still Flashcards
right-mainstem intubation results in ____________ on cxr
opacification of the left lung secondary to unilateral lack of ventilation.
pathology in hemithorax appears as __________, rather than air density (not a pneumothorax) on cxr
hyperdensity
Regarding the epidemiology of asthma in the United States, which of the following is true?
- Incidence is comparable for Caucasians and African-Americans
- Etiology is thought to be genetic, not environmental
- Prevalence increased in the 1980’s, and then decreased in the 1990’s
- More common in males than females in adult and pediatric populations
-Prevalence increased in the 1980’s, and then decreased in the 1990’s
Pulsus paradoxus is defined as ?
a fall in systolic blood pressure of greater than 10mm Hg upon inspiration
Which of the following is correct regarding the use of corticosteroids in acute asthma exacerbation?
- Beneficial effects occur within the first hour of administration.
- Intravenous steroids are superior to the oral route
- Tapering is needed with all corticosteroid regimens
- Inhaled steroids should be avoided
-Inhaled steroids should be avoided
Which of the following is true regarding the treatment of acute asthma exacerbation in the Emergency Department?
- Anticholinergics by inhalation may be beneficial
- Intravenous albuterol may be indicated
- Heliox should only be used in the intubated patient.
- Intramuscular terbutaline is preferred over intravenous
Anticholinergics by inhalation may be beneficia
___________, is a well-recognized occurrence in PNA and should be sought out to ensure appropriate antibiotic coverage.
Co-infection with multiple bacteria, such as Chlamydia and S. pneumoniae
Which of the following patients is the most likely to develop S. pneumoniae pneumonia?
- 65 year old woman with no past medical history
- 59 year old woman who is a cigarette smoker.
- 61 year old man with hypertension
- 64 year old man with type 2 diabetes
-64 year old man with type 2 diabetes
Varicella zoster virus (VZV), the etiologic agent of chicken pox, more commonly presents as__________ in adults, especially smokers or pregnant women
pneumonia
Ventricular fibrillation is primarily treated with defibrillation. If three successive shocks and epinephrine have been given, the next line agent would be ?
an antiarrhythmic, such as lidocaine or amiodarone.
45 year old male presents to the emergency department with CP. While you are talking to him he becomes unresponsive. The monitor shows ventricular tachycardia. The correct sequence of treatment is:
A. amiodarone
B. intubation
C. central venous access
D. epinephrine
E. immediate defibrillation up to three times
immediate defibrillation up to three times
Unstable VT is treated by a series of three stacked shocks, before medications. Early defibrillation is the key to successful resuscitation
optimal dosing of drugs administered endotracheally has not been established, but __________ the IV route is generally accepted
2-2 1/2 times
Epinephrine remains the adrenergic drug of choice in the ACLS guidelines- recommended ________ dose. Doses >1 milligram are not recommended and may be harmful.
the administration of 1 milligram IV or IO of a 1:10,000 solution every 3 to 5 minutes
asystole treatment of choice is
epinephrine or vasopressin and atropine
complete AV block
tno relationship between the P waves (atrial beats) and the ventricular beats.
The latter arises from different foci, thus the QRS complex is wide (impulse is not conducted through the normal pathways) and the rate is often slow at < 50/minutes.
Complete heart block is common in the setting of ischemia and also in the peri-infarct period. The treatment for complete AV block in this setting is usually ____________.
permanent pacing
An 82 year old man presents from the nursing home with fever, cough, nausea, vomiting and diarrhea. His vitals signs are T 102, P 65, BP 100/50, RR 24, and SpO2 92%. The most likely causative organism is:
Legionella -atypical pathogen commonly causing pneumonia. It is often found in the elderly or others with co-morbid illnesses. It is classically associated with GI symptoms and relative bradycardia.
Klebsiella is not a common cause of community-acquired pneumonia. It generally occurs in the elderly, smokers, alcoholics, and those with other co-morbidities. It is classically associated with a bulging fissure on chest X-ray and ____________
currant jelly sputum.
_________ is the most common cause of community- acquired pneumonia. Viral is the second most common cause.
Streptococcus pneumoniae
44 year old male presents with fever, cough and shortness of breath. He is a nonsmoker. He has a lobar infiltrate on CXR.
A 25 year old female presents with fever, productive cough, and shortness of breath. Physical exam reveals T101, RR 24 and SpO2 of 94%. Her left tympanic membrane is inflamed and there are TM bullae. The chest X-ray reveals a large right middle lobe pneumonia. The organism most commonly associated with this type of presentation is
Mycoplasma pneumoniae is a common cause of pneumonia in young adults. It is classically associated with bullous myringitis.
Regarding the role of malignancy in the diagnosis of pulmonary embolism (PE)
25% of PE patients without identifiable risk factors are diagnosed with cancer within 2 years
esophageal and laryngeal cancer, leukemia and lymphoma have a low incidence of PE
ovarian or colon cancers are at higher risk for developing PE- 30% of patients who die of ovarian cancer have PE.
Chemotherapy _______ the risk of developing PE.
increases
Pulseless electrical activity in Emergency Department cardiac arrest victims is associated with ______ in 33%
PE
pneumonia caused by Klebsiella pneumoniae complications
Abscess formation, empyema and bacteremia are frequent complications, and the mortality rate is high
____ causes more deaths worldwide than any other infectious agent.
TB
T/F ?
Cytomegalovirus does not usually cause pneumonia in immunocompetent adults
true
