the ants go marching

Question 1

____________ are all complications of shock

Answer 1

DIC, ARDS, ATN, and high-output CHF

Question 2

Fever in a child less than 30 days can be a marker for bacteremia, sepsis, and meningitis. Clinical findings are notoriously unreliable in this age group. The work up is?

Answer 2

Blood culture, urine culture and LP are required.

Question 3

acute myocardial infarction is defined by two of

Answer 3

• clinical history of chest pain of at least 20 minutes duration
• EKG changes
• positive myocardial enzyme testing.

Question 4

MI drugs fxn

Answer 4

• O2, nitroglycerin and morphine will increase O2 delivery to the heart
• beta blocker will decrease the work of the heart
• aspirin will inhibit platelets.
• heparin if no contraindication
• glycoprotein IIb/IIIa-inhibitor should also be administered

Question 5

Fibrinolytic therapy is indicated for patients with STEMI (as a reperfusion option) if ?

Answer 5

• time to treatment is <6 to 12 hours from symptom onset

- ECG has at least 1-mm ST-segment elevation in two or more contiguous leads.”

Question 6

____________ is the best means to diagnose right ventricular infarction with the ECG.

Answer 6

“Application of “right-sided” precordial leads

Question 7

Aortic dissection rx

Answer 7

Sodium nitroprusside- blood pressure control in dissections as it is an easily titratable antihypertensive

nitroprusside increases heart rate –> may increase shearing forces, beta blocker should be started before (or concurrently with) it.

Question 8

Unstable angina

Answer 8

angina at rest

Question 9

stable angina

Answer 9

angina w/ exertion

Question 10

Rx for dresslers syndrome

Answer 10

NSAIDs

Question 11

Mobitz type 2

Answer 11

constant long PR always

Dropped beats

Question 12

malignant htn is aka

Answer 12

htn emergency
htn crisis

*elevated BP w/ optic edema

Question 13

Westermark sign

Answer 13

sign that represents a focus of oligemia (hypovolemia) (leading to collapse of vessel) seen distal to a pulmonary embolism (PE).

seen in 2% of PE

Question 14

In the face of an AMI, the risks of complete heart block are much greater when new or preexisting bi- or trifascicular conduction blocks are present. In this setting, ____________ is indicated

Answer 14

prophylactic placement of a ventricular demand pacemaker

Question 15

In SAD CAGES is a screening mnemonic for ?

Answer 15

symptoms- not causes- of major depression.

Question 16

Interferon alfa has been associated with?

Answer 16

CNS side effects, including anhedonia, fatigue, anorexia, impaired concentration, sleep disturbance, and suicidal ideation.

*Pretreatment with SSRIs appears to be an effective strategy to minimize depression induced by interferon alfa.

Question 17

Suicide risk among men shows a bimodal distribution with increased risk between the ages of?

Answer 17

15 and 24 and after age 65

Question 18

Suicide risk among women peaks after age?

Answer 18

60

Question 19

Most people who commit suicide suffer from ?

Answer 19

alcoholism
or
15-20% major depression
10% schizophrenia 
40% panic disorder 
also PTSD

Question 20

“SAD PERSONS” scale is used to determine ?

Answer 20

suicide risk

S: Male sex → 1
A: Age 15-25 or 59+ years → 1
D: Depression or hopelessness → 2
P: Previous suicidal attempts or psychiatric care → 1
E: Excessive ethanol or drug use → 1
R: Rational thinking loss (psychotic or organic illness) → 2
S: Single, widowed or divorced → 1
O: Organized or serious attempt → 2
N: No social support → 1
S: Stated future intent (determined to repeat or ambivalent) → 2

Question 21

Silent Suicide

Answer 21

an act of slowly killing oneself by nonviolent means, such as starvation or non-compliance with essential medical treatment

most common in elderly patients and frequently goes unrecognized. Such patients may present to the emergency department repeatedly because of non-compliance with treatment of their medical disorders

Question 22

Occult Suicide

Answer 22

applied to self-destructive acts disguised as accidents and should be suspected in those who have “accidental” self-inflicted gun shot wounds, and in those who “unintentionally” overdose, or who fall from a height.

Question 23

Chronic Suicidal Behavior

Answer 23

consists of recurrent self-destructive acts

Question 24

Parasuicide

Answer 24

attempted suicide, which is seen more as a gesture than a serious act.