Medical

Question 1

IVF Allergic reaction

Answer 1

500 mL

Question 2

Albuterol allergic reaction

Answer 2

90 mcg/2 puffs
or
2.5 mg Neb

Question 3

Ped allergic reaction diphenhydramine

Answer 3

1mg/kg

Question 4

Ped allergic reaction methylprednisolone

Answer 4

2mg/kg

Question 5

Ped allergic reaction epi

Answer 5

0.01 mg/kg, max .3mg

Question 6

IVF Ped allergic reaction

Answer 6

20 mL/kg

Question 7

Ped allergic reaction epi infusion

Answer 7

0.01-0.03 mcg/kg/min

Question 8

AMS, BGL >250

Answer 8

Tall boi

Question 9

AMS, alcohol abuse, bgl <70

Answer 9

100 mg thiamine
D50 x 1 or 1mg glucagon

Question 10

Narcan dose

Answer 10

0.4-2 mg

Question 11

Ped AMS bgl > 250

Answer 11

20 mL/kg

Question 12

Ped AMS, bgl < 60

Answer 12

D25 2ml/kg
or
.5 glucagon IM

Question 13

Ped AMS, bgl < 60, malnourished

Answer 13

25 mg Thiamine
followed by appropriate sugar mgmt

Question 14

AAA

Answer 14

Tall boi, consider blood

Question 15

Bowel/bladder incontinence

Answer 15

Cauda equina syndrome

Question 16

Epistaxis tx

Answer 16

• Blow nose
• Afrin
• Pinch and tilt forward x 10 min
• consider 500 bolus
• consider zofran

Question 17

When to avoid afrin

Answer 17

• DBP >110
• known CAD

Question 18

Fever w/orthostatic BP + tachy

Answer 18

tall boi

Question 19

2 tall bois w/fever consider what?

Answer 19

Norepi 2-12 mcg/min

Question 20

Airbourne precautions is used for?

Answer 20

TB, measles, varicella

Question 21

Droplet precautions for?

Answer 21

Influenza, meningitis, mumps, strep

Question 22

Insulin dose for high sugar

Answer 22

0.1 u/kg/hr

Question 23

What can a rapid drop of glucose cause?

Answer 23

Cerebral edema due to a shift in extracellular osmolality

Question 24

Preferred tx for BGL<60 w/AMS

Answer 24

D10 IV until baseline and >60bgl

Question 25

Sulfonylureas examples and what they can cause

Answer 25

Glyburide, glipzide Can put patients at a higher risk of recurrent symptoms

Question 26

Respiratory insufficiency

Answer 26

Cyanosis, AMS, LOC, fatigue, inability to speak, <90% w/o2

Question 27

Rales/CHF

Answer 27

PPV w/100%, 400mcg Nitro q 5 w/ SBP>90, Furosemide 60-80mg IV if not improving

Question 28

Wheezes

Answer 28

100% O2, Abuterol 90 mcg or 5 mg Ned, Epi 0.3, Solumedrol, consider mag 2g/20min, LAST RESORT= 1mg/kg ketamine bolus SLOW

Question 29

Stridor

Answer 29

Consider obstruction 100% O2 Albuterol Consider Epi Solumedrol

Question 30

Ped Rales

Answer 30

PPV w/100% O2 Consider: 1mg/kg Furosemide

Question 31

Ped Wheezes

Answer 31

- 100% O2 - Albuterol 2.5 mg - Consider Epi: >30 = .3, 15-30 .15, or 0.01mg/kg - Solumedrol 1-2 mg/kg - Mag Sulfate 25-75 mg/kg over 30 min w/ 20ml/kg IVF - Last Resort = 0.5 mg/kg

Question 32

Ped Stridor

Answer 32

Consider Obstruction 100% O2 if <90% consider advanced airway Racemic Epi 0.5 mL/kg, MAX: 5 mL Consider Epi 0.01 mg/kg Solumedrol 1-2 mg/kg

Question 33

Status epilepticus keppra

Answer 33

Keppra 40-60 mg/kg max 4500 mg over 15 min

Question 34

Seizure with BGL<60

Answer 34

D50 or 1mg glucagon

Question 35

Active seizure

Answer 35

Lorazepam 2-4 mg OR Versed 5 mg IV/IO/IN or 10 mg IM/IN

Question 36

Active Seizure with pregnancy

Answer 36

Consider 4 g mag over 15 min, monitor hypotension

Question 37

Ped Seizure

Answer 37

Lorazepam 0.05 - 0.1 mg/kg IV max 4mg Or Versed 0.2mg/kg IM Consider 20mg/kg single dose

Question 38

Ped Seizure with BGL<65

Answer 38

D25 2ml/kg OR Glucagon 0.05 mg/kg

Question 39

Sepsis Criteria

Answer 39

2 or more of: AMS HR>90 Temp >100.4 or <96.8 SBP <90 RR> 20 ETCO2 <25

Question 40

Sepsis Fluid Resus

Answer 40

tall boi and keep sending them until 30 mL/kg or MAP of > 65

Question 41

Sepsis SBP> 90 after resus

Answer 41

100-200 mL/hr, consider 1 g Tylenol

Question 42

Sepsis Fluid Resus not working

Answer 42

Norepi 2-20 if not working Add: 0.03 u/min if not working Add: epi 2-20

Question 43

When to start using Vasopressin

Answer 43

If going beyond 8-10 mcg/min norepi

Question 44

Sepsis ABX

Answer 44

Ceftriaxone 2 g slow or in 100 cc wide open (immunocompetent) OR Cefepime 2 g in 100 cc wide open(immunocomprised)

Question 45

Stroke Labatalol when and how much?

Answer 45

SBP>185 or DBP>110, 10-20 mg IV over 1-2 min max 2 times

Question 46

No more than _____ reduction in MAP

Answer 46

20%

Question 47

MAP

Answer 47

(2D + S) / 3

Question 48

Lucid with precipitous LOC

Answer 48

Epidural hematoma

Question 49

Are prodomal symptoms serious?

Answer 49

No they indicate innocent etologies

Question 50

BB OD

Answer 50

3-10 mg Glucagon IV/IM followed by 3-5 mg/hr infusion

Question 51

TCA OD QRS stuff

Answer 51

>100 predctive of seizures >165 predictive of VT

Question 52

TCA OD Tx

Answer 52

Bicarb 1mEq/kg to maintain QRS <100 100-150 mEq in 1L of NS/D5 @ 100-200/hr

Question 53

Organophosphate/Carbamate OD

Answer 53

Atropine 2 mg IV q 5min 2PAM 600 mg

Question 54

Ped BB OD

Answer 54

1 mg glucagon iv/im

Question 55

Ped Narcan

Answer 55

0.1 mg/kg IV 2-3 min

Question 56

Atropine ped

Answer 56

0.02 mg q5min

Question 57

2 pam ped

Answer 57

25mg/kg

Question 58

Lorazepam ped

Answer 58

0.1 mg/kg

Question 59

Zofran ped

Answer 59

<40 kg 0.1 mg/kg >40 kg 4 mg IV