Rosh 5

Question 1

Yellow tags in MCIs

Answer 1

given to patients that have a respiratory rate less than 30, a radial pulse or capillary refill less than 2 seconds, and are able to follow commands.

Question 2

In which subset of chest pain patients are beta blockers contraindicated?

Answer 2

Patients with cocaine-induced chest pain.

Question 3

JONES criteria

Answer 3

Rheumatic Fever

Joints, Oh, no carditis!, Nodules, Erythema marginatum, Sydenham’s chorea

Question 4

anterior shoulder (glenohumeral) dislocation and the ——— nerve is a common concomitant injury.

Answer 4

axillary

Question 5

A positive Thompson test is the physical examination finding of a __________

Answer 5

ruptured Achilles tendon
examiner squeezes the calf muscles and if the Achilles tendon is intact, passive plantar flexion should occur at the ankle joint.

Question 6

C1 fracture is also called

Answer 6

Jefferson fracture

In this fracture, an axial or vertical compression force is transmitted downward through the occipital condyles, producing a burst fracture which forces the lateral masses of C1 apart.

Question 7

A Hangman fracture refers to a fracture of _________, and is associated with an extension mechanism.

Answer 7

both pedicles of C2

Question 8

A __________ is an avulsion off the end of one of the lower cervical spinous processes.

Answer 8

clay-shoveler fracture

This injury develops when extreme flexion against contracted posterior erector spinal muscles results in fracture of the tip of the spinous process. It is considered a stable fracture.

Question 9

A __________ refers to a fracture of both pedicles of C2, and is associated with an extension mechanism.

Answer 9

Hangman fracture

Question 10

A flexion teardrop fracture results from extreme flexion, with fracture of the ____________.

Answer 10

anterior inferior portion of the vertebral body, the teardrop

this injury usually disrupts the anterior and posterior ligamentous structures, it is often associated with neurologic injury and is highly unstable.

Question 11

A Hangman fracture refers to a fracture of both pedicles of C2, and is associated with _______ mechanism.

Answer 11

an extension

Question 12

Jefferson/Burst Fracture basics

Answer 12

Patient will be a football player or diver
With a history of trauma via axial loading
Most commonly caused by burst fracture of C1
Treatment is a halo
Comments: Unstable fracture

Question 13

Pneumocystis pneumonia: The greater the elevation of __________, the worse the prognosis.

Answer 13

lactate dehydrogenase (LDH)
Serum LDH has a greater sensitivity (approximately 90%) in Pneumocystis jiroveci pneumonia but a poor specificity.

Question 14

Pneumocystis Pneumonia (PCP)

Answer 14

Patient with a history of HIV
CD4 < 200, increased LDH
CXR will show bilateral infiltrates (bat wing pattern)
Treatment is TMP-SMX

Question 15

__________ is the treatment of choice for hereditary angioedema.

Answer 15

C1 esterase inhibitor concentrate

An alternative treatment is fresh frozen plasma, which contains C1 esterase inhibitor, among other components of plasma.

Question 16

Approximately how long will nerve blocks last if 1% lidocaine without epinephrine is used?

Answer 16

30-60 minutes.

Question 17

Thyroid storm basics

Answer 17

Thyroid Storm
• Patient with a history of thyrotoxicosis
• Complaining of tachycardia, hyperpyrexia, agitation, anxiety
• PE will show goiter, lid lag, hand tremor, and warm, moist skin
• Labs will showlowTSH andhighfree T4 or T3
• Most commonly caused by an acute event
• Treatment is:
◦ 1) beta blocker (propranolol)
◦ 2)thionamide(propylthiouracil or methimazole)
◦ 3) iodine solution
◦ 4) glucocorticoids

Question 18

A hyphema is defined as:

Answer 18

A hyphema is defined as blood in the anterior chamber of the eye.

Question 19

Trauma in pregnancy

Answer 19

• MVC > domestic violence > fall
  
  • Left lateral decubitus to prevent supine hypotension syndrome
  • Ultrasound, Kleihauer-Betke test
  • RhoGAM