Day 5 Review - CV3, CV4, ICU/Surgery

Question 1

Empiric tx brain abscess

Answer 1

Antibx (Based on etiology, e.g. - UTI drugs, neurosurgery tx vancomycin/ceftiazidine), needle aspiration, & corticosteroids

Question 2

Cluster HA tx

Answer 2

100% oxygen on non-rebreather for about 30 min; Also can use migraine meds - dihydroergotamine/sumatriptans

Question 3

Patient populations in which triptan drugs contraindicated

Answer 3

Preg, CAD, Prinzmetal angina

Question 4

S/e of theophylline overdose

Answer 4

Seizure (excessive muscle contraction), hyperthermia; Hypotension, cardiac tachyarrhythmias

Question 5

ST elevation corresponding to multiple arteries

Answer 5

Acute pericarditis

Question 6

Hypotension, distant heart sounds, distended neck veins

Answer 6

Beck’s triad of cardiac tamponade

Question 7

Cardiac cath shows equal pressure in all heart chambers

Answer 7

Constrictive pericarditis

Question 8

Chest pain improved w/ leaning forward

Answer 8

Acute pericarditis

Question 9

Bp meds avoided in pts with ischemic stroke or SAH (due to increased ICP)

Answer 9

Nitroprusside & Nitroglycerine

Question 10

Antidote: Antimuscarinic aka Anticholinergic

Answer 10

Physostigmine

Question 11

Antidote: Benzos

Answer 11

Flumazenil

Question 12

Antidote: TCAs

Answer 12

Sodium bicarbonate

Question 13

Antidote: Warfarin

Answer 13

Vitamin K; if immediately needed, FFP

Question 14

Antidote: Methylene glycol

Answer 14

Fomepizole or Ethanol

Question 15

Antidote: Arsenic acid

Answer 15

Dimercaprol, Succinate, or Penicillamine

Question 16

Parkland formula

Answer 16

Resuscitation in burn pts (in addition to maintenance fluids); Replacement LR - 4mL per kg per % burn area in first 24 hrs; Dose half in first 8 hrs and remaining half in next 16 hours

Question 17

Neuroleptic malignant syndrome s/sx

Answer 17

AMS, Muscle rigidity, Hyperthermia, Autonomic instability, Rhabdomylosis

Question 18

NMS Tx

Answer 18

D/c med; IVF cooling/rehydration to prevent rhabdomylosis; Dantrolene (alternatives: Bromocriptine or Amantadine)

Question 19

Mechanism & Levels (PTH, Alk Phos, Ca, Phos): Paget disease

Answer 19

Excess bony turnover; Elevated Alk Phos

Question 20

Mechanism & Levels (PTH, Alk Phos, Ca, Phos): Osteomalacia/Rickets

Answer 20

Vit D def; Serum Ca decreased, PTH elevated, Serum Phos decreased, Alk Phos normal or elevated

Question 21

Mechanism & Levels (PTH, Alk Phos, Ca, Phos): Chronic renal insufficiency

Answer 21

Vit D def - Similar to osteomalacia/rickets; Serum Ca decreased, PTH elevated, Serum Phos elevated (only difference, since kidneys unable to trash), Alk Phos normal or elevated

Question 22

Mechanism & Levels (PTH, Alk Phos, Ca, Phos): Osteoporosis v. Osteopetrosis

Answer 22

Brittle bones v. Rock-like bones; All levels normal

Question 23

Mechanism & Levels (PTH, Alk Phos, Ca, Phos): Primary hyperparathyroidism

Answer 23

Elevated PTH, Elevated Ca, Decreased Phos, Elevated Alk Phos (because Ca increased via bony turnover)

Question 24

Mechanism & Levels (PTH, Alk Phos, Ca, Phos): Hypoparathyroidism

Answer 24

Decreased PTH, Decreased Ca, Elevated Phos; Normal Alk Phos (no bony turnover)

Question 25

Mechanism & Levels (PTH, Alk Phos, Ca, Phos): Pseudohyperparathyroidism

Answer 25

Ca Decreased & Phos elevated (like hypoparathyroidism); PTH elevated