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EM Residency > PEER Review VIII > Flashcards

PEER Review VIII Flashcards

1
Q

Adrenal crisis in ptx w/ chronic adrenal insufficiency

A

Hypotension fails to respond to standard resuscitation

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2
Q

Prognostic indicator for Acute radiation syndrome (ARS)

A

Absolute lymphocyte count at 48hrs (1200 = good prognosis)

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3
Q

Most common causes of increased confusion in febrile elderly ptx

A

Respiratory, urinary or skin infxn

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4
Q

D-dimer is elevated, decreased or normal in primary fibrinolytic?

A

Normal

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5
Q

Hyperkalemia is present in primary or secondary adrenal insufficiency?

A

Primary

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6
Q

What’s the difference between cauda equina and conus medullaris syndromes?

A

Cauda equina - LMN lesion, lumbosacral radiculopathy, dermatomal distribution

Conus medullaris - UMN lesion, spinal cord compression, non-dermatomal

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7
Q

Most common bug in peritoneal dialysis infection

A

Staph epidermidis > Strep sp > E. coli and proteus > S. Aureus

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8
Q

Treatment for rebound hypoglycemia due to sulfonylurea poisoning

A

Dextrose + Octreotide, glucagon IM

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9
Q

Treatment for scabies

A

Topical permethrin

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10
Q

Cold water immersion syndrome

A

Syncope resulting from cardiac dysrhythmia on sudden contact w/ water that is at least 5C lower than body temp

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11
Q

Medications to help with alcohol craving

A

Naltrexone, Acamprosate, Disulfiram

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12
Q

Opportunistic infxns in HIV ptx

A

CD

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13
Q

Benefit of hyperbaric O2 therapy for CO poisoning

A

Reduce risk of delayed neurologic complication

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14
Q

Treatment for narcotic withdrawal

A

Clonidine patch

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15
Q

Goal of UOP in rhabdo w/ acute renal injury

A

3 ml/kg/hr

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16
Q

Txt of CCB poisoning

A

Calcium, glucagon, vasopressor, insulin + dextrose

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17
Q

STD treatment

A

Ceftriaxone 250 mg IM (or cefexime 400 mg PO) + Azithromycin 1g PO

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18
Q

Txt for acute angle closure glaucoma

A

Timolol 0.5% + Apraclonidine 0.1% + prednisolone 1% + Acetazolamide 500 mg PO or IV + Mannitol 1-2 g/kg IV

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19
Q

Most common type of primary headache

A

Tension headache

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20
Q

Caloric reflex test (oculovestibular response)

A

COWS nystagmus

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21
Q

What happens when a magnet is placed over a pacemaker?

A

Disable pacemaker sensor of native beats and set pacemaker to asynchronous fixed-rate mode

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22
Q

What is failure to capture of pacemaker?

A

Pacemaker impulses fail to trigger myocardial depolarization

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23
Q

Posterior fat pad sign on X-ray

A

SCH fx in kids and radial head dx in adults

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24
Q

Clonidine mimics overdose of what class of medication?

A

Opioid

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25
Q

Esophageal food bolus impaction treatment

A

2 doses of 1 mg glucagon, carbonated beverages, NTG

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26
Q

Factor VIII replacement should be done before or after CT head in a patient of hemophilia A with head trauma?

A

Before

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27
Q

Which part of skull is most likely to be fractured in infants?

A

Parietal > occipital, temporal > frontal (least likely)

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28
Q

What are the most effective treatment of heat stroke?

A

Evaporated cooling (fans and spray bottle) and ice water immersion

Placing ice packs on the axillae and groin (adjunctive)

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29
Q

Most common cause of death in pediatric trauma

A

Head injury

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30
Q

What is the early cardinal sign of flexor tenosynovitis?

A

Pain on passive extension of the finger (early), flexed position of the finger at rest, symmetric swelling of the finger, tenderness over the course of the flexor sheath

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31
Q

What can you see on the slit lamp with HSV infection?

A

Superficial corneal epithelial dendritic defect

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32
Q

What is the definition of simple febrile seizure?

A

Age (6 months to 5 yo), Duration (less than 15 min), Episode (1 episode in 24 hr period), location (generalized)

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33
Q

Treatments for tet spell

A

Prostaglandin E, phenylephrine, propranolol, morphine sulfate

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34
Q

Most common pathogen and monoarticular septic arthritis

A

Staph aureus

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35
Q

Which structure has the highest rate of infection due to animal bite?

A

Hand

36
Q

What is the absolute contraindication to succinylcholine?

A

Neuromuscular disease such as Myasthenia gravis

37
Q

Treatment for impetigo

A

Topical Mupirocin

38
Q

Calculation for factor VIII replacement in hemophilia A

A

Kg x % activity x 0.5

39
Q

What’s the location of stroke given these sx?

Coma, hypothermia, pinpoint pupils, loss of cornea reflexes, abnormal caloric response

A

Pon

40
Q

What condition causes a headache with Horner syndrome and contralateral stroke symptoms?

A

Carotid artery dissection

41
Q

What structure should be avoided when performing I&D of a peritonsillar abscess?

A

Carotid artery (2.5 cm behind and lateral to the tonsil)

42
Q

Which type of burn causes more injury to the eye? (Acid vs Alkaline)

A

Alkaline agents cause a liquefactive necrosis (continue to penetrate until removed).

