In Service Prep Review - Em Boards

Front 1

Nitro contraindactions

Back 1

right ventriclar infarct, viagra/cialis use w/in 24-48hrs

Front 2

Rapid ventricular rhythm post tPa treatment?

Back 2

RVR is often self limited.... if persistent STEMI observed consider PCI

Front 3

Inferior MI on 1 - ECG, 2 - which lead to check for Rt sided involvement,?

Back 3

1 - II, III, aVf..... 2 - move V4 to right side to check for right vent involvement to decide weather nitro is safe for use

Front 4

Mobitz I and Mobitz II and 3rd degree block treatment,

Back 4

I - no treatment if asymptomatic, II and 3rd degree may need pacer if unstable, cannot use atropine if widened QRS

Front 5

what is an osborne wave

Back 5

J point elevation as seen in hypothermia

Front 6

st elevations observed in a pt ekg with a rate of 170s?

Back 6

first slow rate to see if they persist, often ischemia is transient 2/2 rate

Front 7

when should we aggressively medically control/cardiovert tachycardic rate in A FIB

Back 7

when there is a fib with signs of RVR

Front 8

MAT common in what pt group?

Back 8

COPD

Front 9

WPW treatment first line, second line. Meds contraindicated?

Back 9

first - procanimide, second - cardiovert, contra - AV NODAL MEDS

Front 10

syncope with deep inverted T waves on ECG

Back 10

SAH/ICH/herniation

Front 11

syncope with arm exericise

Back 11

subclavian steal synd ---- order vasc study

Front 12

syncope with shaving

Back 12

carotid sinus hypersensitiviy (also syncope with head turning)

Front 13

syncope in fire

Back 13

CO poison or cyanide

Front 14

syncope with back pain

Back 14

AAA

Front 15

if question states a presentation for reanl/MSK/GI bleed/syncope is "classic" in presentation (ie flank pain with hematuria with classic pt not being able to find a comfortable position)

Back 15

think AAA - aka the great mimicker

Front 16

AAA u/s - aorta size of normal, emergent repair male and female

Back 16

normal <3cm, male >5.5, female >5cm

Front 17

ED role in management of AAA needing emergent repair after diagnosis while awaiting surgery

Back 17

type and cross like 10 units, central line placement, close monitoring

Front 18

Acute murmur cause MR, AR, AS, TR/TS

Back 18

MR - inferior/post MI, AR - dissection, AS - new onset CHF or advancing CHF exacerbation, TR/TS - endocarditis

Front 19

Pericarditis EKG results andTreatment

Back 19

diffuse ST elevation without reciprocal changes, PR depressions, smiley shaped elevations, NSAIDS, no steroids unless rheumatoligc cause

Front 20

Tamponade EKG, most common 2 causes, treatment

Back 20

electrical alternans, T wave inversions, ----------causes - malignancy or trauma, -------- treatment --- stable - fluids increases pre load inhibiting potential tamponade with right ventricular collapse, unstable-pt needle or surgical window

Front 21

Peptic or gastric ulcers more common

Back 21

peptic ---- night pain relieved by food

Front 22

baby with GI bleed most common diagnosis... with pain and w/o pain

Back 22

w/ - anal fissures -----------w/o - meckles

Front 23

variceal bleed tx

Back 23

fluids, octreotide, abx and emergent EGD (also tranfusion as needed) -----------most important octreotide - has shown reduction in M&M (note - vasopressin does not help)

Front 24

Cullen verus grey-turner sign

Back 24

hemorrhagic pancreatitis-----------cullen = umbilicus ------grey-turner = flank unilateral mainly

Front 25

Admission ranson criteria

Back 25

"GLOWS" Glucose >200 LDH >350Old >55yoWBC >16k SGOT (ast) >250 ------ note late presentation may include a pt w/ abd pain and hypocalcemia

Front 26

When to give abx in pancreatitis

Back 26

if evidence of necrosis on CT

Front 27

#1 surgical entity in elderly

Back 27

chole

Front 28

Charcot triad, pentad

Back 28

cholangitis - thus give abx-------1 fever 2 RUQ pain 3 jaundice----------4 - ams or hypoTN

