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Emergency Medicine > Rosh questions > Flashcards

Rosh questions Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

“weakness with overhead activity”

A

rotator cuff tear

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2
Q

Supraspinatous movement

A

Abduction

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3
Q

infraspinatous movement

A

ER

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4
Q

teres minor movement

A

ER

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5
Q

subscapularis

A

IR

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6
Q

pain with reaching up back; brushing hair

A

rotator cuff tear

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7
Q

+ drop arm

A

rotator cuff

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8
Q

+ empty can test

A

rotator cuff

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9
Q

+ neer test

A

rotator cuff

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10
Q

+ hawkins

A

rotator cuff

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11
Q

Congenital cardiac malformation associated with maternal lithium use

A

Ebstein’s anomaly

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12
Q

stable SVT tx

A

vagal (valsalva, cold water) –> adenosine

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13
Q

unstable SVT

A

cardiovert

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14
Q

Pounding pulses with machine like murmur

A

PDA

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15
Q

PDA radiates to?

A

back

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16
Q

What do you use to close a PDA?

A

indomethicin

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17
Q

back pain better with flexion, worse with extension?

A

spinal stenosis

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18
Q

pneumothorax: tactile fremitus

A

decresed

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19
Q

pneumothorax: resonance

A

hyper-resonance

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20
Q

in a tension pneumothorax the trachea deviates?

A

away from affected side

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21
Q

what is the most commonly damaged intra-abdominal structure in blunt abdominal trauma?

A

spleen

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22
Q

What do you do if you have a positive FAST exam?

A

CT scan

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23
Q

unstable + negative FAST?

A

repeat fast or DPL

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24
Q

unstable + positive FAST?

A

laparotomy

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25
Q

gold standard for management of intra-abdominal bleeding following trauma?

A

lapartotomy

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26
Q

what is the active ingredient in anti-freeze?

A

ethylene glycol

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27
Q

anti-freeze/ethylene glycol OD CM?

A

early: N/V, CNS depression
Late: anion gap metabolic acidosis, hypocalcemia, kidney failure, maltese crosses

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28
Q

antidote for anti-freeze/ethylene glycol OD?

A

fomepizole

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29
Q

MCC of anterior knee dislocation?

A

MVA

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30
Q

Knee instability in multiple directions?

A

anterior knee/tibiofemoral dislocation

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31
Q

Tx of anterior knee dislocation

A

immediately reduced

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32
Q

Likely structures damaged in anterior knee dislocation?

A

common peroneal nerve; popliteal artery

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33
Q

When is reduction CI in knee dislocation?

A

“dimple sign” which indicates posterolateral dislocation

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34
Q

Posterolateral knee dislocation tx

A

immediate open reduction

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35
Q

MCC of atlanto-occipital dislocation?

A

high-speed MVA

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36
Q

MC population for atlanto-occipital dislocation?

A

children

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37
Q

closure of PDA begins when what increases in the immediate post-natal period?

A

bradykinin

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38
Q

HCM inheritance pattern?

A

AD

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39
Q

crescendo-decrescendo pattern loudest over LLSB

A

HCM

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40
Q

ECG of HCM?

A

LV hypertrophy, prominent septal Q waves

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41
Q

Tx of HCM?

A

avoid activity, BB

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42
Q

MC presenting symptom of HCM?

A

dyspnea on exertion

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43
Q

MCC of SCD in young athletes

A

HCM

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44
Q

Heat stroke body temp

A

> 104 F

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45
Q

heat stroke symptoms

A

AMS, organ damage, anhidrosis

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46
Q

Tx heat stroke

A

whole body cooling and IV fluids

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47
Q

heat exhuastion temp

A

100-103

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48
Q

heat exhuastion symptoms

A

dehydration, N/V, weakness

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49
Q

heat exhaustion tx

A

fans, oral water

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50
Q

heat cramps symptoms

A

muscle cramping of calves/abdomen

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51
Q

heat cramps tx

A

oral water

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52
Q

lead poisoning can present like?

