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121 Cards in this Set

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what are the 2 primary treatments of PSVT?

cardizem
narcan
defibrillation
cardioversion
adenosine
cardioversion and adenosine
what is the MC dysrhythmia in kids?

psvt
afib
vtach
vfib
psvt
_ is a transitional dysrhythmia between NS and A fib. Usually the rate is between 240-350 bpm.

vfib
a fib
a flutter
psvt
a flutter
A pt presents with SOB, you notice a murmur, you ask the pt to squat and during that the murmur fades what is it?

Aortic stenosis
HOCM
pericarditis
anteroseptal MI
Hocm
a pt with sudden, painless vision loss in which you see a cherry red spot with or without exudates/hemorrhage superior to the optic disc. what are you worried about?

central retinal vein occlusion
central retinal artery occlusion
central retinal artery occlusion
kerley B lines =?

COPD
CHF
pneumonia
atelectasis
CHF
_ vertigo has vertical nystagmus.

peripheral
central
central, less intense insidious onset, is constant and not positional
_ vertigo is sudden in onset, positional, may or may not have hearing issues, can have horiz/vert/rotational nystagmus.

peripheral
central
peripheral
checking the corneal reflex with a cotton wisp is testing

V1 of trigeminal for motor and VII for sensory

V1 of trigeminal for sensory and VII for motor
V1 of trigeminal for sensory and VII for motor
With vertical nystagmus, a _ lesion in brainstem or cerebellum must be ruled out.

peripheral
central
central
_ is distal weakness that works it way proximally, it is symmetrical, with c/o numbness & tingling to extremities.

MS
MG
Guillain-Barre syndrome
ALS
Guillain-Barre Syndrome
deafness, vertigo & tinnitus =??

labrynthitis
vertigo
BPPV
meniere's
meniere's
weakness of the extensor hallucis longus, decreased sensation over the lateral aspect of the calf and first web is recognized as _

L4
L5
S1
S3
L5
What is the MC dysrhythmia in kids?

vtach
vfib
psvt
sinus tach
psvt
If a pt has ST elevation in II, III, and AVF, what is it?

inferior MI
anterior MI
lateral MI
posterior MI
inferior MI
if a pt presents with vertical nystagmus what type of vertigo is this?

peripheral
central
lateral
central: a lesion in the brainstem or cerebellum must be ruled out
V1 of the trigeminal nerve is responsible for the _ corneal reflex (with cotton wisp).

sensory
motor
sensory; the facial nerve VII is responsible for motor
A pt presents with progressively worsening distal weakness that is working its way proximally, it is symmetric and assoc with n/t. What is it?

MS
MG
Guillian Barre
ALS
Guilian Barre syndrome
A 7 y.o. comes in with a limp c/o hip and groin pain, an xray shows a widenin of the hip joint space.What is it?

SCFE
legg calves perthes
adrenal crisis
legg-calves perthes
What is the MCC of adrenal crisis?

roid OD
addison's disease
stopping steroids too suddenly
stopping steroids too suddenly
a 77 y.o. female, post fall comes in with leg shortening, is held in adduction and internal rotation. What are you thinking?

posterior hip dislocation
anterior hip dislocation
lateral hip dislocation
posterior hip dislocation
what process is MC found in 10-15 y.o. males that are usually obese, if found in a female it tends to be bilateral.

SCFE
legg calves perthes
hip fracture
cellulitis
SCFE: typically obese with a limp, external rotation, thigh/knee pain that is worse with activity.
What must you be concerned about with Legg-Calve-Perthes disease?
AVN of femoral head, >in males ages 3-10 with an antalgic gait.
A pt presents with a high fever a rash that first presented on the hands and feet and is working its way proximally what is it and what do you treat it with?
RMSF and Doxy
A warm, red tender area with poorly demarcted borders that is spreading is most likely ?

erisypelas
cellulitis
carbuncle
furuncle
cellulitis-treat with 1st generation cephalosporins
A 67 y.o. woman presents iwth an erythematous, shiny area of warm and tender skin on her face with a well-demarcated and indurated advancing border, what is it?

cellulitis
erysipelas
impetigo
abscess
erytipelas-IV antibiotics
what is the hallmark of ethylene glycol toxicity?

Ca gluconate crystals
uric acid crystals
ca oxalate crystals
ca oxalate crystals
which psych meds can cause sudden death?