Front 29

mesenteric ischemia suggestive labs

Back 29

elevated WBC, hyper phosphatemia, lactate, acidosis

Front 30

mesenteric ischemia xray buzz word, gold standard

Back 30

"thumb printing", CT angio

Front 31

Obstruction most common cause, 1 large, 2 small

Back 31

1 tumor, 2 adhesions and hernia

Front 32

IBS, 1 treatment, 2 copmlication

Back 32

1 - fluid, bowel rest, high dose steroid, abx, 2 - pseumembranous colitis

Front 33

Recent overseas travel with frothy diarrhea

Back 33

giardia

Front 34

shell fish and diarrhea

Back 34

cholera

Front 35

Parotitis #1 cause and treatment

Back 35

mumps, hot compress and abx

Front 36

Sialolithiasis presentation

Back 36

no reported fever, pain worse after eating

Front 37

Tympanic membrane hemorhaggic blisters

Back 37

HSV

Front 38

Malignant otitis externa, 1risk factors, 2etiology, 3important w/u, 4treatment

Back 38

1 DM and immunocomp, 2pseudomonas, 3CT head for mastoid involvment, 4debridement and abx

Front 39

Auricular hematoma treatment

Back 39

I&D not needle aspiration

Front 40

Nystagmus and tinnitus in central versus peripheral vertigo

Back 40

peripheral nystagmus is mostly horizontal and fatigues, peripheral may have tinnitus whereas central generally does not

Front 41

Peritonsilar versus retropharyngeal which is pediatric

Back 41

retropharyngeal

Front 42

Ludwig angina presentation and early ED management

Back 42

bad dentintion, drooling, voice changes, swelling, pain--------------intubate ASAP as decompinastes

Front 43

Vent failure mnemonica

Back 43

"DOPE" - displacement, obstruction (suction), ptx, equipment fail

Front 44

MC pediatric cranial bone fractured

Back 44

parietal, other bones fx consider abuse

Front 45

orbital blowout fx presentation, treatment

Back 45

exopthalmous, mm entrapment, hyperesthesia (essentially a compartment synd), treatment = canthotomy

Front 46

whiplash injury

Back 46

central cord synd - weakness UE>LE, variable sesnory loss

Front 47

Nexus criteria

Back 47

r/o additional w/u for neck trauma "NSAID"
no neuro def, no spinal tenderness, alert, no intoxication, no distracting injuries (clinician judgment)

Front 48

seatbelt sign neck injury, presentation, treatment in ED

Back 48

carotid art dissectin, horner's syndrome and neck pain, heparin to deter thrombus thus ischemic cranial injury

Front 49

Jefferson versus hangmag injury

Back 49

jeff = C1 and hangman = c2 without

Front 50

pulmonary contusion treatment

Back 50

positive pressure O2, lye pt on lat decub opposit injury, euvolemic state

Front 51

blunt flank injury - scan in adults vs peds in micro versus macro hematuria

Back 51

adults scan for macro not micro, peds scan at microhematuria

Front 52

chest xra with cavitation in alcoholic with fever and mild non-productive cough

Back 52

klebsiella --- cavitation likely an abcess

Front 53

pna w/ widened mediastinum

Back 53

anthrax

Front 54

pna from missouri area

Back 54

blasto

Front 55

pna in farmer

Back 55

hypersensitivity pneumonitis

Front 56

pna in autoshop worker

Back 56

asbestosis

Front 57

Pulm Edema (non-cardiogenic) ddx

Back 57

"HAHA" - high alt, asa, heroin, ards

Front 58

transudate and exudative number one causes of pleural effusion

Back 58

trans - chf, exu - pna

Front 59

metHb causes and treatment

Back 59

nitrate, anesthetic tox, bactrim/dapsone reactions......treat with methylene blue

Front 60

seep sulcus seen on a cxr supine dx?

