11/5/21 Bonus

Question 1

Black tags

Answer 1

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

Question 2

What is considered “high dose” aspirin therapy for management of Kawasaki disease?

Answer 2

80 to 100 mg/kg/day for 14 days, followed by 3 to 5 mg/kg/day for 6 to 8 weeks for those without coronary aneurysms or indefinitely for those with coronary aneurysms.

Question 3

Green tags

Answer 3

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

Question 4

Yellow tags

Answer 4

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

Question 5

Red tag

Answer 5

If they are breathing greater than 30 breaths/minute

Question 6

The increased risk of acute coronary syndromes is most pronounced in younger patients with lupus erythematosus and which other rheumatologic condition?

Answer 6

Rheumatoid arthritis.

Question 7

Which two factors determine the risk of fetal death due to abruptio placentae?

Answer 7

Rapidity of separation and degree of placental surface affected.

Question 8

What is the dose of propofol in procedural sedation?

Answer 8

Initial bolus of 0.5 to 1 mg/kg titrated to effect.

Question 9

Ehrlichiosis and Anaplasmosis

Answer 9

Vector: ticks

Febrile illness, headache, myalgia, rash, chills

Labs w/ leukopenia, thrombocytopenia, inc LFTs

Test whole blood PCR, do not delay treatment

Rx: doxycycline

Question 10

What is the most common complication of a corneal ulcer?

Answer 10

Corneal scarring.

Question 11

What bacteria has a gram stain showing gram-positive cocci in chains?

Answer 11

Streptococcus

Question 12

Pediatric Pulsless V-Tach algorithm

Answer 12

1- immediately defibrillate at 2 joules/kg

2- CPR x two minutes (100-120)

3- defibrillated at 4 joules/kg
*Epinephrine 0.01 mg/kg (0.1 ml/kg of 1:10,000 concentration) q3-5 min starting with the second defibrillation.

4- CPR x two minutes

5- defibrillated at 4 joules/kg
*Amiodarone 5 mg/kg IV/IO or lidocaine 1 mg/kg IV/IO if the patient remains in pulseless ventricular tachycardia after the third attempt of defibrillation.

6- An advanced airway should be placed.

Question 13

Capnocytophaga canimorsus

Answer 13

GNR bacteria

responsible for fulminant bacteremic illness after a dog bite

Question 14

Bartonella henselae

Answer 14

causative agent in cat-scratch disease

clinical syndrome of regional lymphadenopathy developing about one week after a cat bite or scratch

Question 15

Eikenella corrodens

Answer 15

gram-negative rod bacteria transmitted via human bites

Question 16

Pasteurella multocida

Answer 16

can be found in infected dog bites and even more commonly in infected cat bites.

Question 17

What are the common adverse effects seen with etomidate?

Answer 17

Respiratory depression, myoclonus, nausea and vomiting.

Question 18

A seizing patient with hyponatremia should be treated with _________________

Answer 18

3% hypertonic saline 2 mL/kg over 20-30 minutes.

Question 19

What medications should be used with caution in patients with vasospastic angina?

Answer 19

Propranolol (can exacerbate attacks) and aspirin (inhibits prostacyclin at high doses and can precipitate attacks).

Treatment is calcium channel blockers and nitrates

Question 20

Cryptococcus neoformans

Answer 20

• HIV meningitis w/ CD4 < 100/mm3
• India ink stain of CSF (round encapsulated yeast), cryptococcal antigen (CrAg): CSF or serum
• Rx amphotericin B (fungicidal), flucytosine (fungicidal), fluconazole (fungistatic)

Question 21

Disseminated Intravascular Coagulation (DIC) Labs

Answer 21

• thrombocytopenia
• decreased fibrinogen
• increased fibrin split products and Dimer
• increased BT, PT, and PTT

Question 22

Immune thrombocytopenia

Answer 22

• acquired autoimmune thrombocytopenia without an identifiable cause.
• Auto-antibodies attach to platelets which signals for their removal by the reticuloendothelial system.
• sx: plts< 20,000 with normal bone marrow.
• most commonly presents in children 2 to 6 years of age and frequently develops within 3 weeks of a viral illness.
• ITP will typically resolve in 1 to 2 months.
• The chronic form, which is more common in adults and associated with SLE and HIV, can present with epistaxis, gingival bleeding, and menorrhagia

Question 23

What protein is not cleaved into smaller units leading to long strings of multimers and ultimately causes thrombotic thrombocytopenic purpura?

Answer 23

von Willebrand factor.

Question 24

moderate croup

Answer 24

stridor at rest with mild to moderate retractions

Treatment for moderate to severe croup requires administering dexamethasone and nebulized racemic epinephrine.

Question 25

severe croup

Answer 25

Stridor at rest and marked retractions with agitation, lethargy, or cyanosis

Treatment for moderate to severe croup requires administering dexamethasone and nebulized racemic epinephrine.

Question 26

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

Answer 26

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

Question 27

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

Answer 27

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