11/4/21

Question 1

Hypomagnesemia

Answer 1

Malnutrition, alcohol use
Hypocalcemia
Hypokalemia
↑ QT interval, dysrhythmias
Neuromuscular symptoms (e.g., tremor, tetany)

Question 2

INR of ______ is a contraindication to TPA, but anticoagulation therapy alone is not in itself a contraindication

Answer 2

INR of > 1.7

Question 3

Infantile spasms

Answer 3

• epileptic disorder
• presents before 1 yo
• spasms consist of rapid flexor and extensor movements that occur in clusters lasting a few minutes at a time
• 1st line treatment is corticotropin (ACTH)

Question 4

Shoulder Dystocia Management

Answer 4

Empty bladder
McRoberts maneuver: flexing hips and legs
Suprapubic pressure
Delivery of posterior arm
Clavicle fracture
Last resort: Zavanelli maneuver (reinsert fetal head followed by C-section)

Question 5

Shoulder Dystocia Management

Answer 5

Empty bladder
McRoberts maneuver: flexing hips and legs
Suprapubic pressure
Delivery of posterior arm
Clavicle fracture
Last resort: Zavanelli maneuver (reinsert fetal head followed by C-section)

Question 6

What is the most common cause of meningitis in adult patients?

Answer 6

Streptococcus pneumoniae.

Question 7

Neonatal Meningitis

Answer 7

Most common: GBS
Fever, behavioral or neurologic changes
Cefotaxime + ampicillin or gentamicin + ampicillin

Question 8

What is the lower limit of normal systolic blood pressure in a newborn?

Answer 8

60 mm Hg.

Question 9

Toxic Epidermal Necrolysis Rx

Answer 9

Treatment is supportive/ referral to a burn center

supportive treatment: intravenous fluid resuscitation, electrolyte replacement, wound care, infection prevention, and pain control

The use of corticosteroids in the management of TEN is controversial as there is conflicting evidence regarding improvement in mortality and complication rates associated with their use.

Question 10

__________ is commonly caused by Bartonella henselae

Answer 10

Cat Scratch Disease

Treatment is mainly supportive, azithromycin if needed

Question 11

What are the three laboratory hallmarks of tumor lysis syndrome?

Answer 11

Hyperuricemia, hyperkalemia, and hyperphosphatemia.

Question 12

What ECG finding is associated with hypomagnesemia?

Answer 12

QT interval prolongation.

Question 13

What are common causes of painful vision loss?

Answer 13

Acute angle closure glaucoma, optic neuritis, trauma, endophthalmitis, and temporal arteritis.

Question 14

Metabolic Acidosis with Normal anion gap causes

Answer 14

(HARDASS)
Hyperalimentation
Addison Disease
renal tubular acidosis
diarrhea
acetazolamide
spironolactone
saline infusion

Question 15

Winter formula (used to evaluate respiratory compensation)

Answer 15

PCO2 = 1.5 (HCO3−) + 8 +/− 2

PCO2 < Winter formula calculation = respiratory alkalosis
PCO2 > Winter formula calculation = respiratory acidosis

Question 16

What finding would be seen on lateral neck X-ray in epiglottitis?

Answer 16

Thumbprint sign, or enlarged and rounded epiglottis.

Question 17

Findings on electrocardiogram indicative of left main coronary artery occlusion

Answer 17

ST elevation in aVR > V1 with horizontal ST depression in I, II and V4-6

Question 18

If the patient is deemed to be low risk for PE, either by the Wells criteria or clinician gestalt, the __________ should be evaluated.

Answer 18

Pulmonary Embolism Rule-out Criteria (PERC) rule

D-dimer testing should be performed if PERC +

age ≥ 50 years, HR ≥ 100 bpm at any time in the emergency department, room air oxygen saturation < 95%, prior history of venous thromboembolism, trauma or surgery within four weeks, hemoptysis, exogenous estrogen use, or unilateral leg swelling.

Question 19

Ménière disease vertigo

Answer 19

Attacks usually occur in clusters, lasting minutes to several hours, and are unprovoked. Patients generally return to baseline between attacks

Question 20

What lesion clinically resembles a lipoma except it is painful and found primarily in children, adolescents, and individuals with HIV after starting antiretroviral therapy?

Answer 20

Angiolipoma.

Question 21

What formula is used to calculate the minimum systolic blood pressure for a child aged 1–10 years?

Answer 21

Minimum SBP = 70 + (2 x age in years).

Question 22

Normal Pediatric Heart Rates (Awake)

Answer 22

Neonate: 100–205 bpm
1 month to 1 year: 100–190 bpm
1–2 years: 98–140 bpm
3–5 years: 80–120 bpm
6–11 years: 75–118 bpm
≥ 12 years: 60–100 bpm

Question 23

What formula is used to calculate the minimum systolic blood pressure for a child aged 1–10 years?

Answer 23

Minimum SBP = 70 + (2 x age in years).

Question 24

Normal Pediatric Heart Rates (Awake)

Answer 24

Neonate: 100–205 bpm
1 month to 1 year: 100–190 bpm
1–2 years: 98–140 bpm
3–5 years: 80–120 bpm
6–11 years: 75–118 bpm
≥ 12 years: 60–100 bpm