A

microcytic anemia

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53
Q

Basophilic stippling of RBC with GI/CNS symptoms

A

lead poisoning

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54
Q

tx for lead poisoning

A

succimer (sucs to eat lead)

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55
Q

What type of bursitis occurs commonly in runners?

A

pes anserinus

56
Q

what muscles insert at pes anserinus?

A

gracillis, sartorius, and semitendinosus

57
Q

anterior medial knee pain below joint like and TTP over bursa

A

pes anserinus

58
Q

benzo antidote

A

flumazenil

59
Q

APAP antidote

A

N-acetylcysteine

60
Q

opioid antidote

A

naloxone

61
Q

WPW (narrow) stable tx

A

1) vagal

2) adenosine

62
Q

unstable WPW (narrow) tx

A

synchronized cardiovert

63
Q

antidromic (wide complex) tx

A

procainamide

64
Q

WPW in pregnancy tx

A

sotalol or flecainide

65
Q

myocarditis can result in what type of cardiomyopathy?

A

dilated

66
Q

gold standard for diagnosing myocarditis

A

endomyocardial biopsy

67
Q

first line meds for prevention/tx of OA

A

bisphosphonates (alendronate, ibandronate, risedronate, zoledronic acid)

68
Q

iron is directly corrosive to?

A

GI mucosa

69
Q

When should you get serum levels of iron OD?

A

4 hours after ingestion

70
Q

Brugada syndrome is assoc with what arrythmia?

A

V. fib

71
Q

MC arrythmia associated with TCA tox

A

sinus tach

72
Q

pupils in TCA OD?

A

mydriasis

73
Q

TCAs result in what toxic syndrome?

A

anticholinergic

74
Q

antidote for TCAs?

A

sodium bicarb

75
Q

Scleroderma: crest syndrome?

A

calcinosis, raynaud’s, esophageal dysmotility, sclerodactyly, telangiectasias

76
Q

ductal-dependent cardiac lesion

A

coarctation of the aorta

77
Q

Temporal arteritis tx?

A

no vision loss: prednisone

Vision loss: methylprednisolone IV

78
Q

anterior/posterior fat pad in adults?

A

radial head fx

79
Q

anterior/posterior fat pad in kids?

A

supracondylar fx

80
Q

Increased ventricular chamger with normal or reduced wall thickness

A

dilated cardiomyopathy

81
Q

Only BB proven in HF

A

bisoprolol, carvedilol, metoprolol

82
Q

MC cardiomyopathy

A

dilated

83
Q

what types of bites should close by secondary intention?

A

animal bites on hands and feet

84
Q

MC long bone fx

A

tibia

85
Q

MC cancers presenting as spinal cord compression

A

lung, prostate, breast

86
Q

when should you think spinal cord compression?

A

LBP + history of CA

87
Q

What tool is used with APAP toxicity?

A

Rumack-Matthew Nomogram

88
Q

When is Rumack-Matthew Nomogram used?

A

4 hours after APAP toxicity

89
Q

If after 8 hours of ingestion of APAP?

A

give 140 mg/kg loading dose N-acetylcysteine

90
Q

SE of NAC?

A

anaphylactoid rx

91
Q

How many steps in Ottawa ankle rules?

A

4 steps

92
Q

How many cm in Ottawa ankle rules?

A

distal 6 cm

93
Q

Burn with no blisters

A

1st degree

94
Q

burn with blisters

A

superficial partial thickness (2nd degree)

95
Q

burn that is white, leathery, and painless

A

deep partial thickness (second degree)

96
Q

full-thickness = what degree?

A

third

97
Q

parkland formula:

A

4 mL/kg x % total BSA

50% in first 8 hours, remainder over 16 hours

98
Q

Bilateral facet dislocation occurs with what MOI?

A

hyperflexion of neck

99
Q

What med should be considered in patients with chronic stable angina who remain symptomatic despite optimal agents of BB, CCB, nitrates?

