11/2/21

Question 1

Stridor from Vascular ring vs laryngomalacia/ croup

Answer 1

laryngomalacia will be relieved by prone or upright positioning
Coup will be relieved by corticosteroids or epinephrine

Vascular ring will not improve with the above interventions

Question 2

if serum APAP at 4 h is __________ (#) on the Rumack-Matthew nomogram the patient should be treated with N-acetylcysteine.

Answer 2

≥150 μg/mL (1000 µmol/L)

or if above the treatment line if serum APAP concentration is obtained later than 4 h

Question 3

What sign has been suggested as the best indicator of lower respiratory tract infection in children?

Answer 3

Tachypnea.

Question 3

What sign has been suggested as the best indicator of lower respiratory tract infection in children?

Answer 3

Tachypnea.

Question 4

Pediatric Pneumonia Most Common Pathogens by Age

Answer 4

0–3 weeks: GBS

3 weeks to 3 months: C. trachomatis

1 month to 5 years: RSV

6–8 years: M. pneumoniae

Question 5

How to determine Successful placement of TransVenous Cardiac Pacing

Answer 5

Successful placement = placed into right ventricle

Monitor= left bundle branch block with left axis deviation

This occurs at a depth of at least 20 cm.

Question 6

Steps to perform transvenous pacing

Answer 6

• right internal jugular vein or left subclavian vein.
• Central Line technique
• once advanced 10 to 12 cm (ensuring the balloon is out of the introducer sheath and intravascular), inflate the balloon.
• carefully advance the catheter until the tip is situated at the wall of the right ventricle, ~ 20 cm.
• wire should continue to be advanced until proper positioning is indicated by a current of injury (LBBB)
• connect to the pacemaker generator
• Set the rate to 80 to 100 beats/minute and the output to 5 mA.
• Gradually decrease output until capture stops
• Then, slowly increase output to 2.5 to 3 times the threshold to ensure capture.

Question 7

What is the term for a painless, temporary loss of vision in one or both eyes that may present as a symptom of a transient ischemic attack?

Answer 7

Amaurosis fugax

Question 8

Current TIA definition

Answer 8

An episode of neurologic dysfunction caused by cerebral, spinal, or retinal ischemia, without acute tissue infarction

Question 9

____________ is an incomplete spinal cord injury that causes greater neurologic deficits in the upper extremities compared to the lower extremities.

Answer 9

Central cord syndrome

most often caused by a hyperextension mechanism

Question 10

Anterior cord syndrome

Answer 10

• hyperflexion injury or laceration of the anterior spinal artery
• loss of motor and sensory function below the level of injury
• preservation of the posterior column (position, touch, vibration)

Question 11

Ulnar peripheral neuropathy

Answer 11

elbow injury
↓ finger adduction or thumb grasp
fourth or fifth digit paresthesias

Question 12

________ are the most common pelvic fractures and are considered stable fractures

Answer 12

Isolated pubic ramus fractures

Question 13

Superficial Thrombophlebitis rx

Answer 13

warm moist compresses, NSAIDs for pain

Question 14

Labs from arthrocentesis in septic arthritis will show

Answer 14

WBC > 50,000/µL with > 75% PMNs

Question 15

What is the only FDA approved treatment of hiccups?

Answer 15

Chlorpromazine.

Question 16

What is the classic presentation of placenta previa?

Answer 16

Painless massive vaginal bleeding.

Question 17

a transient blue discoloration of the hands and feet when a newborn is cold.

Answer 17

acrocyanosis

it is benign, self-limited condition

pulse oximetry should be in the normal neonatal range

Question 18

When are steroids indicated for the treatment of Pneumocystis jiroveci?

Answer 18

When the PaO2 is < 70 mm Hg or the A-a gradient > 35.

Question 19

When are steroids indicated for the treatment of Pneumocystis jiroveci?

Answer 19

When the PaO2 is < 70 mm Hg or the A-a gradient > 35.