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Question 1

__________ in trauma is classically characterized by hypotension and bradycardia

Answer 1

Neurogenic shock

Question 2

Neurogenic shock treatment

Answer 2

Treat with volume resuscitation and norepinephrine.

Question 3

Injuries above _________ level can result in sympathetic disruption and neurogenic shock

Answer 3

T6

Question 4

Intubate complete spinal cord injuries at ____ level and above.

Answer 4

C5

Question 5

Neurogenic shock is a type of _______ shock

Answer 5

The hypotension of neurogenic shock is a distributive process, resulting in dry, warm/flushed skin with good peripheral pulses.

Question 6

MAP goal in spinal trauma

Answer 6

MAP of 85-90
Use fluid resuscitation first.
Norepinephrine infusion, if needed.

Question 7

Bradycardia treatment in neurogenic shock

Answer 7

Atropine for bradycardia, if needed.

Question 8

Patients with ETOH related complaints should get this type of counseling

Answer 8

cessation

Question 9

This must always be preformed with adenosine

Answer 9

Ensure rapid push
Rhythm Strip

Question 10

All AV nodal blocking agents, including adenosine, should be avoided in

Answer 10

wide complex tachycardias that are irregular and polymorphic (ie, beat-to-beat variation in QRS complex morphology)

and/or

extremely short R-R interval which indicates an accessory pathway of Wolff-Parkinson-White syndrome

Question 11

Adenosine side effects

Answer 11

nausea, chest tightness, shortness of breath, facial flushing, headache, dizziness, and a sense of impending doom

Question 12

Adenosine Dose

Answer 12

6 mg followed by 12 mg into a proximal vein via rapid IV push followed by immediate flush

Question 13

Absolute contraindications to Adenosine

Answer 13

Absolute contraindications include irregular or polymorphic rhythms and ventricular pre-excitation.

Question 14

Diagnosis of DIC involves a combination of laboratory tests and clinical evaluation. Laboratory findings suggestive of DIC include

Answer 14

low platelets
elevated D-dimer
decreased fibrinogen
prolongation of clotting times ie PT

Question 15

The traditional pentad of fever, microangiopathic hemolytic anemia, thrombocytopenia, renal dysfunction and neurologic deficits reflects?

Answer 15

TTP

Question 16

HUS shares some clinical features with TTP. Both manifest as:

Answer 16

Shares: microangiopathic hemolytic anemia and thrombocytopenia

HUS emphasizes renal injury
TTP instead causes neurologic dysfunction

Question 17

Hemolytic uremic syndrome (HUS) - should you use antibiotics?

Answer 17

the current recommendation is not to use antibiotics due to evidence that they may increase shiga toxin production or release

Question 18

______________ may increase likelihood of HUS and are not recommended for patients with Shiga toxin-producing E. coli infection.

Answer 18

Antibiotics and antimotility agents