Acid burn cause coagulation necrosis that limit penetration

43
Q

Which vitamin toxicity can cause intracranial hypertension?

A

Vitamin A

44
Q

What is the management of a button battery being lodged in the esophagus or stomach?

A

Emergency removal if it’s in the esophagus (alkaline injury can cause perforation to the esophageal mucosa)

discharge home and follow up next day if it is in the stomach (make sure it pass the pylorus in 48 hours)

45
Q

Spontaneous bleeding of hyphema can occur in pt with which condition?

A

Sickle cell disease (avoid acetazolamide)

- can use topical B-blocker to decrease IOP

46
Q

Which type of orbital fracture requires an emergent surgical consultation?

A

Orbital roof fracture (concomitant brain injury)

47
Q

What medication should you give patient with polycythemia in ED?

A

ASA (prevent stroke)

48
Q

Which type of lymphadenopathy is most likely to be associated with a serious underlying pathology?

A

Supraclavicular

49
Q

Which medication help with renal stones expulsion?

A

Tamsulosin and Nifedipine

50
Q

What is the effect of soma or carisoprodol?

A

Sedative-hypnotic agent (active metabolite meprobamate can cause myoclonus encephalopathy)

51
Q

What is the hallmark sign of Fournier gangrene?

A

Gas in the scrotal wall

52
Q

Treatment of subungual hematoma

A

Nail trephination (nail removal is necessary only if there is significant nail bed injury and an unstable fingertip)

53
Q

Treatment for inhalation anthrax (widened mediastinum, hilarious adenopathy and effusions on CXR)

A

IV Ciprofloxacin

54
Q

Which electrolyte abnormality cause adynamic (paralytic) small bowel ileus?

A

Hypokalemia

55
Q

Which disease has blood-and-thunder appearance of retina?

A

Central retinal vein occlusion (diffuse hemorrhages and dilated vessels)

56
Q

Most common cause of unilateral Bell palsy

A

HSV

57
Q

Most common cause of bilateral Bell palsy

A

Lyme disease

58
Q

Treatment for high altitude sickness syndrome

A

Ibuprofen, compazine, Acetazolamide, Dexamethasone

59
Q

Why should nitroprusside be avoided in event of ICH?

A

Increase ICP

60
Q

Most common organ injured by gunshot wound to abdomen

A

Small intestine > colon > liver

61
Q

Most common organ injured by stab wound to the abdomen

A

Liver > small intestine > diaphragm > colon

62
Q

What are the absolute contraindications to tPA?

A

Any prior hemorrhagic stroke, ischemic stroke within 3 months, active bleeding, known intracranial neoplasm, structural cerebral vascular malformation, suspected dissection/pericarditis

63
Q

How to differentiate between CCB and BB toxicity?

A

CCB toxicity causes hyperglycemia

64
Q

Txt for acute radiation proctocolitis

A

Analgesics and sulcrafate

65
Q

Pt taking linezolid should avoid which drugs?

A

MAO inhibitor (dextromethorphan, pseudoephedrine, serotonergic drug)

66
Q

Txt for Hirsprung disease in ED

A

Gastric and rectal decompression, Abx, IVF

67
Q

Most common cause of death in ptx with severe Parkinson’s disease

A

Respiratory failure

68
Q

Txt for bubonic plague

A

Streptomycin or gentamicin

69
Q

Most common zone of injury to penetrating trauma to the neck

A

Zone 2

70
Q

Most common cause of esophageal perforation

A

EGD

71
Q

What are the significant side effects of Venlafaxine?

A

QRS prolongation and convulsions

72
Q

Signs of scombroid poisoning

A

Facial flushing, throbbing headache, diarrhea, abdominal cramp

73
Q

Contraindication to Coude catheter

A

Hx or urethral strictures (creation of false tracts)

74
Q

Most common fracture in anterior shoulder dislocation

A

Hill-Sachs deformity (compression fx of posterolateral humeral head)

75
Q

Side effects of IVIG therapy

A

Vomiting, hypotension, seizure

76
Q

Which ophthalmologic disease associated with temporal arteritis?

A

Central retinal artery occlusion (CRAO)

77
Q

What is the most reliable sign of uterine rupture during labor?

A

Non-reassuring fetal heart rate patterns

78
Q

What are the absolute contraindications to the use of succinylcholine?

A

Ischemic stroke, myopathy

79
Q

Spontaneous pneumothorax is mostly closely associated with which pathogen in HIV patient?

A

Pneumocystis Jiroveci

80
Q

Most common neurovascular injury in posterior elbow dislocation

A

Ulnar nerve > brachial artery

81
Q

Which anti-epileptic medication is ineffective in controlling lithium-induced seizures?

A

Phenytoin

82
Q

What treatment should be added to bactrim in Pneumocystis Jiroveci with PaO2

A

Steroids for 3wks

83
Q

What is the most common cause of Ludwig angina?

A

Dental abscess

84
Q

Triad ymptoms of Wernicke encephalopathy

A

encephalopathy, opthalmoplegia and ataxia

85
Q

What is the primary reason to use HBO therapy in common monoxide poisoning?

A

Delay neurologic complications

86
Q

Common medications that can induce serotonin syndrome

A

Dextromethorphan, Lithium, Tramadol, Linezolid

87
Q

EKG abnormalities in SAH

A

Deep T-wave inversion, U wave, QT prolongation

EM Residency (1 decks)

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