Emergency Medicine

Question 1

ETT size

Answer 1

(Age/4) + 4

Question 2

Sudden hypoxemia/deterioration in intubated patient

Answer 2

Displacement of ETT
Obstruction of ETT
Pneumothorax
Equipment failure

Question 3

Intrinsic (prenatal) risk factors for SIDS

Answer 3

Non-white race
Male
< 37 wk GA
Maternal Smoking and/or alcohol use

Question 4

Extrinsic (postnatal) risk factors for SIDS

Answer 4

Prone or side sleep position
Sleeping on adult mattress, couch, playpen, soft bedding
Bed-sharing
URI
maternal smoking after birth

Question 5

Suddenly alteration in breathing
Cyanosis or pallor
Change in tone
altered LOC
successful recovery with no medical condition to explain event

Answer 5

Brief resolved unexplained event (BRUE)

Question 6

Low risk BRUE

Answer 6

> 60 days
32 wk GA
First time
No CPR
No concerning history or physical

Question 7

Antibiotic for cat and dog bites

Answer 7

Augmentin

If penicillin allergy, clindamycin + Bactrim

Question 8

Target lesion within hours
Necrotic
Self-limited

Answer 8

Brown recluse (loxosceles reclusa)

Question 9

Barely noticeable puncture wound
Myalgias
Hypertension

Answer 9

Black widow (lactrodectus mactans)

Question 10

Snake
Triangular head and fangs
Red and yellow
Fang marks
Local erythema and swelling
LAD
Bullae

Answer 10

Venomous snake

Question 11

Indications for anti venom (crotalidae polyvalent immune fab)

Answer 11

Coagulopathy
Hypotension
Systemic collapse
Tissue injury

Question 12

Irritability
Increased HC
Pallor, anemia
Headache, vomiting, drowsiness
Tearing of intracranial bridging veins

Answer 12

Subdural hematoma

Associated with SIADH

Question 13

Subdural hematomas
Retinal hemorrhages
Bulging fontanelle

Answer 13

Shaken baby syndrome

Question 14

Tearing of smalls vessels of pia matter
LOC
Headache
Meningeal irritation

Answer 14

Subarachnoid hemorrhage

Question 15

Blunt head trauma
Pupillary findings
LOC then lucid period, followed by deterioration

Answer 15

Epidural hematoma

Lens-shaped. Do not cross suture lines

Question 16

Initial work up for concern for abuse

Answer 16

Head CT
Ophthalmologic exam
Skeletal survey

Question 17

Most common skull fracture in children
Often occur in Parietal region
Associated with scalp hematomas

Answer 17

Linear fracture

Question 18

Visible bleeding from ear
Hemotympanum
Hearing loss
Facial paralysis

Answer 18

Temporal bone fracture

Question 19

Ecchymoses behind ear
Periorbital ecchymoses
Can involve CN 6 and 7

Answer 19

Basilar skull fracture

Question 20

Criteria for brain death

Answer 20

Known and irreversible cause of coma
No hypotension, hypothermia, metabolic disturbance, sedation
2 brain death examinations by different examiners done 12 and 24 hours apart
No ancillary studies

Question 21

Indication for ENT drainage in nose trauma

Answer 21

Swelling of nasal septum
Obstruction

Question 22

Fractures with high specificity for abuse

Answer 22

Metaphyseal “bucket handle”
Posterior rib
Spinous process
Scapular
Sternal

Question 23

Electric current courses through body
Deep tissue burned
Internal organ injury

Answer 23

Arc exposure

Question 24

Non accidental burns

Answer 24

Hands, feet
Face, eyes, ears
Perineum
Stocking and glove
Full thickness

Question 25

Parkland formula

Answer 25

4cc/kg x wt (kg) x % BSA affected

Question 26

Rule of 9s for burns

Answer 26

Arms = 9% each
Legs = 18% each
Trunk = 36%
Head/neck = 10%
Perineum = 1%