Week 4

Question 1

Preeclampsia is defined as

Answer 1

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

Question 2

Eclampsia is defined as

Answer 2

development of seizures in a patient with preeclampsia.

Question 3

HELLP syndrome is defined as

Answer 3

the clinical presentation of hemolysis, elevated liver enzymes, and low platelet count.

Question 4

Diagnostic criteria for DKA include the following

Answer 4

• BGL >250 mg/dL
• Anion gap >17
• pH ≤7.3
• Bicarbonate ≤18

*sodium-glucose cotransporter-2 inhibitors have a higher risk of developing euglycemic DKA.

Question 5

Unique DKA labs

Answer 5

• ABG
• ## Beta-hydroxybutyrate

Question 6

DKA Therapeutic Considerations

Answer 6

• Fluids are initial treatment always
  then
  -Check the potassium level:
  K ≥3.3 –> start insulin
  K <3.3 mEq/L–> replenish potassium before initiating insulin infusion.

Question 7

Parkland Formula

Answer 7

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 8

STE in II,III, AVF
location

Answer 8

Inferior

STD AVL

STE in II,III, AVF
location

Question 9

STE V1and V2
Location

Answer 9

Septal

STD V5 V6

STE V1and V2
Location

Question 10

I, aVL, V5-V6 STE

Answer 10

Lateral MI

Question 11

Thrombotic thrombocytopenic purpura pneumonic

Answer 11

FAT RN

Fever, Anemia, Thrombocytopenia, Renal, Neuro Symptoms

All features DO NOT need to be present at the same time

Consider diagnosis without the full pentad

Question 12

ATLS ABCs- A

Answer 12

Secure airway, if indicated:
GCS <8, inability to protect airway, or concomitant facial/neck trauma.

Drug assisted/ RSI is preferred

Anticipate potential upcoming events, injury evolution, or need for pain control that might lead to compromised airway, and secure airway prior to decompensation (eg, facial bleeding, cervical spine injury).

Question 13

ATLS ABCs- B

Answer 13

BREATHING
Rapidly treat any suspected or known pneumothorax or hemothoraces.
Place a chest tube (28-32 French per Advanced Trauma Life Support 10 guidelines).

Question 14

ATLS ABCs- C

Answer 14

CIRCULATION
Shock may be Hemorrhagic, neurogenic, cardiogenic, or obstructive.

-Perform a FAST

-Control hemorrhage with pressure dressings or tourniquets

-Consider pelvic binder

-Avoid high-volume crystalloid- 1 L of LR total is recommended (per Advanced Trauma Life Support 10 guidelines).

• Transfuse blood products in a 1:1:1 ratio of packed red blood cells (PRBCs) : fresh frozen plasma (FFP) : platelets.

-Patients with clear evidence of significant hemorrhage who present within the first 3 h after injury should receive TXA

Question 15

ATLS ABCs- D

Answer 15

DISABILITY
-Rapid neurological assessment.
-GCS, neurological exam, brainstem reflexes, and pupillary exam results.
- cervical collar and cervical spine precautions

-If concern for elevated intracranial pressure (ICP):
Elevate head of bed to 30°
-Administer 3% sodium chloride for acute ICP management (500 mL can be bolused).
-If acute decompensation, then give mannitol (1-1.5 g/kg bolus).
-Request neurosurgical consult.

Question 16

ATLS- ABCs- E

Answer 16

EXPOSURE
Roll patient to evaluate injuries to the back and examine the axilla and groin.

Question 17

TTP age group

Answer 17

TTP is much more common in adults than children.

Question 18

TTP CBC findings

Answer 18

Severe thrombocytopenia (<30 × 109/L) and hemolytic anemia, as demonstrated by schistocytes on peripheral smear

PT/INR, PTT, Coombs, and fibrinogen are typically normal (unlike DIC).

Question 19

TTP rx

Answer 19

the removal of anti-ADAMTS-13 antibodies and replacement of ADAMTS-13 with emergency plasma exchange therapy

Question 20

If the QRS complex is ________________ AV nodal blockers should be avoided.

Answer 20

widened (or of changing morphology) or the rhythm is irregular