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Peds Boards 2021 > Emergency Medicine > Flashcards

Emergency Medicine Flashcards

1
Q

What is the most likely diagnosis for patient with difficulty breathing, fatigue, lethargy, tachycardia, tachypnea and gallop after viral URI?

A

Cardiogenic shock

due to pump failure

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2
Q

What is the most likely diagnosis for toddler who presents with sudden trismus, torticollis, choreiform movements, opsithotonos (head and heels bent backwards and body bent forward)?

A

Acute Dystonic reaction

overdose of antipsychotics

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3
Q

What is the most likely diagnosis and treatment for patient presenting with hemorrhagic blister that progresses to necrotic ulceration and no other symptoms after spending time in the attic/ woodpiles/ closet in Southwest/ Southeast/ Midwast?

A

Dx: Brown Recluse Spider Bite
Tx: local wound care

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4
Q

What is the most likely diagnosis for patient presenting with SOB, headache, altered mental status, discoloration of blood, normal PaO2, and cyanosis?

A

Amyl/ butyl/ isobutyl nitrate intoxication
(can be found in room deodorizers)
(tx: methylene blue)

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5
Q

What is the most likely diagnosis for child presenting with holding arm close to body, elbow flexed and forearm pronated and normal Xray?

A

Nursemaid elbow

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6
Q

What is the most likely diagnosis for child presenting with irritability, fever, and soft tissue swelling of mandible with Xray showing cortical hyperostosis (thickening and bony expansion due to periosteal inflammation and new bone development)?

A

Caffey Disease

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7
Q

What is the most likely diagnosis of teen presenting with hypertension, agitation, mydriasis, hallucinations, and nystagmus?

A

PCP

phencyclidine

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8
Q

What are the 3 indications for head CT after head injury for patients older than 2 based on PECARN?

A
  1. Glascow coma score less than 15
  2. skull fracture
  3. altered mental status
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9
Q

What drug overdose can result in the complication of rhabdomyolysis?

A

PCP (Phencyclidine)

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10
Q

What is the likely etiology for a patient presenting with cyanosis, decreased oxygen saturation on pulse ox, and normal partial pressure of oxygen on arterial blood gas?

A

Methemoglobinemia

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11
Q

What is the likely diagnosis for a child with a double density shadow in the esophagus on Xray?

A

Ingestion of button battery

can lead to erosive esophagus

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12
Q

What is the most common finding on urinalysis after antifreeze ingestion?

A

Calcium oxalate crystals

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13
Q

What is the next best step for a patient presenting with cardiogenic shock who develops fluid overload (pulmonary edema) after fluid bolus?

A

epinephrine drip

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14
Q

What type of fracture is one that causes separation of the physis resulting in widening of physis?

A

Salter Harris type 1

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15
Q

What type of fracture passes through the physis and exits through metaphysis?

A

Salter Harris type 2

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16
Q

What is the treatment for methemoglobinemia?

A

Methylene blue

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17
Q

What is the most likely diagnosis for a pt presenting with nausea, vomiting, tense abdomen with severe pain, HTN, tachycardia, elevated LFTs, and severe generalized cramping with history of bull’s eye like lesion on extremity with diaphoresis?

A

Black widow spider bite

tx: benzos or opioids

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18
Q

What is the initial step in management for patient who was bitten by a venous snake?

A

clean and immobilize the extremity in a safe secure area away from the snake

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19
Q

What type of fracture passes through the physis, adjacent metaphysis, and epiphysis?

A

Salter Harris type 4

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20
Q

What is the treatment for serotonin syndrome if benzos and supportive care not effective?

A

Cyproheptadine

21
Q

What is the treatment management for a human bite?

A

Augmentin

22
Q

What is the treatment plan for a child who ingested acidic agent (like pool cleaner) with minimal symptoms?

A

Endoscopy to assess for risk of necrosis (esophageal or gastric)

23
Q

What is the most likely diagnosis for pt with jaundice, fatigue, anemia with schistocytes and microspherocytes, and necrotic gangrenous ulceration at previously painful site after working in attic/ shed?

A

Brown Recluse Spider

24
Q

What is the next step of management for a child presenting with pulseless electrical activity (PEA)?

A

CPR followed by epinephrine every 3-5 minutes

25
Q

What is the next step of management for a child presenting with pulseless with V-tach or V-fib on monitor?

