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Question 1

Transfusion Complications

Massive transfusion

Answer 1

Massive transfusion: coagulopathy, hypothermia, hypocalcemia

Question 2

Transfusion Complications

most common complication, fever/chills

Answer 2

Febrile reaction

Question 3

Transfusion Complications

ABO incompatibility, immediate fever/chills, HA

Answer 3

Hemolytic reaction

Rx: stop transfusion, IVF, diuretics

Question 4

Transfusion Complications

urticaria or hives

Answer 4

Allergic reaction:

Question 5

Transfusion Complications
like ARDS

GVHD: immunocompromise, rash, pancytopenia, increased LFTs
Prevention: irradiated blood products in immunocompromised

Answer 5

TRALI

Rx: stop transfusion

Question 6

Transfusion Complications

immunocompromise, rash, pancytopenia, increased LFTs

Answer 6

GVHD

Prevention: irradiated blood products in immunocompromised

Question 7

Transient Synovitis

Answer 7

Patient will be a child 3 - 10-years-old
With a history of URI
Complaining of hip pain
Treatment is supportive with NSAIDs

Question 8

Aortic Dissection

Type A

Answer 8

Type A - involves ascending aorta

Question 9

Aortic Dissection

Type B

Answer 9

Type B - involves only descending aorta

Question 10

Aortic Dissection
Treatment
2-drug strategy

Answer 10

Treatment is reduce BP/HR

2-drug strategy:

1st: β-blockade- Esmolol IV is preferred
2nd: antihypertensive- Nicardipine IV

Question 11

Aortic Dissection
Treatment
1-drug strategy

Answer 11

Labetalol IV 10-20 mg bolus over 2 min –> drip

Labetalol IV has 7 times more beta blocker activity than alpha blocker activity; therefore, often inadequate for blood pressure control.

Question 12

Aortic Dissection

Hemodynamic goals

Answer 12

HR <60 beats/min.
Systolic blood pressure <120 mm Hg

In the event of blood pressure discrepancy among extremities, dose the antihypertensive medication based on the extremity with the higher SBP.

Question 13

TPA indication in PE

Answer 13

Persistent hypotension or shock due to acute pulmonary embolism is the only widely accepted indication for systemic thrombolysis

Question 14

What structure lies immediately posterior to a peritonsillar abscess?

Answer 14

The internal carotid artery

Question 15

Laryngotracheitis (Croup)

Treatment

Answer 15

Treatment is steroids, aerosolized epinephrine

Question 16

What classic unstable cervical spine injury should be suspected in axial load mechanisms such as diving?

Answer 16

Jefferson fracture (a burst fracture of C1)

Question 17

Auer rods is a buzz word for?

Answer 17

Acute myeloid leukemia

Question 18

The most common organism causing otitis externa is ______________

Answer 18

Pseudomonas aeruginosa

Question 19

Isolated fractures of the ___________ are the most common pelvic fractures encountered.

Answer 19

pubic rami

nondisplaced pubic ramus fracture is often treated conservatively in elderly patients.

Question 20

What nonopioids can cause a false-positive opioid drug screen?

Answer 20

Poppy seeds and fluoroquinolones.

Question 21

Alkaline burns, such as those seen with button battery ingestions, are associated with what pathological finding?

Answer 21

Liquefaction necrosis.

Question 22

Ciguatera

Answer 22

a fish-derived toxin

neurologic and gastrointestinal symptoms, including nausea and vomiting, hot-cold reversal (cold allodynia), and ataxia.