Floor management 2

Question 1

sliding scale insulin

Answer 1

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Question 2

maherker (?)

Answer 2

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Question 3

fishbone diagrams

Answer 3

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Question 4

cough medicine at the U

Answer 4

tessalon

Question 5

problems with insulin drip

Answer 5

1) barrier to discharge

2) require frequent glucose check

Question 6

hemoconcentration on labs

Answer 6

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Question 7

opiate withdrawal timeframe

Answer 7

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Question 8

coreg

Answer 8

carvedilol

Question 9

when to replete calcium

Answer 9

…

Question 10

when transferring patients on floor always remember

Answer 10

1) check for adequate oxygen

2) don’t transfer with restraints if high oxygen needs

Question 11

when patient agitated always check for

Answer 11

1) hypoxia (hypoxia causes agitation)

Question 12

systematic approach to chest pain

Answer 12

1) arrow approach

Question 13

systematic approach to dyspnea

Answer 13

…

Question 14

ABG ordering options

Answer 14

Can order ABG with lytes + lactate + co-ox panel (hemoglobin + carbon monoxide)

Question 15

when you order a V/Q scan

Answer 15

• (high radiation but no contrast so can be used for patients with renal failure)
• patient must have clear lungs (it will not be able to determine V/Q mismatch)

Question 16

Next step up from venturi mask and acute respiratory failure

Answer 16

BPAP

Question 17

space for needle decompression

Answer 17

second intercostal space, over the third rib, midclavicular, regardless of place of pneumo (air rises)

Question 18

chest tube placement for pneumo

Answer 18

always angled up

Question 19

MAP formula

Answer 19

MAP = (COxSVR) + CVP

Question 20

normal MAP

Answer 20

60-65

Question 21

average circulating blood volume

Answer 21

5 L

Question 22

definition of oliguria

Answer 22

less than 250 mL urine in 12 hours

Question 23

problem with procalcitonin

Answer 23

• takes so long

Question 24

withdrawal protocol at the U

Answer 24

CIWA

Question 25

HCAP

Answer 25

healthcare-associated pneumonia

Question 26

typical chest pain

Answer 26

chest pain worsened by exertion or emotional stress and relieved by rest and/or nitroglycerin

Question 27

hemorrhaging appearance on non contrast CT

Answer 27

- hyperdensity (white)

Question 28

how to diagnose an anatomic cause of infertility (such as scarring from PID)

Answer 28

hysterosalpingogram

Question 29

ischemic hepatopathy presentation

Answer 29

rapid and massive increase in transaminases

Question 30

bacterial meningitis treatment in kids

Answer 30

IV vanc + CTX (resistant s pneumo coverage) +/- dexamethasone for HIB meningitis (reduces hearing loss risk)

Question 31

progesterone stimulation test

Answer 31

- In patients with underdeveloped HPA axis, the corpus luteum is underproducing progesterone. The endometrium builds up under the influence of estrogen, but without progesterone to tell endometrium to slough off, bleeding happens because of estrogen breakthrough bleeding. Normally, progesterone will fall as corpus luteum degenerates, leading to menses. - If you give someone progesterone and this causes bleeding, you know they are adequately producing estrogen because they have -

Question 32

Toxic shock syndrome risks

Answer 32

tampon use recent surgery skin lesions/burns sinusitis/nasal surgery

Question 33

toxic shock syndrome presentation

Answer 33

high fever + hypotension + diffuse macular rash involving palms and soles + desquamation 1-3 weeks after disease onset + vomiting/diarhea + AMS

Question 34

CGD diagnosis

Answer 34

dihydrorhodamine 123 test or nitroblue tetrazolium testing

Question 35

CGD presentation

Answer 35

pneumonia + cutaneous abscesses + suppurative adenitis (recurrent pulmonary and cutaneous infections)

Question 36

statin mechanism

Answer 36

HMG-CoA reductase enzyme inhibition, preventing conversion of HMG CoA to mevalonic acid, increasing number of cell membrane LDL receptors.

Question 37

statin-induced myopathy mechanism

Answer 37

decrease coenzyme Q10 synthesis, which is involved in muscle cell energy production

Question 38

volume cutoff for urinary retention

Answer 38

over 150 mL

Question 39

postpartum urinary retention management

Answer 39

- analgesics - encourage ambulation - urinary catheterization

Question 40

contraindication with LMWH

Answer 40

ESRD (metabolized by kidney)

Question 41

anticoagulation for provoked DVT

Answer 41

at least 3 months, heparin + warfarin, continue heparin for 4-5 days until INR is therapeutic

Question 42

low-molecular weight heparins

Answer 42

enoxaparin dalteparin fondaparinux

Question 43

Caveat about DVT presentation

Answer 43

About half of cases are asymptomatic