PBL Quiz 1

Question 1

All patients with ACS + ongoing pain should be treated with

Answer 1

FONAS
Fluids
Oxygen (<90)
Nitro
ASA 325
Statin

Question 2

Tx for UA/NSTEMI

Answer 2

Dual + anticoagulant
BB
Nitro

Question 3

Tx for STEMI

Answer 3

Dual + anticoagulant
BB
Reperfusion
ACEI for long-term

Question 4

Tx for inferior/posterior wall MI

Answer 4

Dual + anticoagulant
Reperfusion

Avoid Morphine, nitro, CCB
Caution with BB

Question 5

Tx for cocaine-induced or prinzmetal MI

Answer 5

Benzo (Lorazepam) or CCB

BB should be avoided

Question 6

Standard HF treatment long-term

Answer 6

ACEI or ARB, BB, diuretic (Furosemide)
add spironolactone if needed

Question 7

Acute tx for HF

Answer 7

IV furosemide
seated position
supplemental oxygen
mechanical ventilation

Question 8

pericarditis tx

Answer 8

colchicine + NSAIDS

glucocorticoids instead of NSAIDs if contraindications

Question 9

tx aortic stenosis

Answer 9

aortic valve replacement
intraaortic balloon pump and percutaneous aortic valvuloplasty until replacement

Question 10

tx aortic regurgitation

Answer 10

after load reducers - ACEI, ARBs, Nifedipine, Hydralazine

replacement or repair

Question 11

tx mitral stenosis

Answer 11

percutaneous balloon valvuloplasty - best in young w noncalcified valves
otherwise - do valve replacement

Question 12

tx mitral regurg

Answer 12

after load reducers - ACEI, ARB, Hydralazine, Nifedipine)

repair > replacement

Question 13

tx MVP

Answer 13

reassurance + BB

Question 14

management pneumothorax (watered down)

Answer 14

first episode + small + stable - observation + supplemental oxygen w nonrebreather mask

large - needle or catheter aspiration - 2nd intercostal space midclavicular

unstable - chest tube thoracostomy - 5th intercostal space mid to anterior axillary line

Question 15

how would you define stability for pneumothorax

Answer 15

RR < 24
HR < 120 and > 60
O2 > 90%
Normal BP
Able to speak in full sentences

Question 16

how would you define a small pneumothorax

Answer 16

</= 3 cm at apex
</2 cm at hilum

Question 17

MC cause SVC syndrome

Answer 17

small cell bronchogenic CA

Question 18

sx SVC

Answer 18

facial, neck, upper extremity edema
facial plethora
chest pain
respiratory sx
neurologic sx
dyspnea (MC sx)

Question 19

mc cause of Lambert eaten myasthenic syndrome

Answer 19

small cell lung CA

Question 20

sx lambert eaten

Answer 20

proximal muscle weakness that improves w repeated use
dry mouth
postural hypoTN
erectile dysfunction
hyporeflexia
sluggish pupillary response
NO MUSCLE ATROPHY

Question 21

MC cause superior sulcus (Pancoast) tumors

Answer 21

non-small cell lung CA

Question 22

sx superior sulcus (Pancoast) tumors

Answer 22

shoulder and arm pain - may radiate to head and neck
weakness and atrophy of muscles of hand or arm
ulnar neuropathy

Question 23

what is prominent in anterior shoulder dislocation

Answer 23

acromion

Question 24

seizures - sodium channel blockers

Answer 24

phenytoin
carbamazepine
oxcarbazepine
eslicarbazepine
lamotrigine
lacosamide
rufinamide

Question 25

seizures - GABA enhances

Answer 25

Barbiturates
benzos
tiagabine
vigabatrin

Question 26

seizures - glutamate receptor blockers

Answer 26

perampanel
felbamate

Question 27

seizures - drugs that interfere with/block calcium channels

Answer 27

ethosuximide - T type
Gabapentin, pregabalin

Question 28

MOA Valproate

Answer 28

enhances GABA
inhibits glutamate and NMDA receptors
increases refractory period of voltage-gated sodium channels

Question 29

first line for focal and secondarily generalized seizures

Answer 29

Lamotrigine
Carbamezpine
Oxcarbazepine
Levetiracetam

Question 30

first line for primary generalized tonic clonic, atypical absence, myoclonic, atonic seizures

Answer 30

valproate
lamotrigine
levetiracetam

Question 31

screening for lung CA

Answer 31

annual low dose CT between 50-80 if 20 pack year hx or quit within 15 years