11/5/21

Question 1

In addition to a third generation cephalosporin and vancomycin, which additional empiric antibiotic should be considered in adult patients over 50 years of age who are suspected of having bacterial meningitis?

Answer 1

Ampicillin

Question 2

Following the diagnosis of pertussis, should close contacts be treated?

Answer 2

Due to the high communicability and potential for severe disease in young children, the CDC recommends initiating antibiotics for all close contacts, regardless of age or vaccination status, preferably within three weeks of diagnosis.

Question 3

What is a dependent pocket of pus seen in the anterior chamber called?

Answer 3

Hypopyon.

Question 4

Most mallet finger injuries are treated with

Answer 4

• volar splinting of the DIP joint in extension x six weeks

- Refer to a hand surgeon for follow-up

Question 4

Most mallet finger injuries are treated with

Answer 4

• volar splinting of the DIP joint in extension x six weeks

- Refer to a hand surgeon for follow-up

Question 5

A Boutonniere finger deformity

Answer 5

Caused by rupture of the central slip

characteristic DIP joint extension and proximal interphalangeal joint flexion

Question 6

What can be used to treat hemodynamically stable torsades de pointes that is refractory to magnesium?

Answer 6

Transvenous overdrive pacing.

Question 7

What are some relative contraindications to implementation of therapeutic hypothermia after ventricular fibrillation arrest and return of spontaneous circulation?

Answer 7

Relative contraindications include severe cardiogenic shock, life-threatening dysrhythmias, and uncontrolled bleeding.

Question 8

How many patients with spontaneous esophageal rupture report no history of emesis?

Answer 8

25%

Question 9

esophageal perforation contrasted CT

Answer 9

A water soluble contrast agent (ex diatrizoate meglumine) is preferred due to less mediastinal soiling and interferes less with visualization on endoscopy than barium contrast.

Question 10

What is ciliary flush?

Answer 10

Conjunctival injection that is greatest around the limbus. This is seen in cases of iritis.

Question 11

HCM Murmur

Answer 11

PE will show harsh crescendo-decrescendo systolic murmur that increases in intensity with Valsalva maneuver and decreases with squatting

Question 12

hypertrophic cardiomyopathy (HCM) EKG

Answer 12

deep, narrow Q waves in the lateral and inferior leads with tall R waves in V1-V2 and large amplitude QRS complexes

Question 13

What class of analgesic medications is contraindicated in the treatment of a patient with a traumatic hyphema?

Answer 13

Non-steroidal anti-inflammatory medications.

Question 14

Reasons for ↑ protein on Lumbar Puncture

Answer 14

bacterial or TB meningitis, SAH, traumatic tap, MS, Guillain-Barré

Question 14

Reasons for ↑ protein on Lumbar Puncture

Answer 14

bacterial or TB meningitis, SAH, traumatic tap, MS, Guillain-Barré

Question 15

High Altitude Pulmonary Edema (HAPE) Rx

Answer 15

Treatment is immediate descent (most effective), supplemental oxygen

Most life-threatening high altitude illness

Question 16

_______ is the only recognized reliable IO line finding on CBC

Answer 16

Hemoglobin

Question 17

What is the mainstay of treatment for hypertrophic cardiomyopathy?

Answer 17

Long-term beta-blocker therapy.

Question 18

_______ tags are given to patients without spontaneous respirations after one attempt to reposition the airway fails.

Answer 18

Black tags

Question 19

______ tags are given to anyone that is able to walk away from the incident site and they are considered the walking wounded.

Answer 19

Green tags

Question 20

______ tags are given to patients that have a respiratory rate less than 30 breaths/minute, a radial pulse or capillary refill less than 2 seconds, and are able to follow commands

Answer 20

Yellow tags

Question 21

If they are breathing greater than 30 breaths/minute, they are assigned a _________ tag

Answer 21

red tag

Question 22

What are the only two treatments rendered during START triage protocol?

Answer 22

Airway repositioning and direct pressure for hemorrhage control.

Question 23

Disaster Triage- START

Answer 23

Black: deceased or expectant
Red: immediate
Yellow: delayed
Green: minor

Question 24

In patients with evidence of hemodynamic compromise and cardiac contusion, what medication may be used to improve cardiac output?

Answer 24

Dobutamine.

Question 25

How much air should be used to hyperinflate the tracheostomy cuff?

Answer 25

Up to 50 mL of air, but bleeding can be controlled with 10 to 35 mL depending on the size of the cuff.

Question 26

Steps to control massive hemorrhage from a cuffed tracheostomy

Answer 26

1- Hyperinflate the tracheostomy cuff

2- Secure Airway with ET tube

3- Remove trach tube

4- Digitally compress innominate artery

Question 27

What is the mechanism of action of fomepizole?

Answer 27

It inhibits alcohol dehydrogenase.

Question 28

What is the gold standard for diagnosis of placental abruption?

Answer 28

Tococardiography.