Resp/Cardiac/Acute/ Nicu

Question 1

3. Teenager took 15 tabs of an oral hypoglycemic and hospitalized. 48 hours later is
   stabilized. Demanding to leave. She is homeless and lives on the street. What is her greatest risk factor for repeated suicide attempt?

a. Mechanism of suicide attempt b. Female
c. Being alone
d. Spontaneous suicide attempt

Answer 1

Consensus: D

The greatest RF is a) previous hx, impulsivity

Question 2

7. 12 yo F, menarche, multiple days of heavy bleeding, soaking through multiple pads. No FHx bleeding disorder. She is now having to change pads every 1 hour. Management?

. D&C

b. High dose OCP
c. Some other hormone related thing d. Tranexamic acid

Answer 2

ocp

Question 3

Description of an anorexic teenage girl. What would be the most likely finding on ECG?

d. a. peaked T waves e. b. prolonged QT
f. c. right axis deviation g. d. ST elevation

Answer 3

Consensus: A (prolonged QT)
Vandermorris says prolonged QT is what is typically taught and what should be chosen on exam for now… but both Nelson’s and UTD say that the QT is usually normal and more likely to see PR prolongation or ST changes

Question 4

011, Question 11. A 15 year-old girl presents with a 6 month history of 8 kg weight loss. She does not have any other symptoms. She is not bothered by the weight loss and has no difficulties with eating. She is doing well in school, participates in gymnastics 5 times per week, is happy and has a good family life. On exam, her HR is 70 bpm and her BP is
100/60. Her BMI is 15 kg/m2. She has a normal physical exam. You request a CSF (colony stimulating factor), electrolytes, urea, creatinine, ferritin and albumin, and they are all normal. What should you do next:

Answer 4

1. Request anti-TTG and a small bowel xray
2. Consult a dietitian and a psychologist (isn’t this more active?!)
3. Admit for observation
4. Ask her parents to monitor her diet and to reduce her physical activity
   Consensus: D