Zebra Conditions

Question 1

What is the presentation for a AAA?

Answer 1

Men over the age of 50, women over the age of 60
Pain in the back, flank, abdomen or groin that is unaffected by position.
A boring pain or piercing pain
A pulsatile abdominal mass

Question 2

What is the ancillary study of choice for a AAA?

Answer 2

abdominal aorta ultrasound

CT is used to DDx a leaking or ruptured AAA

Question 3

What is the cut off for dilation and aneurism?

Answer 3

3.8cm (normal is 2 cm)

Question 4

What is the management for a AAA?

Answer 4

Emergent referral when there are symptoms
Urgent referral when >6cm seen on x-ray with only back pain
Semi-urgent referral when >6cm seen on x-ray with no symptoms
Nonurgent referral when <6cm with LBP and no red flags

Question 5

What % of AAA lead to rupture?

Answer 5

1/3

Question 6

What is the prognosis of AAA?

Answer 6

Long term prognosis is often effected by other health problems and comorbidities.

Question 7

What is the risk of death if a 6cm AAA is untreated?

Answer 7

At 1 year 25%, at 5 years 50%

Question 8

What is the risk for death of an untreated AAA greater than 6cm?

Answer 8

At 1 year 50%, at 2 years 75%, at 5 years 90%

Question 9

What is the presentation for cauda equina syndrome?

Answer 9

Urinary retention, bladder dysfunction, loss of sexual function, saddle paresthesia

Question 10

What are commonly the causes of CES?

Answer 10

Midline disc herniations, spinal stenosis, tumor or SOL

Question 11

What is the ancillary study of choice to DX a CES?

Answer 11

MRI

Question 12

What is the management for CES?

Answer 12

Urgent referral to a neurologist. Emergent is rapid onset of symptoms.

Question 13

What is the prognosis for CES?

Answer 13

Heavily depends on how long they were symptomatic: hindrances to full recovery include delayed treatment, wide loss of sensation, rapid onset

Question 14

What are the contraindications to giving nitroglycerin?

Answer 14

BP <90

Question 15

What is the management for a suspected cardiac patient?

Answer 15

Monitor vitals,
calm and reassure the patient,
stay with the patient and instruct someone to get help/ aspirin/ AED/ call 911 as needed,
Give nitroglycerin unless contraindicated
Chew an aspirin
Apply oxygen if in shock
Apply AED/CPR as necessary

Question 16

What is the correct dosage for aspirin in a suspected heart attack?

Answer 16

325 mg

Question 17

What is the presentation of MI?

Answer 17

3Ds in the PNW

Diaphoresis, dyspnea, dizziness, syncope, palpitations, nausea, weakness

Question 18

What removes the suspicion that chest pain is not due to cardiac?

Answer 18

if pain is modifiable or reproducible

Question 19

What causes a VAD?

Answer 19

damage to the vertebral artery from turning the head, car accidents, or a vasospasm. a CTM may also cause the damage

Question 20

What is Wallenberg syndrome

Answer 20

Occlusion of the posterior inferior cerebellar artery

Question 21

What is locked in syndrome?

Answer 21

When the patient is paralyzed but conscious

Question 22

What are the symptoms of a VAD?

Answer 22

5D and 3N

Dizziness, dysphasia, drop attacks, dysarthria, diplopia, ataxia, nausea, numbness (of one side of the body), nystagmus

Question 23

What is the treatment for a VAD?

Answer 23

Call 911

Question 24

What is the risk of an untreated DVT?

Answer 24

A pulmonary emboli

Question 25

What is the risk of death in a DVT?

Answer 25

95% of pulmonary emboli are from DVT and 30% are fatal

Question 26

Are distal or proximal DVTs more common?

Answer 26

Proximal, in the popliteal

Question 27

What are risk factors for DVTs?

Answer 27

Recent surgery, immobilization

Question 28

What is the classic presentation for a DVT?

Answer 28

Painful, swollen, red, tender leg

Question 29

What is virchow’s triad?

Answer 29

Immobilization, damaged blood vessels, hypercoagulable state

Question 30

What are wells criteria rules for DVT?

Answer 30

If less than 2, DVT is unlikely
If greater than 6 high probability
If less likely order a d-dimer to rule out pulmonary embolism

Question 31

What does a positive d-dimer tell you?

Answer 31

That the patient needs to get a CT angiogram

Question 32

What is the management for a DVT?

Answer 32

Urgent referral for anticoagulants- after it is under control-
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