EM/Urgent Care

Question 1

SIRS criteria

Answer 1

• Temp>38(100.4) or <36(96.8)
• RR >20
• Pulse > 90
• WBC >12k, <4K or >10% bands

Question 2

Sepsis fluid bolus?

Answer 2

30 ml/kg if hypotensive or lactate >4

Question 3

What’s hyphens?

Answer 3

Blood in anterior chamber of the eye

Question 4

Patient comes in with nontraumatic painful eye. What can you do to rule out acute angle glaucoma or Uveitis?

Answer 4

Proparacaine —- if relieves pain think conjunctivitis, keratitis or corneal ulcer

Question 5

Compartment space pressure for compartment syndrome?

Answer 5

> 30mmhg

Question 6

Treatment of cat scratch disease?

Answer 6

None! It’s self limiting lymphadenopathy. Some use azithromycin 500mg x 5days

Question 7

Is angioedema an allergic rxn?

Answer 7

No! Idiopathic accumulation of bradykinin. Can occur months to years after ace use.

Question 8

What’s “pseud” fish allergy/scombroid poisoning?

Answer 8

1-2hrs after eating contaminated fish. Due to histone in muscles being converted to histamine by bacteria. Usually do to poorly preserved fish. This is self-limiting and last about 4 to 6 hours and is treated with H one in H2 blockers.

Question 9

Ciguatera Poisonig

Answer 9

Due to an injgestion of re-fish that have accumulated to significant amount of dinoflagellate. Occurs 1-6 hrs after. Get weird neurological symptoms. 

Question 10

Within how long after injection can you use activated charcoal?

Answer 10

One hour

Question 11

When do you check an acetaminophen level in a patient who you are afraid may have overdosed?

Answer 11

Four hours after ingestion of acetaminophen. Based on this level he will treat with N-acetylcysteine

Question 12

Symptoms of serotonin syndrome?

Answer 12

Anxiety, agitation, delirium, headache, seizures, tachycardia, hypothermia, diaphoesis, diarrhea, nausea, crastlessness, tremor, Hyperreflexia, dysarthria, ataxia, jerks, twitches. Can also see with my nasal it especially when combined with steroids