Adult Medical

Question 1

Allergic Reaction

Answer 1

Sensitivity to an allergen causing hives, pruritus, flushing, rash, nasal congestion, watery eyes, &/or angioedema not involving airway

Question 2

High-risk allergic reaction

Answer 2

Allergic reaction with a history of anaphylaxis, or significant exposure with worsening wheezes, diminished breath sounds, hoarseness, stridor, edema involving the airway, hypotension (SBP <90).

Question 3

Anaphylaxis

Answer 3

Severe allergic reaction with one or more of the following: respiratory distress, bronchospasm, wheezes, diminished breath sounds, hoarseness, stridor, edema involving the airway, hypotension (SBP <90).

Question 4

In extremis

Answer 4

Anaphylaxis with one or more of the following: airway compromise, altered mental status, SBP <70

Question 5

When should you use epinephrine with caution?

Answer 5

Patients >35yo, or with a history of coronary artery disease or hypertension

Question 6

Indications for naloxone administration

Answer 6

1. Environment is suspicious for use of opioids
2. Pt is unconscious/poorly responsive and respiratory rate appears slow (<12/min) or shallow/inadequate (or pt is unconscious and not breathing)

Question 7

Poison Control telephone number

Answer 7

(800) 222-1222

Question 8

Criteria for sodium chloride when suspecting TCA overdose

Answer 8

Sodium Bicarbonate 1 mEq/kg IV/IO - if any of the following are present:

• SBP <90
• QRS >0.12 seconds (3 small boxes)
• Seizures

Question 9

Suspected Sepsis Criteria

Answer 9

• Temperature
• RR >20bpm
• HR >90bpm
• ETCO2 ≤ 25 mmHg

Question 10

High Risk Indicators for Sepsis

Answer 10

• Hx of pneumonia, UTI, MRSA
• Cancer pts
• Nursing home residents
• Pts with indwelling catheters
• Immune-compromised pts

Question 11

Zofran Contraindications

Answer 11

First 8 weeks of pregnancy

Question 12

Acetaminophen contraindications

Answer 12

• Severe hepatic
• Active liver disease
  Discontinue infusion if SBP drops to <100

Question 13

Ketamine contraindications

Answer 13

• Pregnancy
• Multi-system trauma
• Suspected internal bleeding
• Active external bleeding

Question 14

Ketorolac contraindications

Answer 14

• ≥65 yo
• Pregnancy
• NSAID allergy
• Active bleeding
• Multi-system trauma
• Current use of anticoagulants or steroids
• Hx of renal disease/insufficiency/transplant

Question 15

Fentanyl/Midazolam contraindications

Answer 15

• SBP <100
• SpO2 ≤ 94% or RR <12
• ALOC or suspected moderate/severe TBI
• Do not administer midazolam to pts ≥ 65 yo
• Reduce fentanyl doses to 25 mcg for pts ≥65 yo
• There is an increased risk of deeper level of sedation & airway/respiratory compromise when administering midazolam to pts receiving fentanyl

Question 16

Normal SpCO Reading

Answer 16

SpCO 0 - 3%

Question 17

Abnormal SpCO Reading

Answer 17

SpCO 3 - 12%

Question 18

Severe Anxiety

Answer 18

• Uncontrollable feelings of panic, fear, doom, or impending danger
• Tachypnea/hyperventilation
• Tachycardia
• Cold, sweaty, numb, or tingling hands or feet

Question 19

Behavioral Crisis (Including severe agitation with altered mental status)

Answer 19

• Intense paranoia
• Disorientation/hallucinations
• Extreme aggression/violent behavior
• Danger to self/others
• Hyperthermia
• Increased strength