8/22/21

Question 1

Lunate dislocation

Answer 1

FOOSH
Palpable volar wrist fullness
X-ray lateral view: “spilled teacup sign”
X-ray AP view: “Piece of pie sign”

*Risk of Median nerve injury, needs Immediate orthopedic consultation

Question 2

Perilunate Dislocations

Answer 2

MC carpal dislocation
Palpable dorsal wrist fullness
X-ray lateral view: capitate dorsally dislocated

*Risk of Median nerve injury, needs Immediate orthopedic consultation

Question 3

Concerning Phenytoin Toxicity Reaction

Answer 3

hypotension, bradycardia, cardiac toxicity (due to propylene glycol diluent)

Question 4

HTN emergency Acute Pulmonary Edema Rx

Answer 4

Nitroglycerin: 0.4 mg q5min sublingual PRN
or
Nitroglycerin IV

Bonus:
Enalaprilat: 0.625-1.25 mg IV bolus or
Captopril: 25-50 mg PO/sublingual or
Nitroprusside: Initial dose 0.3 µg/kg/min IV titrate to effect by 0.5 µg/kg/min q5 min (max 10 µg/kg/min)

Question 5

Under what age is a surgical cricothyrotomy not recommended?

Answer 5

4 yo

Question 6

Pediatric Needle cricothyrotomy Steps

Answer 6

Use large gauge needle with angiocatheter ( 14 or 16 gauge)

A syringe with saline may be attached to the needle when making the puncture and once the needle has entered the trachea, air bubbles will appear on aspiration of the syringe.

After the angiocatheter is advanced into the trachea, a 3.5-mm endotracheal tube cap may be attached to the angiocatheter and bag mask ventilation is performed.

Question 7

Surgical airway of choice in children < 10-12

Answer 7

Needle Cricothyrotomy

surgical cricothyrotomy not recommended under 4 yo

Question 8

What class of medications may induce mania if given to patients with bipolar disorder?

Answer 8

Selective serotonin reuptake inhibitors

Question 9

On LP, What is the normal opening pressure in adults?

Answer 9

5–20 cm H20

Question 10

What two muscles unite to form the Achilles tendon?

Answer 10

Gastrocnemius and soleus

Question 11

A treatment for carcinoid syndrome and crisis

Answer 11

octreotide, a somatostatin

majority of carcinoid tumors have somatostatin receptors which, when blocked, will inhibit the release of hormone

Question 12

X-ray will show “steeple sign” on PA view

Answer 12

Laryngotracheitis (Croup)

Question 13

What classic sign is associated with pneumothorax on a supine radiograph of the chest?

Answer 13

Deep sulcus sign.

Question 14

The thumbprint sign on xray is classically associated with ___________

Answer 14

epiglottitis

Question 15

__________ on xray is classically associated with a retropharyngeal abscess.

Answer 15

Widening of the prevertebral soft tissues

Question 16

Repetitive vomiting acid base disturbance

Answer 16

hypochloremic metabolic alkalosis from loss of stomach acid.