Week 1

Question 1

Iron Overdose Treatment

Answer 1

-Decontamination
——Whole bowel irrigation facilitates removal of iron from the (GI) tract prior to absorption.

-Chelation
——Early treatment with IV deferoxamine:
———Symptomatic patients (intractable vomitus, metabolic acidosis, lethargy, hypotension, or signs of shock/end-organ injury)

———Serum iron concentration >500 μg/dL (>89.5 μmol/L)

Question 2

Key Meds in penetrating trauma

Answer 2

TDAP
Antibiotics (ancef)
Pain control
TXA

Question 3

Often missed exam

Answer 3

Neuro
Rectal

Question 4

Post intubation steps

Answer 4

Vent
Foley
Sedation

Question 5

If acute cholangitis is suspected, ______________ is the preferred imaging modality.

Answer 5

CT with IV contrast

Question 6

Cholangitis vs Cholecystitis consults

Answer 6

Cholangitis:
Consult GI for urgent ERCP

Cholecystitis:
Consult general surgery or interventional radiology for either a cholecystectomy or temporizing percutaneous cholecystostomy.

Question 7

Severe cholecystitis antibiotics

Answer 7

piperacillin-tazobactam 3.375 g IV q6h
plus
vancomycin loading dose of 25-30 mg/kg IV

Question 8

All potential surgical cases need these labs

Answer 8

Type and screen
Co-ags

Question 9

Trauma chest tube size

Answer 9

28-32

Question 10

Hypotension parameters are as follows:
Term neonates (0-28 days old)
Systolic BP (SBP) < _______ mm Hg

Answer 10

Systolic BP (SBP) <60 mm Hg

Question 11

Hypotension parameters are as follows:
Infants (1-12 months old)
SBP < ________mm Hg

Answer 11

SBP <70 mm Hg

Question 12

Neonatal Sepsis Meds

Answer 12

-10-20 mL/kg rapid 0.9% NS

• ampicillin
  plus
• cefotaxime or gentamicin

consider
- acyclovir for suspected neonatal herpes
- adding vancomycin (Some use vancomycin for all cases of late-onset neonatal sepsis)

Question 13

Hypotension parameters are as follows:
Children 1-10 years old
SBP <______ mm Hg

Answer 13

SBP <70 + (2 age) mm Hg

Question 14

The rule of 50- Hypoglycemia

Answer 14

D10- 5 mL/kg
D25- 2 mL/kg
D50- 1 mL/kg

Note that all three, when multiplied, equal 50 (e.g. 5ml/kg x 10 = 50)

Question 15

Hypotension parameters are as follows:
- in term neonates (0-28 days old)
- in infants (1-12 months old)
- in children 1-10 years old
- in children ≥10 years old

Answer 15

Systolic BP (SBP) <60 mm Hg in term neonates (0-28 days old)
SBP <70 mm Hg in infants (1-12 months old)
SBP <70 + (2 age) mm Hg in children 1-10 years old
SBP <90 mm Hg in children ≥10 years old

Question 16

Hypotension parameters are as follows:
Systolic BP (SBP) <60 mm Hg in ____________

Answer 16

term neonates (0-28 days old)

Question 17

Boerhaave’s Syndrome Management should include

Answer 17

Pain control
PPI
Broad-spectrum abx (vanc/ zosyn)
NPO
Early consultation with specialists (GI, ENT, or CT surg)
ICU admit

Question 18

Acute-angle closure glaucoma treatment

Answer 18

Timolol - 1 drop every 30 minutes × 2 in the affected eye only
Apraclonidine 0.5% 1 drop every 30 minutes × 2 in the affected eye only
Acetazolamide 500 mg
Mannitol 1-2 g/kg if no response to other medications
*Mannitol is contraindicated in renal failure or pulmonary edema, and caution with CHF.

Measure IOP q60 min to determine the response to treatment.

Once the IOP has decreased, apply to affected eye only:
Prednisolone acetate 1% 1 drop every 15 minutes × 4

If medical therapy is unsuccessful–> emergency surgery or laser iridotomy.

Question 19

Parkland Formula

Answer 19

Fluid requirement in 24 hours is as follows:
= 4ml x TBSA (%) x body weight (kg)
50% given in first eight hours
50% given in next 16 hours.

Question 20

_____ is the preferred paralytic for RSI in GBS.

Answer 20

Roc