A

ranolazine

100
Q

First line tx of tension pneumo

A

thoracostomy at 2nd ICS and midclavicular line with chest tube placement

101
Q

Tx to remove fluid from pleural space?

A

thoracocentesis

102
Q

How many doses is human rabies immunoglobulin?

A

one dose

103
Q

How many doses is the inactivated rabies vaccine?

A

4x over 14 d

104
Q

Not-previously vaccinated w/ rabies exposure

A

RIG 10 U/kg infiltrate wound

Vaccine 1 mL IM delt day 0, 3, 7, 14

105
Q

Previously vaccinated w/ rabies exposure

A

RIG not indicated

Vaccine 1 mL IM delt day 0, 3

106
Q

MC congenital heart disease

A

VSD

107
Q

What rabies treatment is never given alone?

A

human rabies immunoglobin

108
Q

AMS CM?

A

HA + GI upset, weakness, fatigue, dizzy, lightheadedness, insomnia

109
Q

AMS tx?

A

stop ascent, supportive care (APAP, ibuprofen)

-Acetazolamide, oxygen

110
Q

High altitude cerebal edema?

A

ataxia, confusion, AMS

111
Q

high altitude cerebral edema tx?

A

immediate descent

112
Q

Cyanotic congenital heart diseases start wtih what letter?

A

T

113
Q

Common spinal fx in football?

A

Jeferson fx

114
Q

Acute SCFE CM?

A

ER deformity, limited ROM at hip, inability to bear weight

115
Q

chronic SCFEE CM?

A

dull, achy pain in hip, groin, thigh, or knee

116
Q

OD on BB tx?

A

atropine

117
Q

What cholesterol med can exacerbate gout?

A

Niacin

118
Q

Calcaneal apophysiitis?

A

Sever disease

119
Q

apophysitis of tuberosicty of 5th metatarsal

A

Islen’s

120
Q

Salicilate toxicity (ASA) acid/base

A

metabolic acidosis and respiratory alkalosis

121
Q

OD with v/d, fever, tinnitus, and vertigo

A

ASA/salicylate

122
Q

antedote for salicilate toxicity (ASA)

A

sodium bicarb

123
Q

Organophosphate toxicity results in what toxidrome?

A

cholinergic

124
Q

cholinergic mneumonic

A

SLUDGE: salivation, lacrimation, urination, diarrhea, GI cramps, emesis
DUMBBELLS: diarrhea, urination, MIOSIS, brady, bronchospasm, emesis, lacrimation, lethargy, salivation/seizure

125
Q

organophosphate treatment

A

1) decontamination
2) atropine
- pralidoxime is definitive antidote

126
Q

proximal humerus fracture tx

A

immobilization

127
Q

common n injured in proximal humerus fracture

A

axillary

128
Q

Acetaminophen toxicity stages

A

I: <24 hours; anorexia N/V
II: 1-3 d; transaminitis, increased INR, increased bilirubin, RUQ pain
III: 3-4 d: multiorgan failure, coma, death
IV: 4d-2 weeks: resolution

129
Q

Hyphema categories:

A

I: <1/3
II: 1/3 - 1/2
III: >1/2
IV: total anterior chamber volume

130
Q

What EKG findings show concern for left main coronary artery?

A

ST elevation in aVR >1 mm or greater than the elevation seen in the ST segement of V1

131
Q

PCI contact to device time

A

90 minutes

132
Q

Non-PCI center: transfer if contact to device can be less than?

A

120 minutes

133
Q

non-PCI center: thrombolytics if contact to device >

A

120 minutes

134
Q

thrombolytics in x minutes of ED arrival, if selected

A

30 minutes

135
Q

Meperidine eyes?

A

causes miosis, but in cases of toxicity, unlike other opioids, causes mydriasis in cases of toxicity

136
Q

Hematoma more likely to be associated with concurrent brain injury and parenchymal damage?

A

subdural hematoma

Emergency Medicine (7 decks)

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