Critical care

Question 1

Increased skin pigmentation?

Answer 1

Acute adrenal insufficiency - Primary

Question 2

What usually causes acute secondary adrenal insufficiency?

Answer 2

stopping long term exogenous steroids

Question 3

Predominant manifestation of adrenal crisis?

Answer 3

Shock. And other non specific symptoms

Question 4

Treatment of adrenal crisis?

Answer 4

IV fluids (2-3 liters), dexamethasone bolus (4mg) every 12 hours (hydrocortisone is second choice)

Question 5

Thyroid storm is usually caused by what?

Answer 5

An acute event, such as trauma, surgery, infection

Question 6

Presentation of thyroid storm?

Answer 6

Tachycardia/Afib, high fever, agitation, altered mentation

Question 7

Treatment of thyroid storm?

Answer 7

Propranolol, steroids

Question 8

S/S of Acute angle closure glaucoma.

Answer 8

Headache, N/V, severe eye pain, decreased vision, halos

Question 9

treatment of acute glaucoma?

Answer 9

Timolol, pilocarpine, apraclonidine.

Laser peripheral iridotomy

Question 10

S/S of acute PE

Answer 10

Usually SOB (rapid onset!), pleuritic pain, cough. Maybe sudden death

Question 11

risk factors for PE?

Answer 11

Virchow’s triad

Question 12

PE diagnostic studies

Answer 12

CT angiography
ABG - resp alkalosis
EKG - tachy, ST-T wave changes
D dimer

Question 13

PE treatment

Answer 13

Anticoagulate - LMWH, then LMWH or warfarin to continue for 3 months minimum
IVC filter for pts who can’t tolerate anticoagulation

Question 14

Causes of ARDS

Answer 14

sepsis syndrome
severe multiple trauma
gastric content aspiration

Question 15

What is happening in ARDS?

Answer 15

Increase in alveolar capillary permiability, leading to protein rich pulmonary edema

Question 16

S/S of ARDS

Answer 16

Rapid onset of severe dyspnea, refractory to O2 therapy

Question 17

ARDS treatment

Answer 17

Treat underlying cause, intubate, ventillator PPV and low PEEP

Question 18

young woman at rest in the early morning, associated ST elevation, negative cardiac enzymes

Answer 18

Prinzmetals Angina

Question 19

diagnosis of angina pectoris

Answer 19

ST changes on stress test with ECG

Question 20

tx of angina pectoris

Answer 20

ASA, O2, Nitro, Morphine

Beta blockers, CCBs, ACEIs

Question 21

Common causes of upper GI bleed

Answer 21

PUD, esophagitis/gastritis, Mallory-Weiss tear, esophageal varices

Question 22

Common causes of lower GI bleed

Answer 22

Diverticulosis, angiodysplasia, IBD, hemorrhoids/fissures, neoplasm, AVM