10/31/21

Question 1

What is the treatment of bleeding from an infantile hemangioma?

Answer 1

Direct pressure (the vast majority are small and self-limited).

Question 2

What management is indicated for patients with sickle cell disease who have an acute ischemic stroke?

Answer 2

Exchange transfusion.

Question 3

Valproic acid toxicity antidote

Answer 3

L-carnitine– hastens the resolution of coma and prevents hepatotoxicity.

Can also use Activated charcoal and hemodialysis

Question 4

diarrhea, weight loss, anemia, and fever in HIV, think of this bug

Answer 4

Mycobacterium avium complex (MAC)

Question 5

What is the mechanism of action of tranexamic acid?

Answer 5

Reduces plasminogen activation to plasmin

–> preventing binding to fibrin thus inhibiting clot breakdown

Question 6

TXA dose

Answer 6

The dose is 1 gram IV bolus over 10 minutes followed by 1 gram IV over 8 hours.

Question 7

Penetrating Neck Trauma zones

Answer 7

Zone I: clavicle to cricoid cartilage (highest morbidity and mortality)
Zone II: cricoid cartilage to mandible (best prognosis, most accessible)
Zone III: mandible to skull base

Question 8

Methanol Intoxication

Answer 8

Antifreeze, windshield washer fluid, paint thinners
Methanol → formic acid (toxic metabolite)
Visual Sx (snowstorm)
Anion gap metabolic acidosis, increased osmolar gap
Rx: fomepizole (first line), folinic acid, bicarbonate

Question 9

Nerve block for ipsilateral lower lip and chin

Answer 9

Mental

Question 10

Idarucizumab is a reversal agent for what?

Answer 10

Dabigatran

Question 11

A peripheral smear in HUS will show?

Answer 11

evidence of red blood cell fragmentation

aka schistocytes and helmet cells

Question 12

This antihypertensive in pregnancy is contraindicated with fetal effects including oligohydramnios, renal agenesis, fetal skull abnormalities, and increased risk of stillbirth.

Answer 12

Angiotensin-converting-enzyme (ACE) inhibitors (e.g. captopril)

Question 13

What CSF study should be performed if cryptococcal meningitis is suspected?

Answer 13

India ink stain.

Question 14

When do infants begin to walk?

Answer 14

Most infants begin taking their first steps between 9–12 months.

Question 15

When do infants begin to walk?

Answer 15

Most infants begin taking their first steps between 9–12 months.

Question 16

Ethambutol side effects

Answer 16

TB treatnment
First-line TB agents include isoniazid, rifampin, pyrazinamide and ethambutol.

side effects:
optic neuritis 
red-green color blindness 
peripheral neuropathy 
hepatotoxicity

Question 17

In a patient who presents to the Emergency Department after an acute digoxin overdose, at what level of potassium should Digoxin immune fab automatically be initiated?

Answer 17

Potassium > 5 mEq/L.

Question 18

All patients with a knee dislocation should undergo vascular assessment using _________ even if the physical exam is unremarkable

Answer 18

CT angiography and/or ankle-brachial index with observation for serial exams

*even if the physical exam is unremarkable.

Question 19

neurovascular structures most frequently injured with a tibiofemoral dislocation

Answer 19

• popliteal artery

- peroneal nerve is the most frequently encounter neurologic injury, affecting up to 40% of patients.

Question 20

What is the ankle-brachial index?

Answer 20

The ratio of the systolic blood pressure at the ankle compared to the systolic brachial pressure. An ABI of < 0.9 is considered abnormal.