Miscellaneous

Question 1

How is mild hypothermia managed (32-35 C)?

Answer 1

Passive external warming (e.g. removal of wet clothing, cover with blankets). Can give warmed crystalloid for hypotension

Question 2

How is moderate hypothermia managed (28-32 C)?

Answer 2

Active external warming (e.g. warm blankets, heating pads, warm bath). Can give warm crystalloid

Question 3

How is severe hypothermia managed (<28 C)?

Answer 3

Active internal warming (e.g. warmed pleural or peritoneal irrigation, warmed humidified oxygen). Can give warmed crystalloid for hypotension.

Question 4

What are good equations for remembering compensation for acid-base disorders (4 equations)?

Answer 4

• Met acidosis: PaCO2=1.5 (HCO3-) + 8 ± 2
• Met alkalosis: ↑PaCO2 by 0.7 mmHg for every 1 mEq/L rise in serum HCO3-
• Acute resp acidosis: ↑Serum HCO3- by 1 mEq/L for every 10 mmHg rise in PaCO2
• Acute resp alkalosis: ↓Serum HCO3- by 2 mEq/L for every 10 mmHg decrease in PaCO2

Question 5

What are the major complications of refeeding syndrome?

Answer 5

Edema, heart failure, seizures

Question 6

How is intraocular pressure evaluated?

Answer 6

Gonioscopy is the gold standard (slit lamp looks at the iridocorneal angle).
Tonometry is not quite as good but measures IOP.

Question 7

A diet heavy in what food puts patients at risk for niacin deficiency (pellagra)?

Answer 7

Corn (niacin in corn is not absorbable)

Question 8

What is the management of exertional heat stroke vs nonexertional (or classic) heat stroke?

Answer 8

Exertional: Ice-water immersion, fluids.
Nonexertional: evaporative cooling (e.g. spraying lukewarm water while fans blow air on pt’s skin) - nonexertional tends to occur in the elderly. Ice water immersion is associated with increased mortality in these patients

Question 9

What is CREST syndrome?

Answer 9

Calcinosis cutis, Raynaud phenomenon, esophageal dysmotility with reflux, sclerodactyly, and telangiectasia

Question 10

What are the criteria for metabolic syndrome?

Answer 10

At least 3/5:

1. Abdominal obesity (M >40in, F >35 in)
2. Fasting glucose >100-110
3. Blood pressure >130/80
4. Triglycerides >150
5. HDL M < 40, F < 50

Question 11

What medication has been found to be helpful for treating amyloidosis?

Answer 11

Colchicine

Question 12

What are lab findings in cholesterol crystal embolism?

Answer 12

Elevated serum creatinine, eosinophilia, hypocomplementemia. May have WBCs and eosinophiluria on UA. Skin or renal biopsy shows biconvex, needle-shaped clefts within occluded vessels

Question 13

What are complications of heat stroke?

Answer 13

ARDS, rhabdo, renal failure, and DIC