SSRI
SNRI
TCA
TCAs
_ are contraindicated in cocaine toxicity due to unopposed alpha stimulation can cause hypertension

alpha blockers
beta blockers
CCB's
nitrates
beta blockers
what is the treatment of aortic aneurysm/dissection?
labetolol 0.25mg IV. & nitroprusside 0.3=10ug/kg/min
what is the MC organ damaged with blunt trauma?

large colon
small colon
liver
spleen
spleen
what is the MC organ damaged with penetrating trauma?

large colon
small colon
liver
spleen
liver
what is the most reliable symptom of compartment syndrome?

pulselessness
pain
poikilothermia
parasthesia
parasthesias
what is the hallmark of ethylene glycol toxicity?

confusion
hematuria
ca oxalate crystals in urine
unresponsiveness
ca oxalate crystals in the urine
t/f

charcoal is the TOC of ethylene glycol toxicity.
false; it is of limited benefit, infusion of ethanol or fomepizole inhibit toxic pathway, dialysis if level >25
where is IO access in kids?

proximal tibia
proximal fibula
distal fibula
distal tibia
kids=proximal tibia
what is placement of choice for an IO in an adult?
distal tibia
sickle cell is a vasocclusive crisis, what is the treatment?
hydration and pain control
t/f

the TOC with TTP is platelet transfusion.
FALSE!!! plasmaphoesis, FFP and pRBC's
is heparin intrinsic or extrinsic
intrinsic-VII, IX, X, XI, XII
what factors are vitamin K dependent?
2, 7, 9, 10
Mad as a hatter
blind as a bat
red as a beet
hot as a hare
dry as a bone..what is it?

cholinergic OD
anticholinergic OD
opiate OD
Sympathomimetic OD
anticholinergic OD
a pt presents with respiratory acidosis, constricted pinpoint pupils, what do you think it is?

sympathomimetic OD
opiate OD
cocaine OD
asa OD
opiate OD
what common 3 things cause respiratory alkalosis? ABC....
amphetamines
beta agonists
cocaine
at what level is APAP toxic?

50mcg/ml
100mcg/ml
150mcg/ml
200mcg/ml
150mcg/ml at this level treat with NAC 140mg/kg then 70mg/kg x17 doses
MCC of sudden cardiac death in adults is?

vtach
psvt
asystole
vfib
vfib-defibrillate
what is the tx of stable vtach?

cardioversion
verapamil
amiodarone
cardizem
amiodarone
what is the tx of unstable vtach?
cardiovert, if pulseless defibrillate
what is the tx of choice for unstable aflutter?

defib
digoxin IV
cardioversion
amiodarone
synchronized cardioversion
what is the TOC of stable aflutter?

cardioversion
amiodarone
digoxin
diltiazem
diltiazem
Where do you perform a needle decompression on a pneumothorax ?
2nd ICS mid-clavicular line
tx of frostbite?
active rewarming, analgesia, elevation, tetanus
t/f

eclampsia occurs up to the time of delivery
false; can occur up to 10 days after delivery
a pt presents with a red, swollen and painful great toe joint. Aspirate of the joint shows negative bifringement crystals. What do you think?

gout
cellulitis
pseudogout
gout-
A pt shows with pain in the hip joint that is red, swollen and warm, joint aspirate shows positive bifringement crystals. What is it?
pseudogout
A 69 y.o. female presents with excertional dyspnea, angina and one episode of syncope this morning. You note a cresendo-decresendo murmur on auscultation. What type of murmur do you have?

Aortic Stenosis
Aortic Regurg
Mitral Stenosis
Mitral Regurg
aortic stenosis
What is the MC location for an esophageal FB in adults? In kids?
adults-LES
kids-cricopharyngeous muscle
What is the 1st and 2nd MCC of SBO's in adults?
1st-adhesions
2nd-incarcerated hernias
what is the MC and frequent manifestation of gout?
podagra
a pregnant woman with an opened cervical os that is bleeding is considered?

missed Ab
threatened Ab
inevitable Ab
incomplete Ab
inevitable Ab
an opened cervix with incomplete passage of fetal contents is ?

missed Ab
threatened Ab
inevitable Ab
incomplete Ab
incomplete Ab
a pregnant woman has retained deceased fetal tissue after abortion is ?

missed Ab
threatened Ab
inevitable Ab
incomplete Ab
missed Ab
what is the mainstay of treatment of a PE?

thrombolytics
anticoagulants
thrombic pumps
anticoagulants
Mi's are a result of __ vs ___.
coronary artery plaque rupture vs vasospasm
blood at the urethral meatus is virtually diagnostic for _ injury and demands early imaging before catheter placement.

