Common Problems In Acute Care

Question 1

What is used for the treatment of acute gout attack?

Answer 1

NSAIDs, colchicine

Question 2

What is used for the prevention of gout?

Answer 2

allopurinol

Question 3

What are causes of neuroleptic malignant syndrome?

Answer 3

excess of SSRIs, antipsychotics, or deficit of dopaminergic drugs

Question 4

What is used in the treatment of neuroleptic malignant syndrome?

Answer 4

IV fluids to flush out the drugs

Question 5

What are causes of serotonin syndrome?

Answer 5

SSRIs, SNRIs, TCAs, MAOIs, tramadol, triptans, zofran, cipro

Question 6

What is a normal compartment pressure

Answer 6

0-8

Question 7

What compartment pressure reading would require fasciotomy?

Answer 7

compartment pressure > 30 or delta pressure (DBP-ICP) >30 indicates need for fasciotomy

Question 8

What delta pressure reading would require fasciotomy for a patient with suspected compartment syndrome?

Answer 8

delta pressure (DBP-ICP) ≤ 30 indicates need for fasciotomy

Question 9

At what time interval would it no longer be appropriate to suture any animal bite?

Answer 9

any animal bite wound that is older than six hours should be left to heal by secondary intention

Question 10

What is indicated for the treatment of Steven Johnson Syndrome?

Answer 10

IVIG and steroids

Question 11

What immunosuppressive therapy is indicated for post-transplant care

Answer 11

1. Steroid — prednisone or methylprednisolone
2. Antimetabolite — azathioprine, mycophenolate, or cyclophosphamide
3. Calcineurin Inhibitor — tacrolimus or cyclosporine

Question 12

What is the most common type of skin cancer?

Answer 12

Basal Cell Carcinoma

Question 13

What category of burn is defined as dry, red, without blisters, involving the epidermis only?

Answer 13

First degree

Question 14

What category of burn is defined as moist, with blisters, extending beyond the epidermis?

Answer 14

Second degree

Question 15

What category of burn us defined as dry, leathery, black, pearly, or waxy, extending from epidermis to dermis to underlying tissues (fat, muscle, and/or bone)?

Answer 15

Third degree

Question 16

What percentage of the body is each arm according to the rule of nines?

Answer 16

Each arm = 9

Question 17

What percentage of the body is each leg according to the rule of nines?

Answer 17

Each leg = 18%

Question 18

What percentage of the body is the thorax according to the rule of nines?

Answer 18

Thorax = 18% front & 18% back

Question 19

What percentage of the body is the head according to the rule of nines?

Answer 19

Head = 9%

Question 20

What percentage of the body is the perineum/genitals according to the rule of nines?

Answer 20

Perineum/genitals = 1%

Question 21

What criteria indicate the necessity of referral to a burn center?

Answer 21

second degree burn>10% of the TBSA
third degree burns
burns in children
chemical or electrical burn
inhalation injury
any burn with accompanying trauma

Question 22

Headache, visual complaints, jaw claudication, nodular/enlarged/tender temporal artery, fever, chills, and rigors in a patient over the age of 50 is suspiciouss for what condition?

Answer 22

Giant Cell Arteritis

Question 23

What lab findings are expected in giant cell arteritis?

Answer 23

normal WBC, high ESR, temporal artery biopsy positive in 85-95% of cases

Question 24

What is indicated in the management of giant cell arteritis?

Answer 24

steroids, referral

Question 25

Hard exudates, microaneurisms, hemorrhages (ruptured microaneurisms), cotton wool spots, and cupping of the disc (cup to disc ratio > 1/2) are associated with which diagnosis?

Answer 25

Diabetic Retinopathy

Question 26

AV nicking is associated with which diagnosis?

Answer 26

Hypertensive Retinopathy

Question 27

Constriction of the visual fields is associated with which condition?

Answer 27

Open Angle Glaucoma

Question 28

What is normal intraocular pressure?

Answer 28

10-20

Question 29

What is the treatment for open angle glaucoma?

Answer 29

prostaglandin analogues (lantanoprost), alpha blockers (brimonidine), beta blockers (timolol), and miotic agents (pilocarpine)

Question 30

Extreme eye pain, blurry vision, halos around lights, with dilated or fixed pupil is associated with which condition?

Answer 30

Closed Angle Glaucoma

Question 31

What is the treatment for closed angle glaucoma?

Answer 31

carbonic anhydrase inhibitors, acetazolamide, mannitol, or surgery 

Question 32

Painless, clouded/blurred/dim vision, difficulty seeing at night, sensitivity to light and glare, fading/yellowing of colors, diploia in a single eye, halos around lights, absent red reflex, and opacification of the lens is associated with which condition?

Answer 32

Cataracts

Question 33

What is the treatment for cataracts?   

Answer 33

surgery

Question 34

What is the diagnostic criteria for AIDS?

Answer 34

AIDS = CD4 <200 and/o presence of opportunistic infection (500-1,200 normal CD4 count)

Question 35

Joint pain/stiffness that is better in the morning and worsened as the day progresses, aggravated by activity, and relieved by rest is consistent with which diagnosis?

Answer 35

Osteoarthritis

Question 36

What is the treatment for osteoarthritis?  

Answer 36

NSAIDs

Question 37

Joint pain/stiffness that is worse in the morning and improves as the day progresses is consistent with which diagnosis?

Answer 37

Rheumatoid Arthritis

Question 38

What is the treatment for rheumatoid arthritis? 

Answer 38

NSAIDs, DMARDs, steroids, antimalarials, gold salts

Question 39

What condition associated with SLE should be explored in a patient with SLE?

Answer 39

antiphospholipid syndrome

Question 40

What labs/diagnostics are associated with SLE?

Answer 40

ANA + in 95% of patients, anemia, leukopenia, and thrombocytopenia are often present

Question 41

What does the management of SLE consist of?

Answer 41

sun protection, topical glucocorticoids, NSAIDs, steroids, hydroxychloroquine

Question 42

A facial fractures involving a transverse fracture through the maxilla and pterygoid plates is a…?

Answer 42

Le Forte I — transverse fracture through the maxilla and pterygoid plates  (floating palate)

Question 43

A facial fractures involving a fracture transecting the nasal bones, medial anterior orbital bones is a…?

Answer 43

Le Forte II —  fracture transecting the nasal bones, medial anterior orbital bones (foating maxilla)

Question 44

A facial fractures involving a transverse fracture of nasofrontal suture, medial orbit wall, lateral orbit wall (floating face) is a…?

Answer 44

Le Forte III — transverse fracture of nasofrontal suture, medial orbit wall, lateral orbit wall (floating face)

Question 45

What rate should fluids be infused in the treatment of rhabdo?

Answer 45

IV fluids should be titrated to maintain urine output of 200-300 per hour.

Question 46

What is the treatment for neuroleptic malignant syndrome?

Answer 46

withdrawal of the offending dopamine antagonist or reinstatement of the dopamine agonist and supportive care which may include dantrolene

Question 47

What are signs/symptoms of acetaminophen overdose?

Answer 47

hepatotoxicity and delirium

Question 48

What is the treatment for acetaminophen overdose?

Answer 48

charcoal, N-acetylcysteine (Mucomyst)

Question 49

What abnormal labs will be seen in salicylate overdose?

Answer 49

hyperkalemia, elevated LFTs, metabolic acidosis

Question 50

What is the treatment of antifreeze (ethylene glycol) ingestion?

Answer 50

fomepizole

Question 51

What are symptoms of methanphetamine overdose?

Answer 51

mydriasis (dilated pupils), hyperthermia, hallucinations