CCS

Question 1

Initial order and treatment for Pulmonary edema

Answer 1

• LMNOP and dobutamine(if needed)
• Chest x-ray
• EKG
• Oximeter
• Echocardiogram

Question 2

A fib work up in CCS

Answer 2

• Echocardiography
• TSH and T4
• Electrolytes
• Troponin or CK-MB levels

Question 3

Syncope Work up

Answer 3

• EKG
• Echocargiogram
• Troponin/CKMN
• Head CT

Question 4

IBS work up

Answer 4

-Colonoscopy
-CT abdomen
-Stool guaiac,Stool white cell,culture,ova and parasite
-ESR
-Stool bacterial culture
-72 hour stool fat
-

Question 5

GI bleeding initial orders in CCS

Answer 5

• Bolus of normal saline or ringer
• CBC
• PT/INR
• Type and Cross
• Consultation with Gastro
• EKG

Question 6

when to move the patient out of the ER —> ICU

Answer 6

-When is stabilizaed and you have a presuntive diagnosios

Question 7

DDX for SOB

Answer 7

CHF
pneumonia
acute MI
Pulmonary embolism

Question 8

COPD exacerbation initial orders

Answer 8

Pulse oximetry
oxygen
ABG
PEFR
Chest x-ray AP and lat
Vitals
BMP
CBC
Cardiac monitor

Question 9

COPD exarbation intial treatmetn

Answer 9

O2
Nebulized albuterol and ipatrooim
IV Methyl predni
empitic antibiotics
Sputum stain
NIPPV if PCO2>45  or PH>7.3
hopitalize if necesary

Question 10

ER generic orders

Answer 10

• Vitals
• Oxygen
• pulse oxymeter
• IVA
• EKG
• Cardia monitor
• U/A
• BMP
• CBC
• Check interval Hx
• Blood culture
• Antiboitics (if necessary)

Question 11

office management of first prenatal visit

Answer 11

• blood type and screen direct/indirect coombs
• CBC
• CMP
• Cervical pap
• Urinalysis, urine culture
• Rubella antibody
• Hepatitis B surface Ag
• VDRL or RPR
• HIV ELISA
• Cervical culture for chlamydia
• US

follow up in 4 weeks

Question 12

SEPSIS Shock

Answer 12

Start Antibiotics withing 2 hours of presentation

• Arterial line
• Central line
• ABG
• Cultures

Question 13

Fluids resistent low BP in shock

Answer 13

GIVE Pressors.

Tachycardia present: Noerpi
No tachy: Dopamin

Question 14

monitor in shock once in stable in ICU

Answer 14

Daily

• CBC
• BMP
• Urine output

Question 15

P2Y12 antagonist of choice for those going for angioplasty

Answer 15

Prasugrel

Question 16

Emergency HTN initial work up

Answer 16

HEAD CT
Chest X ray
ECG
BMP
CBC
UA
lipid profile
Cardiac monitor
BP monitor

Question 17

suspect MI initial orders

Answer 17

ECG
cardiac enzymes
chest x ray
CBC
BMP
PT/INR
PTT
LFT

STEMI: Cath
non STEMI: MONAC BC hepatirin
Unstable angina: Cath

Question 18

Chest pain DDX

Answer 18

MI
PE
Acute pneumothorax
Aortic disecction
Perciarditis

Question 19

staging of lung cancer orders

Answer 19

• CT abdomen and pelvis
• MRI brain
• Bone scan
• PFT
• LFT
• consult onco
• consults radiation oncologist

Question 20

DDX of acute right upper quadrant

Answer 20

Hepato-biliary

• Cholecystitis
• Cholangitis
• Choledocolithiasis
• Hepatitis
• Pancreatitis
• pyelonephritis
• Appendicitis
• Pneumonia

Question 21

CURB 65

Answer 21

confusion
urea>7 or BUN>19
Respiration >30
Blood pressure SBP<90 or DBP<60
Age >65

> 2=in patient
3=ICU

Question 22

acute asthma initial orders

Answer 22

• O2
• Albuterol
• Ipatropium
• IV methyl prednisolione
• Mg

Question 23

loud P2

Answer 23

sign of pulmonary fibrosis

Question 24

prior toi surgery orders

Answer 24

Blood type and crossmatch
CMP
CBC
PTT
PT
INR
Chest x ray
EKG

Question 25

dementia work up

Answer 25

• CT head
• TSH
• CMP
• RPR or VDRL
• B12

Question 26

Anemia workup

Answer 26

• CBC
• Peripheral smear
• Reticulocyte
• Haptoglobulin
• LDH
• Bilirubin
• TSH with T4
• B12
• B9
• Iron studies
• Urinalysis with microscopic analysis

Question 27

pathologic jaundice worku up

Answer 27

Bilirubin
blood type mother and inflant
direct coombs
CBC,Reticulocyte,blood smear:assess hemolysis
Urinalysis and urine culture
TORCH