prostatic
urethral
ureteral
spermatic cord
urethral
a pt who has been at the beach all day presents c/o dizziness, nausea, H/A and diaphoresis. what do you think?

heat stroke
heat exhaustion
heat exhaustion

heat stroke would have core temp >104, altered mental status, anhydrosis, and elevated transaminases
what is the MC affected valve by endocarditis from IV drug use?

aortic
mitral
tricuspid
tricuspid
the inability to retract foreskin over glans (proximally) is called?

phimosis
paraphimosis
phimosis
the inability to reduce proximal foreskin over glans (distally).

phimosis
paraphimosis
paraphimosis
t/f

diverticulosis does not commonly cause bloody stools
false; it does
MC location for c-spine fracture?

C1
C3
C5
C7
C5
MC site for spinal subluxation?
C5 on C6
MC location for compartment syndrome?
anterior tibial
non-bilious vomiting, forceful vomiting in kids?

gastritis
esophagitis
pyloric stenosis
gastric outlet obstruction
pyloric stenosis
All of the following are appropriate treatments of ITP except ?

IVIG
FFP
platelet infusion
Steriods (prednisone)
not FFP
which of the following is the most important preventative measure in the prevention of wound infection?

sterile technique
wound irrigation
prophylactic antibiotics
wound irrigation
which of the following bugs is most commonly implicated in meningitis of pt's 2mo-50y.o.?

h. flu
s. pneumo
n. mening.
s. pneumo
An HIV pt presents with a seizure what are you most concerned about?

intercranial lesion
meningitis
intercranial lesion
A 4 y.o. presents with colicky abdominal pain and vomiting with "dark jelly like" diarrhea. What is it?

adhesions
SBO
intusseception
appendicitis
crohn's disease
intussuception
foamy, foul smelling vaginal d/c with a pH of >5.5 is ??

trich
BV
candida
trich
What is the formula for figuring out Anion Gap?

Na+(Ca + HCO3)
Na-(Ca + HCO3)
K+(Ca+HCO3)
K-(Ca+HCO3)
Na-(Ca + HCO3)
What is the normal Anion Gap?
< or equal to 12 to 14
what is the tx of torsades?

adenosine
cardizem
magnesium
digoxin
magnesium
what is the 1st course of action in a pt with high potassium?

insulin
glucose
ca gluconate
kayexalate
ca gluconate
the MC presenting sign of an elderly women with an MI?

chest pain
chest pressure
dyspnea
diaphoresis
dyspnea
aspirin toxicity would cause?

metabolic acidosis
metabolic alkalosis
respiratory acidosis
respiratory alkolosis
A & C
A & D
B & C
A & B
metabolic acidosis & respiratory alkalosis

A & C
intra-uterine pregnancies are seen on transvaginal ultrasound at what beta hcg level?

250-500
500-750
1000-1500
>6000
1000-1500
if you have a pt with pelvis injuries and blood at the urethral meatus, what is the TOC before placing a foley cath?

IVP
ultrasound
retrograde urethrogram
retrograde urethrogram
The GCS on a pt that opens eyes to verbal command, localizes pain, and converses but is disorientated is?

13
14
15
12
12

3=opens eyes to verbal command
5=localizes pain to painful stimulus
4=disorientated but converses
_ cord syndrome is seen with full or partial loss of bilateral pain and temperature sensation and paraplegia. Often with flexion injuries and carries a poor prognosis.

posterior cord syndrome
anterior cord syndrome
central cord syndrome
brown-sequard syndrome
anterior cord syndrome
_ cord syndrome is usually seen with hyperextension injuries. This is characterized by weakness greater in the upper extremities than the lower, and distal is worse than proximal.

posterior cord syndrome
anterior cord syndrome
central cord syndrome
brown-sequard syndrome
central cord syndrome
A 70 year old male presents to the ER after a whiplash injury. He ambulates in well but has an extremely weak handshake. What is it?

posterior cord syndrome
anterior cord syndrome
central cord syndrome
brown-sequard syndrome
central cord syndrome
what is the MC type of odontoid fracture?

1
2
3
4
type 2. Involves only the base of the dens
hypotension, JVD, and muffled heart sounds is called _ triad.

