Week 2

Question 1

ABX for concern of bowel perf

Answer 1

Piperacillin-tazobactam 3.375 g

Question 2

Treatment of hernia if reducible or incarcerated without signs of strangulation:

Answer 2

Attempt reduction
–pain control
–allow gravity to assist
– cool compress or ice pack over the hernia

Complications: reduction of necrotic bowel, bowel injury, and incomplete reduction

If there is evidence of strangulation (critical appearance, evidence of obstruction, overlying skin change):
Consult Surgery for urgent operative intervention. Do not attempt

Question 3

Treatment of hernia If there is Evidence of strangulation:

Answer 3

critical appearance, evidence of obstruction, overlying skin change

Consult Surgery for urgent operative intervention.

Do not attempt

Question 4

Painless Vision loss categories

Answer 4

• Detachment (retinal)
• Vascular (CRAO, CRVO)

Question 5

Central Retinal Artery Occlusion Exam

Answer 5

• afferent pupillary defect
• Pale white portion of the involved retina, with a cherry red fovea

Question 6

Central Retinal Artery Occlusion Treatment

Answer 6

Currently, no standard guideline-endorsed therapies exist.

Question 7

Fundoscopic exam reveals multiple retinal hemorrhages, termed “blood and thunder.”

Answer 7

Central retinal vein occlusion

Question 8

Every Eye complaint should get these exams

Answer 8

-Visual Acuity
- IOP
- Visual Field

Question 9

In CO poisonings, hyperbaric oxygen indications include:

Answer 9

• Hypotension
• Coma/seizure
• Ischemia/dysrhythmias
• Focal neurologic exam
• cerebellar signs
• Carboxyhemoglobin >25% or >20% (in pregnancy)
• AMS
• acidosis (severe pH <7.1)

Question 10

First step to an airway case

Answer 10

Airway repositioning/ suction

Question 11

Difficult airway case should always include this step

Answer 11

Chric set up

Question 12

Face trauma should always get what imaging

Answer 12

Face CT

Question 13

The Parkland formula

Answer 13

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 14

_____ is the preferred paralytic for RSI in GBS.

Answer 14

Rocuronium

Question 15

Atropine dosing for bradycardia

Answer 15

Atropine 0.5-1 mg IV q3-5min
max dose 3 mg

Question 16

Bradycardia- overdose/medication toxicity

Answer 16

• Glucagon bolus followed by continuous infusion
• Calcium chloride 1 g or calcium gluconate 3 g
• High-dose insulin
• IV lipid emulsion

Question 17

If patient does not respond to atropine or transcutaneous pacing, administer:

Answer 17

Epinephrine 20-50 µg IV bolus
or
Epinephrine 2-10 µg/min IV infusion

Question 18

Asthma- adjunct treatments to decrease the likelihood of intubation for refractory symptoms

Answer 18

-magnesium sulfate 2 g

-β2-agonist therapy
–subq Terbutaline
–IM epinephrine 0.3 mg

Question 19

SJS treatment with ____________ appears to be the most widely accepted therapy.

Answer 19

IV immunoglobulin (IVIG)

Question 20

____________ is safe and possibly effective in the treatment of cocaine associated chest pain.

Answer 20

Nitroglycerin