A

Defibrillation 2 J/kg (followed by second attempt increased to 4 J/kg)

26
Q

What does MUDPILES stand for?

A 
causes of metabolic acidosis with anion gap
M: methanol
U: uremia
D: DKA
P: phenol
I: iron/ INH
L: lactate
E: ethanol/ ethylene glycol
S: salicylates/ sepsis
27
Q

How do you calculate body surface area involved in a burn?

A

rule of 9’s
9% per arm, chest, abdomen, or head +neck
18% per leg

28
Q

How do you calculate fluid replacement for burn victims

A

maintenance fluids plus 3 ml/kg per 1% body surface area with partial/ full thickness burn
(half over initial 8 hours, second half over 16 hours)

29
Q

What is the most likely complication of a hydrocarbon (gasoline) ingestion?

A

aspiration chemical pneumonitis

dx: CXR

30
Q

What is the most likely diagnosis for pt presenting with abdominal distention, abdominal pain, anorexia, bilious vomiting, palpable upper abdominal mass, and Xray showing air fluid level in dilated duodenal loop proximal to mass after bike accident?

A

Duodenal hematoma

31
Q

What is the most likely diagnosis of patient presenting with distorted shapes, sizes, color or spatial relationships in a patient with Infectious Mononucleosis?

A

Alice in Wonderland syndrome

32
Q

What is the time frame for the first acetaminophen level after overdose?

A

4 hours post ingestion

33
Q

What is the metabolite that is responsible for hepatic damage after acetaminophen overdose?

A

N-acetyl-p-benzoquinone imine (NAPQI)

34
Q

What is the 1st line treatment for an acute dystonic reaction?

A

Benadryl 1-2 mg/kg IM or IV

35
Q

What is the pathophysiological finding associated with Nursemaid elbow?

A

radial head subluxation

36
Q

What is the most likely diagnosis for a 1-4 year old who presents with acute refusal to bear weight, point tenderness without ecchymosis, and Xray showing subtle oblique, non-displaced hairline fracture of the mid to lower tibia?

A

Toddler’s fracture

37
Q

What is the percentage of girls who are sexually abused have sexually transmitted infections (STIs)?

A

8%

38
Q

What is the most likely diagnosis for patient presenting after ingestion of unknown substance presenting with vomiting, diarrhea (may have blood) and abdominal pain?

A 
Iron intoxication (i.e. swallowed prenatal vitamins)
(tx: IV fluids and deferoxamine
39
Q

What is the EKG changes associated with overdose of amitriptyline?

A

prolonged PR, QRS and QT intervals

40
Q

What is the treatment for organophosphate poisoning (DUMBELS- defecation, urination, miosis, bronchospasm/ bradycardia, emesis, lacrimation, salivation)?

A

Atropine

41
Q

… is prominent postauricular ecchymosus that develops 1-3 days after basilar skull fracture

A

Battle sign

42
Q

What type of fracture results in complete obliteration of the physeal plate without bony fracture?

A

Salter Harris type 5

43
Q

What are the 3 factors associated with poor prognosis after a submersion event?

A
  1. more than 25 minutes of CPR needed in ER
  2. longer submersion duration
  3. delay in initiation of CPR
44
Q

What substance overdose is associated with hyponatremia?

A

MDMA (Ecstasy)

45
Q

What is the recommended treatment for bite from a suspected rabid animal?

A
  1. thorough cleansing
  2. human rabies IgG
  3. 4 dose series of human diploid cell or purified chick embryo cell vaccine (day 0, 3, 7, 14)
46
Q

What is the most appropriate management for a human bite without underlying vital structure exposure?

A

copious irrigation and Augmentin

no need to suture close

47
Q

What is the treatment for a patient with a dirty wound who is unimmunized/ has less than 3 tetanus vaccines?

A

tetanus IgG and vaccine

Dtap is less than 7 or Td/tdap for 7 or older

48
Q

What is the difference between compensated shock and decompensated shock?

A

compensated- maintain blood pressure (due to elevated HR & vasoconstriction)
decompensated- hypotensive despite above measures

49
Q

What is the characteristic finding on peripheral smear associated with lead poisoning?

A

basophillic stippling on peripheral smear

Peds Boards 2021 (22 decks)

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