Obj. 1 - 14 miscellaneous

Question 1

What is the difference between primary and secondary surveys in a trauma?

Answer 1

Primary survey: identify and manage life-threatening conditions
Secondary survey: Head to toe assessment for other injuries

Question 2

What 5 things are in Lactated Ringer’s?

Answer 2

sodium
chloride
lactate
potassium
calcium

Question 3

What is the Glasgow Coma Scale score for a dead patient?

Answer 3

3

Question 4

What are the 3 elements of the Glasgow Coma Scale?

Answer 4

Eye opening
Verbal response
Motor response

Question 5

What is the TIMI score used to assess?

Answer 5

risk of death/ischemic events in unstable angina/NSTEMI patients

Question 6

What are the Wells criteria used to assess?

Answer 6

risk of developing DVT/PE

Question 7

What is the APACHE score used to assess?

Answer 7

estimate of ICU mortality

Question 8

What is SIRS?

What are the SIRS criteria?

Answer 8

Systemic Inflammatory Response Syndrome
1. Body temp > 100.4
2. HR > 90
3. RR > 20
4. WBC high or low, or left shift
Two or more of the criteria = SIRS
If source of infection is identified, then SIRS is then called sepsis.

Question 9

What is shock?

Answer 9

when blood flow cannot meet the metabolic demands of the body

Question 10

What is the cause of the problem in ‘hypovolemic’ shock?

Answer 10

~not enough juice = low preload = low stroke volume = low cardiac output
(hemorrhage, burns, vomiting, third spacing)

Question 11

What is the cause of the problem in ‘distributive’ shock?

Answer 11

~juice is out in the suburbs instead of downtown where it’s needed - due to LOW systemic vascular resistance
~sepsis, anaphylaxis, vasodilator drugs, acute adrenal insufficiency

Question 12

What is the cause of the problem in ‘obstructive’ shock?

Answer 12

~mechanical obstruction of blood flow = low preload

~tension pneumothorax, pericardial tamponade, valvular stenosis

Question 13

What is the cause of the problem in ‘cardiogenic’ shock?

Answer 13

~intrinsic factors that reduce cardiac output, usually poor contractility
~MI, dysrhythmia

Question 14

Name 4 possible causes of anion gap metabolic acidosis

Answer 14

~renal failure (e.g. uremia)
~lactic acidosis (e.g. sepsis)
~ketoacidosis (e.g. DKA, starvation)
~poison (e.g. methanol, ethylene glycol/antifreeze)

Question 15

What toxic substance syndrome is this:
~agitated, anxious, increased BP, dilated pupils
~cocaine, amphetamines, ephedrine

Answer 15

sympathomimetic syndrome

Question 16

What toxic substance syndrome is this:
~comatose/obtunded, pinpoint pupils
~barbiturates, benzos, EtOH, opioids

Answer 16

sympatholytic syndrome

Question 17

What toxic substance syndrome is this:
~bradycardia, miosis, diaphoresis, excess salivation, incontinence
~organophosphates

Answer 17

cholinergic syndrome

Question 18

What toxic substance syndrome is this:
~tachycardia, dilated pupils, dry skin, urinary retention
~atropine, antihistamines

Answer 18

anticholinergic syndrome

Question 19

What toxic substance syndrome is this:
~MYOCLONUS, hyperthermia, diaphoresis, confusion
~MAOI, SSRI

Answer 19

serotonin syndrome

Question 20

What terrorist attack is this?
~Progressive, symmetric, DESCENDING weakness starting in cranial nerve muscles, then neck, arms, legs
~e.g. starts with blurred vision, diplopia, dysphagia, dysphonia
~antitoxin available

Answer 20

botulism

Question 21

What’s the average time from onset to death with inhaled anthrax?

Answer 21

3 days

Question 22

What’s the drug treatment for Yersinia pestis?

Answer 22

streptomycin or gentomycin