Week 3

Question 1

Parkland Formula

Answer 1

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 2

should generally be avoided in patients with new onset of an evolving neurological syndrome.

Answer 2

Succinylcholine

This is due to the risk of hyperkalemia. Depolarizing paralytics

Question 3

Pulmonary function test for GBS indictaing need for intubation

Answer 3

Forced expiratory volume <20 mL/kg
Negative inspiratory force <30 cm H20

Question 4

Guillain-Barré syndrome treatment

Answer 4

IVIG or plasma exchange

Neurology colleagues should be involved early once the diagnosis is suspected to help mobilize these resources or arrange for them elsewhere.

Question 5

_____ is the preferred paralytic for RSI in GBS.

Answer 5

Rocuronium

Question 6

Atropine dose

Answer 6

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

Question 7

Bradycardia- overdose/medication toxicity

Answer 7

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

Question 8

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

Answer 8

-magnesium sulfate 2 g

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

Question 9

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

Answer 9

IVIG

Question 10

___________ is the first line therapy for cocaine chest pain

Answer 10

benzos

Question 11

Cocaine: Consider ___________ for pts with ischemic changes on EKG with persistent HTN after 1st line therapy as beta blockers are contraindicated

Answer 11

IV phentolamine

Question 12

Status Epilepticus algorithm

Answer 12

1st- Benzo
2nd- Kepra
3rd- Ketamine/ Phenobarb
4th- Propofol

Question 13

Post perirectal ID management

Answer 13

Sitz baths
Stool softeners
Wound dressings/ packing change

Question 14

Special labs for ETOH case

Answer 14

Poc BGL
OSM gap
Anion gap
Co-ingestions

Question 15

Eclampsia, for systolic BP ≥160 mm Hg or diastolic BP ≥110 mm Hg, give antihypertensives:

Answer 15

Labetalol 20 mg IV or
Hydralazine 5-10 mg IV

Aim to stabilize BP ≤160/90 mm Hg.

Question 16

Seizure ppx in Eclampsia

Answer 16

magnesium sulfate:
4-6 g IV over 20 minutes –> infusion of 2 g/h.

*If the patient seizes, give an additional 2 g IV bolus.

*monitor reflexes

Question 17

Preeclampsia is defined as

Answer 17

new-onset HTN after 20 weeks gestation
-plus-
proteinuria or signs of end-organ dysfunction.

Question 18

Eclampsia is defined as

Answer 18

development of seizures in a patient with preeclampsia.

Question 19

________ is the clinical presentation of hemolysis, elevated liver enzymes, and low platelet count in pregnancy

Answer 19

HELLP syndrome

HELLP is considered a variant of preeclampsia with severe features.

Question 20

Standard Naloxone dose

Answer 20

0.4 mg IV,l IM, IN, or IO every 5 minutes

or

2 mg if the initial response is inadequate and repeat 2 mg as needed.