

Acetaminophen OD rx for

• First 4 hours
• Over 8 hours

Answer 4

• within 4 hours of ingestion–> level drawn at 4 hours and plotted on the nomogram for treatment decisions.
• between 8–24 hours of ingestion–> level drawn immediately upon arrival / begin NAC while awaiting the level.

Question 5

What is the most common side effect of intravenous N-acetylcysteine?

Answer 5

Anaphylactoid reaction

Question 6

What laboratory abnormalities are hallmarks of thrombotic thrombocytopenic purpura and can be used to make a presumptive diagnosis of the disorder?

Answer 6

Microangiopathic hemolytic anemia and thrombocytopenia

Question 7

Thrombotic Thrombocytopenic Purpura (TTP)

Answer 7

• Sx: Fever, AMS, HA, seizure, NVD
• Labs: elevated LDH, elevated indirect bilirubin, microangiopathic hemolytic anemia, and thrombocytopenia
• Decreased protease ADAMTS13 activity
• Rx: plasma exchange with intravenous corticosteroids

Question 8

What is another large-vessel vasculitis aside from giant cell (or temporal) arteritis?

Answer 8

Takayasu arteritis.

Question 9

What management is indicated in a child who presents with complete airway obstruction if back blows fail to relieve the obstruction?

Answer 9

Laryngoscopy with Magill forceps.

Question 10

The antidote for magnesium sulfate toxicity is __________

Answer 10

calcium gluconate

Question 11

What are the side effects of rapid intravenous calcium gluconate injection?

Answer 11

Vomiting, vasodilation, dysrhythmia, hypotension, and bradycardia

Question 12

sharply marginated, annular lesion with raised or vesicular margins with central clearing and scale at the leading edge of erythema

Answer 12

Tinea corporis, also known as ringworm

Question 13

Fetal Heart Rate: Mnemonic

VEAL CHOP

Answer 13

Variable: cord compression
Early: head compression
Accelerations: okay
Late: placental insufficiency

Question 14

Epinephrine in Pediatric Advanced Life Support

Answer 14

• no maximum dose
• Dose: 0.01 mg/kg of 1:10,000 (0.1 mg/mL) epi
• q 3–5 minutes
• After ROSC, IV drip at 0.1–1 mcg/kg/min, titrated to effect

Question 15

________ is sudden, transient, painless monocular vision loss and is equated to a transient ischemic attack of the eye.

Answer 15

Amaurosis fugax

Question 16

_______ is the paralysis or weakness of the eye muscles.

Answer 16

Ophthalmoplegia

Question 17

Cyanide posioining presents with

Answer 17

Neurologic symptoms ranging from headaches to comas and seizures.
Treatment is with hydroxycobalamin

Question 18

Phosgene Poisoning

Answer 18

• interferes with oxygen diffusion across the alveoli–> respiratory distress.
• smells like freshly cut hay or grass
• treatment is supportive

Question 19

Sarin Poisoning

Answer 19

• organophosphate nerve gas–> cholinergic toxidrome.

- Treatment is with atropine and pralidoxime.

Question 20

A bitter almond odor and cherry red skin suggest what diagnosis?

Answer 20

Cyanide toxicity.