11/6/21

Question 1

___________ is the predominant pathogen in erysipelas.

Answer 1

Streptococcus pyogenes

It is a group A beta-hemolytic streptococci also known to cause streptococcal pharyngitis, scarlet fever and rheumatic fever.

Question 2

What structure in the brain produces CSF?

Answer 2

Choroid plexus.

Question 3

What are the diagnostic criteria for preeclampsia?

Answer 3

Hypertension after 20 weeks of pregnancy plus proteinuria or other signs of end-organ dysfunction

Question 4

Gestational Hypertension

Answer 4

PE will show new-onset SBP ≥ 140 mm Hg or DBP ≥ 90 mm Hg at ≥ 20 weeks gestation
If proteinuria or signs of end-organ damage develop: preeclampsia
If BP elevation persists > 12 wks postpartum: chronic hypertension
If BP returns to normal by 12 wks postpartum: transient hypertension of pregnancy

Question 5

Which beta-blocker overdose is most likely to cause seizures?

Answer 5

Propranolol

high lipid solubility so it readily cross the blood brain barrier resulting in a greater degree of CNS symptoms, ie obtundation, respiratory depression, and seizures.

Question 6

What infectious agent can precipitate chorea in children?

Answer 6

Group A Streptococcus (strep throat) can lead to Sydenham chorea.

Question 7

How to remove live insect from ear

Answer 7

1- kill with mineral oil

2- remove with forceps

Question 8

Pediatric Pulsless V-Tach algorithm

Answer 8

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 9

What is the most common electrolyte abnormality in rhabdomyolysis?

Answer 9

Hypocalcemia, which results from the deposition of calcium into damaged muscle.

Question 10

What clotting factors does warfarin inhibit?

Answer 10

Factors II, VII, IX, X, and proteins C and S.

Question 11

What clotting factors does warfarin inhibit?

Answer 11

Factors II, VII, IX, X, and proteins C and S.

Question 12

Pellagra is the end result of severe _________ deficiency.

Answer 12

niacin aka vitamin B3

Patient presents with dermatitis, dementia, and diarrhea

Question 13

_______________ is a potential serious complication associated with overaggressive treatment of DKA

Answer 13

cerebral edema

This is most commonly seen in children under 5 yo.
IVF rehydration should be undertaken in a less aggressive manner and monitored closely in pediatric patient population.

Question 14

____________, a gram-negative rod bacteria, is responsible for fulminant bacteremic illness after a dog bite

Answer 14

Capnocytophaga canimorsus

Question 15

_________ is the causative agent in cat-scratch disease

Answer 15

Bartonella henselae

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

Question 16

___________ is a gram-negative rod bacteria transmitted via human bites

Answer 16

Eikenella corrodens

Question 17

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

Answer 17

Pasteurella multocida

Question 18

Why is it so important to meticulously assess facial and scalp bites from large dogs in children?

Answer 18

Innocuous-looking wounds can be associated with skull penetration and resulting brain abscess.

Question 19

Ketamine Containdication

Answer 19

It has few contraindications but should not be used in patients with a history of schizophrenia.

Shown to increase psychosis, auditory hallucinations, and paranoia in patients with schizophrenia.

Question 20

What are the common adverse effects seen with etomidate?

Answer 20

Respiratory depression, myoclonus, nausea and vomiting.

Question 21

Is the risk of epilepsy increased in children who have had a febrile seizure?

Answer 21

Yes, slightly. Risk is 1–2% instead of 0.5–1% in the general population.

Question 22

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

Answer 22

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

Treatment is calcium channel blockers and nitrates

Question 23

A seizing patient with hyponatremia should be treated with _____________

Answer 23

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

Question 24

Rhabdo UA

Answer 24

Urine is typically red or brown in color due to myoglobin excretion and is notable for a falsely positive hemoglobin in the absence of large numbers of red blood cells in the urine

Question 25

The following situations for submassive PE may warrant administration of thrombolytics

Answer 25

• cardiopulmonary arrest 2/2 PE with a BP > 90 mm Hg after resuscitation,
• severe or worsening RV strain
• extensive clot burden
• free-floating right atrial or ventricular thrombus.

For patients that are hemodynamically unstable and without contraindications to fibrinolytic therapy, the recommendation is to administer fibrinolytic therapy then start anticoagulation. If thrombolysis is contraindicated or unsuccessful, embolectomy is an alternative therapy.

Question 26

High-quality chest compressions are associated with CO2 values of?

Answer 26

CO2 values > 10 mm Hg