Miscellaneous

Question 1

What could be the cause of refractory hypertension?

Answer 1

Renal Artery Stenosis.

Question 2

In a patient with tension pneumothorax what is a key exam finding?

Answer 2

Trachial deviation.

Question 3

What eye signs are associated with someone on cocaine?

Someone on opioids?

Answer 3

Mydriasis (dilated pupils): cocaine

Mitosis (pinpoint pupils): opioids

Question 4

Normal lab values:
Na
Potassium
Bicarbonate
PCO2

Answer 4

135-145.
3.5-5.
18-22.
35-45

Question 5

What causes orthostatic hypotension?

Answer 5

Usually secondary to dehydration and need IV fluids.

Question 6

What is this drug: ondansetron

Answer 6

Zofran. Dexamethosone enhances effectiveness using with cancer drugs when N/V occurs.

Question 7

What is the test of choice for a low protest probability of a DVT?
What is the test of choice for an intermediate to high probability?

Answer 7

D-diner assay.

Compression US of lower extremity

Question 8

When suspecting restless leg syndrome in a patient, what screening lab should be ordered?

Answer 8

Ferritin as iron deficiency is a common cause of secondary RLS.

Question 9

Superior Vena cave syndrome has what signs?

What is this most commonly associated with?

Answer 9

Facial & upper arm swelling and cyanosis.

Small cell carcinoma of the lung or non Hodgkins Lymphoma.

Question 10

What is the antiphospholipid antibody syndrome?

Answer 10

Body makes antibodies that attack phospholipids(fat) that are found in blood cells and lining of blood vessels. The damage causes blood clots to form in the arteries and veins leading to: stroke, AMI, DVT, PE; in prego can lead to multiple miscarriages or premature birth due to eclampsia

Question 11

What is Nt-BNP lab test used for?

Answer 11

Used to evaluate dyspnea as either from heart failure or a pulmonary issue.
A normal level excludes heart failure. Elevated level indicated heart failure.

Question 12

What are the MCC of orthostatic hypotension?

What are examples of each cause?

Answer 12

Medications: ACEI, CCB, diuretics, tricyclics
hypovolemia: blood loss, excessive diuresis, adrenal insufficiency(Addison’s)
autonomic insufficiency: caused by DM

Question 13

How do you differentiate between hypovolemia and autonomic insufficiency as the underlying cause of orthostatic hypotension?

Answer 13

Hypovolemia:  a compensatory increase in HR will occur when the BP decreases in the standing position.
Autonomic insufficiency(DM):  a significant decrease in BP when standing without a compensatory increase in HR.

Question 14

What treatment is given for alcohol withdrawal?

Answer 14

Benzos for withdrawal seizures, Thiamine.

No antipsychotics.