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Question 1

If concern for elevated intracranial pressure (ICP)

Answer 1

-Elevate head of bed to 30°.
-3% sodium chloride for acute ICP management (500 mL can be bolused).
-If acute decompensation, then give mannitol (1-1.5 g/kg bolus).
-Request neurosurgical consult.

Question 2

Eclampsia BP meds

Answer 2

If BP ≥160/110 mm Hg, give antihypertensives

Labetalol 20 mg IV or
Hydralazine 5-10 mg IV

Question 3

Laboratory evaluation- eclampsia

Answer 3

CBC
Electrolytes, blood urea nitrogen, creatinine
Urinalysis (for protein)
LFTs (ALT, AST, lactate dehydrogenase, bilirubin)
Uric acid (often requested by obstetrics)

If there is evidence of severe disease, then adding prothrombin time, partial thromboplastin time, and fibrinogen may be prudent

Question 4

Empiric IV antibiotics for diverticulitis

Answer 4

Piperacillin-tazobactam 4.5 g IV q8h

or

Ciprofloxacin 400 mg IV q12h or levofloxacin 750 mg IV q24h plus metronidazole 500 mg IV q8h

Question 5

Consult general surgery for _________ in diverticulitis

Answer 5

abscess
peritonitis
septic shock
perforation
obstruction

Question 6

Intraocular pressures associated with orbital compartment syndrome and retinal ischemia are _____________

Answer 6

> 40 mmHg

Question 7

Steps for surgical airway

Answer 7

• PPE (glasses)
• stand on patients right
• Extend the neck
• grasp the lower aspect of the thyroid cartilage firmly
• initial vertical incision from the mid thyroid cartilage to the cricoid cartilage
• anticipate large blood spray
• Horizontal incision of membrane
• Pass bougie
• Load tube/ inflate
• Suture in place

Question 8

Sedative for transcutaneous pacing

Answer 8

Midazolam - 1-2.5 mg , total dose > 5 mg is not needed.

Ketamine 1-2 mg/kg

Question 9

Initial mechanical ventilation settings- general

Answer 9

Volume-assist control
Rate 8-12/min
Tidal volume: 5-8 cc/kg
FiO2 100% (1.0) and ween down
PEEP 0-5 mmH20

Question 10

Hs and Ts
H

Answer 10

Hypovolemia
Hypoxia
Hydrogen ion excess (acidosis)
Hypoglycemia
Hypokalemia
Hyperkalemia
Hypothermia

Question 11

GCS score

Answer 11

MOTOR 6
6 Follows commands
5 Localizes to pain
4 Withdraws from pain
3 Flexes in response to stimuli (decorticate posturing)
2 Extends in response to stimuli (decerebrate posturing)
1 Does not move in response to stimuli

VERBAL5
5 Coherent speech
4 Confused speech
3 Incoherent words
2 Incomprehensible sounds
1 No speech

EYES 4
4Opens spontaneously
3 Opens to noise
2 Opens to pain
1 Does not open