11/3/21 bonus

Question 1

What is the dose of ketamine used for rapid sequence intubation?

Answer 1

1–2 mg/kg IV or 3–4 mg/kg IM.

Question 2

Pralidoxime

Answer 2

Pralidoxime

Question 3

An ankle-brachial index of 1.0 is considered?

Answer 3

within normal limits

• 1.0 and 1.4 is normal.
• 0.9 - 1.0 is borderline.
• 0.9 or less= PAD.
• 0.4 and 0.7= moderate PAD.

Question 4

Traveler’s Diarrhea Treatment

Answer 4

Treatment is rehydration and ciprofloxacin or azithromycin (pregnant women and children)

Question 5

Right to left shunt

Answer 5

In a right-to-left shunt, oxygen-poor blood from the right heart does not pass through functional ventilated alveoli, impairing oxygenation of blood as it moves through the lungs and towards the arterial side of circulation.

Common causes of shunt include pneumonia, pulmonary edema, atelectasis, and acute respiratory distress syndrome.

Hypoxemia secondary to right-to-left shunt will respond poorly to supplemental oxygen

Question 6

glyburide is what kind of medicine

Answer 6

Sulfonylureas

Question 7

Do children with exposure to household electrical currents need continuous cardiac monitoring?

Answer 7

No. Healthy children with exposure to regular currents without water only require an ECG.

Question 8

Vasospastic Angina (Prinzmetal Angina) rx

Answer 8

Treatment is calcium channel blockers and nitrates

Question 9

Where is Histoplasmosis capsulatum endemic, necessitating screening questions to assess the risk of underlying fungal infection before starting patients on immunosuppressive therapy, such as a TNF-alpha inhibitor?

Answer 9

The Midwest

Question 10

High Altitude Cerebral Edema (HACE) Rx

Answer 10

Rx: O2, dexamethasone, immediate descent

Question 11

Is anterior or posterior hip disloaction more common

Answer 11

• vast majority are posterior dislocations
• shortened, adducted, and internally rotated leg
• most common associated injury is an acetabular fracture
• Sciatic nerve injury affects 10 - 20% of individuals.

Question 12

Massive hemoptysis definition

Answer 12

≥ 100 mL/hour or ≥ 500 mL over 24 hours

Question 13

______ is a vasodilator that causes a reduction in both the preload and the afterload

Answer 13

Nitroglycerin

Question 14

Acute Decompensated Heart Failure Treatment

Answer 14

• • BPAP: ↑ oxygenation, ↓ work of breathing, ↓ preload, afterload
• • Nitroglycerin: ↓ preload, afterload
• • Furosemide: diuresis
• • Hypotension w/o shock: dobutamine (may worsen hypotension)
• • Severe hypotension w/ shock: norepinephrine (↑ systemic vascular resistance, ↑ HR, ↑ BP, ↑ myocardial O2 demand)

Question 15

What is the name for small, less than 2 cm, horizontal lines representing edematous interlobular septa or lymphatic vessels seen in the lower zone periphery on a chest X-ray in patients with congestive heart failure?

Answer 15

Kerley B lines.

Question 16

Forceful contraction of which muscle is responsible for causing the most common type of pelvic avulsion fracture?

Answer 16

Hamstring muscle.

Question 17

Pelvic Avulsion Fracture

Answer 17

• Powerful contraction of lower leg muscle on a developing apophysis
• Most common type: ischial tuberosity avulsion
• Diagnosed with AP and frog-leg radiographs
• Treated with rest, crutch use, and pain control
• Surgical pinning rarely required

Question 18

What encapsulated organisms become opportunistic in splenectomy patients?

Answer 18

Hemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis.

Question 19

How is the qSOFA score calculated?

Answer 19

Parameters include:

• altered mental status (GCS <15)
• respiratory rate ≥ 22/min
• SBP ≤ 100 mm Hg.
• score ≥ 2 indicates organ dysfunction and mortality risk approx. 10%

Question 20

Systemic inflammatory response syndrome (SIRS) criteria

Answer 20

needs 2 or more of the following:

1) temperature > 100.4°F or < 96.8°F
2) HR > 90 bpm
3) RR > 20/min or PaCO2 < 32 mm Hg
4) WBC > 12,000/μL, < 4,000/μL, or > 105 bands.

Question 21

Sepsis Definition

Answer 21

Suspected or proven infection with signs of systemic inflammation and an increase in Sequential Organ Failure Assessment (SOFA) score of 2 or more from baseline

Question 22

Septic shock criteria

Answer 22

presence of sepsis, vasopressors to maintain MAP > 65 mm Hg, and a lactic acid level > 2 mmol/L despite adequate IVF