End of Lecture Sample Questions

Question 1

Night in backyard cleaning his storage shed ~45 min ago when he was bitten by something. He now complains of severe abdominal pain and nauseous and hypertensive. What most likely bit him?

A. Black Widow
B. Brown Recluse
C. Granddady long leg
D. Scoprion

Answer 1

A. Black widow

Keys: abdomen, HTN

Question 2

What trx do you suggest to someone bitten by black widow?

A. Scorpion antivenin
B. Dapsone
C. Black widow antivenin
D. Amoxicillin

Answer 2

C. Black widow antivenin

NO ABX!

Question 3

While climbing camelback mountain w/ friends, you are bitten by a rattlesnake on the leg. What is the preferred trx of your injury in the field?
A. Tourniquet to the involved extremity
B. Apply constriction band to the involved extremity
C. Cut and suck the venom from the wound
d. Apply warm compresses to the wound

Answer 3

B. Apply constriction band to the involved extremity

Wat to still feel a pulse (arterial)

Warm compress would make it worse!!!

Question 4

Your friends transport you to the hospital for further eval after snake bite. While in ED, you are noticed to have progressive swelling of leg, hypotension, platelet count of 50K, and a PT of 25 sec. Should you be given an antivenin?
A. Yes
B. No

Answer 4

A. Yes!

Question 5

What is the treatment of choice for an anaphylactic rxn to bee sting?

Answer 5

Epinephrine (IM)

Question 6

What is the pathognomonic PE finding w/ scorpion sting?

Answer 6

Roving eye movements

Question 7

58 y.o. gentleman presents w/ hypothermia. Core temp is 85.5F. Which of the following is the most accurate?
A. Shivering is common
B. Osborne J wave pathognomic
C. Rough handling can produce dysrhythmias
D. NGT should be inserted

Answer 7

C. (and tech B).

Shivering stops @ 90

Osborne J starts @ <86

jostling too much can cause arrythmias

Question 8

Pt presents after being bitten while outside.  Bite has a large area with muscle cramps.  What is the most likely cause?
A. black widow
B. hobo spider
C. Brown recluse 
D. tarantula
E. Scorpion

Answer 8

A. Black widow

Brown recluse causes umbilicated

Question 9

What is the most lethal form of acute mouthing isllnes?

Answer 9

HAPE (high alt)

Question 10

What is the most important trx option for acute mountain sickness?
A. O2
B. Dexamethasone
C. Hyperbaric therapy
D. Acetazolamide
E. Immediate descent

Answer 10

E. Immediate descent

Question 11

What is the difference between stridor and wheezing?

Answer 11

Stridor = inspiratory, upper airway

Wheeze: expiratory, lower airway

Question 12

Whats the clinical significance of head bobbing and see-saw breathing?

Answer 12

Both are signs of impedngin respiratory fialure

Question 13

Your pt presents for eval of an elevated temp and productive cough. 134/80, 50, 24, 102.4, 92% RA. Labs significant for leukocytosis 16k, Na 127. Based on presentation, what agent do you suspect and how do you treat it?

Answer 13

Legionella

Trx: Azithromycin

Question 14

What are the components of CURB 65 and how is it used?

Answer 14

Confusion
Uremia (BUN > 20)
Resp Rate >30 br/min
BP <90/60
Age > 65

Mortality predictor; 1 pt per item
0-1 = OP, 2 = admit; 3 -5 = ICU

Question 15

What is the treatment of choice for high altitude pulm edema?

Answer 15

immediate descent

Question 16

You are evaluating a 56-year-old M w/ hx of colon cancer , on chef, who presents for eval of SOB. 90/40, 123, 28, 87% RA, 101.1. How do you proceed?

Answer 16

Standard hx including HPI
IV O2, monitor
IVF (NS/LR)
CXR

PE found on CT
-anticoagulation

Question 17

What can give you a false + d-dimer?

Answer 17

Cancer, inflammation, infection, age (>70), Recent sx, trauma, MI, pregnant, arterial thrombosis, actue CVA, superficial phelbitis, RA, liver dz

Question 18

What can give you a false negative d-dimer?

Answer 18

Warfarin, symptoms < 5 days, small clot burden