Beck's
Connor's
Treet's
Beck's
A 19 y.o. male presents to the ER with a stab wound to the chest from a knife, he c/o dyspnea. Absent left breath sounds. What is it?
pneumothorax
Your pt comes to the ER with a stab wound to the left chest, dyspnea but his lungs are clear. He is hypotensive and has JVD.
What are you thinking about?
cardiac tamponade
A 25 y.o. female presents after a high speed MVA with dyspnea and tachycardia. There is local bruising over the right side of her chest. The CXR shows a right upper lobe consolidation. What is it?

cardiac contusion
pulmonary emboli
pulmonary contusion
cardiac tamponade
pulmonary contusion
The most frequently injured sold organ associated with blunt trauma is the _.

small bowel
spleen
liver
spleen
the most frequently injured solid organ associated with penetrating trauma is the _.

small bowel
large bowel
liver
spleen
liver
what is the treatment of a pneumothorax?
tube thoracostomy
pt presents with stroke symptoms of syncope & weakness, which artery would be involved?

basilar
cerebellar
cerebral
basilar
pt presents with stroke symptoms of HA, N & V and central dizziness. Which artery is involved?

basilar
cerebellar
cerebral
cerebellar
which artery is MC involved in the stroke process?

middle cerebral
vertebrobasilar
basilar
cerebellar
middle cerebral artery
which value of the following requires further workup and treatment in the scenario of an ischemic stroke?

serum glucose >200
MAP 76
SBP 90
serum glucose, you want it below 150.
what is the best class of meds to use in the tx of seizures?
benzo's
the loss of the ankle reflex is loss at _.

L4
L5
S1
S2
S1 injury
what is the #1 cause of SAH?

trauma
AVM
ruptured aneurysm
idiopathic
trauma
if a pt presents with a "horrible" worst headache of her life and the CT is negative, what is the next best thing to do?
LP
A 52 y.o. woman presents with a severe throbbing frontal headache, and is tender over the temporal artery. Her ESR is 57, what is the diagnosis? What is the tx?
temporal arteritis, temporal artery biopsy is diagnostic and the tx is prednisone. If left untreated can cause vision loss.
what is the treatment of a post LP headache? Mild and Severe.
mild-analgesics
severe-blood patch
what is the MC bug involved with meningitis most of the time?

s. pneumo
n. mengitidus
s. aureus

what is the treatment
s. pneumo and ceftriaxone
what is the treatment of all pt's with posterior nasal bleeding?

packing
admission
ENT consult
lido with epi injection
admission with EnT consult
A 67 yo woman presents with c/o decreased strength and stability of her legs that began yesterday. Her only pertinent history besides her HTN is that she had a viral illness about a week ago that was treated with fluids and rest. Her PE shows loss of DTR's distal weakness of all 4 extrimities, legs are worse than the arms. During exam she notes decreased sensation in her feet. What does she have?

myasthenia gravis
guillain-barre syndrome
multiple sclerosis
guillain-barre syndrome: watch for respiratory failure
proximal muscle weakness that is relieved with rest but associated with ptosis and diplopia, confirmed with edrophonium test. what is it?

myasthenia gravis
guillain-barre syndrome
multiple sclerosis
myasthenia gravis
the EMS calls and describes the following pt. LOC with tonic/clonic contractions. Some circumoral cyanosis is noted, loss of bladder control is noted. What type of seizure is it?

absence
grand mal
partial
complex partial
grand mal-will be followed by a postictal period
a 7 y.o. male presents, his parents state that he has been c/o a sore throat. He is in the tripod position with drool coming out of her mouth. What do you think?

peritonsillar abscess
epiglottitis
strep pharyngitis
croup
epiglottitis
what "sign" will you see on a soft tissue neck of a child with epiglottitis?
thumbprint sign
t/f

group A, beta-hemolytic strep is associated with sequelae of RF and PSGN. Treating strep pharyngitis prevents RF but not PSGN.
true
A 29 y.o. male who had been treated for strep throat the previous week presents iwth progressive difficulty swallowing. PE reveals a fluctuant mass on the right side of the soft palate and deviation of the uvula to the right. What are you thinking?

peritonsillar abscess
epiglottitis
croup
retropharyngeal abscess
peritonsillar abscess
what is the MC bug involved with pneumonia in a non-smoker is?

s.aureas
klebsiella
legionella
s. pneumo
mycoplasma
s. pneumo
A 27 y.o. pt presents with pneumonia, bullous myringitis, and a cxr that looks worse than expected. What type of pneumonia are you thinking?

s. pneumo
klebsiella
mycoplasma pneumonia
h. flu
mycoplasma pneumonia