Deck 1

Question 1

Asthma ventilation settings

Answer 1

Low RR
High inspiration flow rate
Maintain plateau pressure below 30
Permissive hypercapnia

Question 2

aerospace manufacturing pneumoconiosis

Answer 2

Berylliosis

Question 3

Pneumoconiosis types

Answer 3

Asbestosis: shipping, roofing, plumbing
• Berylliosis: aerospace, fluorescent bulbs
• Byssinosis: cotton
• Silicosis: foundries, sandblasting, mines
• Coal worker’s lung: coal
• Siderosis: iron
• Stannosis: tin
• SOB + nonproductive cough + chronic hypoxia
• PFTs: reduced lung volumes
• CXR: interstitial fibrosis
• Asbestos: from the roof, but affects the base (lower lobes)
• Silica, coal: from the base(earth), butaffect the roof (upper lobes)
• Corpulmonale

Question 4

Apnea in neonate from opioid dependent mother

Answer 4

Treat only with respiratory support and ventilation. Naloxone not recommended can lead to seizures and withdrawal

Question 5

Pregnant. Elevated blood pressure. Maybe right upper quadrant pain

Answer 5

HELLP Syndrome (Hemolysis, Elevated Liver function tests, and Low Platelets)
	•	Patient will be a pregnant
	•	Labs will show microangiopathic hemolytic anemia (low hemoglobin and schistocytes on blood smear), thrombocytopenia, and elevated liver function tests
	•	Management is blood pressure management, magnesium sulfate for prevention of eclamptic seizures and delivery of the fetus

Question 6

How to prevent boutonnière deformity

Answer 6

Put PIP in extension. Leave DIP and MCP normal range of motion

Question 7

Scleroderma renal crisis treatment

Answer 7

Treat renal failure lyre abnormalities.

Once hyperK corrected can start captopril

Question 8

efavirenze side effects

Answer 8

vivid dreams, headache, severe rash, dizziness and lightheadedness

Question 9

indinavir side effects

Answer 9

kidney stones, hyperbili, hepatitis

Question 10

normal adult spinal cord ends as conus medullaris at what level

Answer 10

L1-L2

Question 11

Indications for emergent hemodialysis in acute salicylate toxicity

Answer 11

serum salicylate level >100 (acute) (40 chronic)
rapid rising level
AMS
Kidney or liver failure
pulmonary edema
severe acid/base disturbance
worsening clinical status

Question 12

Type I hypersensitivity

Answer 12

Type I reactions are immediate hypersensitivity where binding of antigens to IgE on mast cells and basophils leads to deranulation of mediators

Question 13

Type II hypersensitivity

Answer 13

involve cell lysis resulting from antibody binding to membrane-bound antigens (auto immune hemolytic anemia)

Question 14

Type III hypersensitivity

Answer 14

immune complex-mediated reactions. Antibodies bind to antigens to form immune complexes. These are deposited on vessel walls leading to local inflammation and eventually tissue injury. Type III reactions are seen in systemic lupus erythematosus and serum sickness. Serum sickness presents with rash, fever, polyarthralgias and polyarthritisusually begins 1-2 weeks after exposure to a causative agent.

Question 15

Type 4 hypersensitivity

Answer 15

cell-mediated delayed hypersensitivity requires sensitized lymphocytes to start the inflammatory reactions. Type IV reactions are seen in contact dermatitis, Stevens-Johnsonsyndrome and toxic epidermal necrolysis.

Question 16

Interpretation of medical literature: which is strength of recommendation and which is quality of the evidence

Answer 16

Classes are strengths of recommendation Class I to III (I is highest, IIa moderate strength, IIb weak recommendation, III benefit equals risk or risk is greater)
Levels are levels of evidence (A to C. C is expect opinion)

Question 17

Behcet syndrome

Answer 17

recurring genital, oral ulcerations. relapsing uveitis.

Question 18

estimate weight peds

Answer 18

(2 x age) + 8

Question 19

pediatric dextrose administration in hypogylcemia

Answer 19

<1 year: D10 2-5 mL/kg
1-8 years: D25 2mL/kg
>8 years: D50 1 mL/kg

Question 20

keraunoparalysis

Answer 20

transient extremity paralysis from vasospasm after lightning injury

Question 21

malrotation with midgut volvulus

Answer 21

80% cases present in first month of life. infant with bilious vomiting.
upper GI study gold standard showing corkscrew appearance of jejunum. tx with fluids, NG tube, abxs, surgery.

Question 22

thrombotic thrombocytopenic purpura

Answer 22

autoantibody mediated inhibition of enzyme ADAMTS13. results in microangiopathic hemolytic anemia and thrombocytopenia. classic pentad: fever, microangiopathic hemolytic anemia, thrombocytopenia, renal dysfunction, and neurologic changes. plasma exchange tx, also IV corticosteroids.
labs: elevated LDH, elevated indirect bilirubin, normal coags, microangiopathic hemolytic anemia, thrombocytopenia

Question 23

post-partum endometritis

Answer 23

risk factors: C section, PROM > 24 hours, stage 2 labor >12 hours, high number of pelvic exams
tx: clinda plus gent, unasyn

Question 24

hyperosmolar hyperglycemic state

Answer 24

profound dehydration, hyperosmolarity and decreased mental status

Question 25

serum sodium correction for glucose

Answer 25

add 1.3 to 1.6 mEq/L for each 100mg/dL above normal glucose