Back 60

ptx

Front 61

complication of near drowning

Back 61

delayed pulm edema (admit for observation)

Front 62

What is breath stacking and what complication can it lead to? How to fix the problem

Back 62

presents in an intubated asthma pt with new onset hypoTN---------------cause is too fast of RR and alveoli become full of air as they trap a lot of air.....to treat either pause the vent or push hard on the chest

Front 63

#1 cause hemoptysis

Back 63

bronchitis

Front 64

massive hemoptysis cause of death and treatment (4 types in order)

Back 64

asphyxia -------------------treatment - 1flex bronch at bedside, 2rigid bronch in OR, 3embolization by IR, 4open CT surg

Front 65

MC peds frx

Back 65

salter II

Front 66

best and worst prognosis of salter harris

Back 66

I is best and V is worst

Front 67

Buckle fracture aka

Back 67

torus fracture

Front 68

toddler's fx

Back 68

spiral tibial fx --- common in toddlers from falling while running-------all other spiral fx are concerning for abuse

Front 69

bucket handle frature

Back 69

metaphyseal chip concerning for abuse

Front 70

stellate skull fx w/u

Back 70

abuse

Front 71

scaphoid fx complication

Back 71

non-union = arhtitis long term and short term avascular necrosis from radial art damag

Front 72

amputation of finger point at which conservative managment is all that is indicated, what is that management?

Back 72

distal to DIP -------------clean, consider rongeur for excess exposed bone, give abx

Front 73

open paint gun injury managment

Back 73

ortho consult for debridement of paint as this will screw ish up

Front 74

Jersey Finger - path, presentation, management

Back 74

"grabbing a jersey in a sport" --------flexor tendon of ring finger damaged------------cannot flex at DIP, possible mass palpable-----------managment - splint wi/ surg consult w/in 24hr

Front 75

Mallet finger - path, presentation, management

Back 75

injry to extensor -------finger flexed at rest (no opposing tendon) -------- splint in extension for 8 wks

Front 76

gamekeeper's thumb aka skier thumb

Back 76

game as in chicken in act of strangulation-------ulnar collateral lig dmg from hyper abduction-----------if complete laxivty consult ortho/hand surg or ensure hand surg f/u 24 hour

Front 77

what is a felon and treatment

Back 77

deep nail bed infection AT growth plate -------------I&D on palmer surface

Front 78

human bit etio, tx

Back 78

eikenella, do not close completely, irrigate copious, cephalospon

Front 79

kanavel's sign - dz assoc, 4 components, treatemetn

Back 79

pyogenic flexor tensoynovitis-----------------at rest held in flex, pain with extension, swelling, tenderness on flexor sheath ------treat - I&D in OR

Front 80

Boxer fx - bone and treat

Back 80

5th metacarpal fx --------treat - ulnar gutter with ortho f/u

Front 81

mc wrist dislocation

Back 81

scapholunate lig --- will have gapping btwn scaphoid and lunate

Front 82

Smith vs Colle's fx

Back 82

both ar FOOSH------------Colles = hand is dorsal (frx is angulating under palmer surface of hand)

Front 83

posterior fat pad adult and ped injury

Back 83

posterior = pathologic (anterior simply increases suspicion but can be normal) -------adult - radial head, ped - supracondylar fx

Front 84

Monteggia vs Galezzi

Back 84

treatment for both = ORIF because of potential radial nn dmg ---------------"MUGR" - monteggia ulnar and galezzi radial ---(note that the name also has the proximal fx as the proximal letters in the word - thus monteggia is proximal forearm and galeazzi is distal)------------"GRDD" - galeazzi's really dirty dick - galeazzi, radial fx, distal shaft, dislocation of ulnar----------------"MUPD" michigin univeristy police depart - monteggia, ulnar fx, proximal shaft, dislocation of radius

Front 85

Hip resting presentation in internal rotation versus external rotation for what pathology?

Back 85

internal = dislocation ---------external = fx of femur ----------"ID and EF"

Front 86

Lisfran fx - injury pattern, sign on xray, treatment

Back 86

often happens in very mild injury pattern like a missed step -------------"fleck sign" = gapping bwtn 1st/2nd metacarp.....or a chip at metacarpal base---------treatment - surgical correction as non-union is common

Front 87

5th metatarsal fx 2 types names and treatment

Back 87

dancer's and jones ---------dancer's = epiphysis - needs hard shoe-------------jones = diaphysis - non-union high prevalance thus surgical intervention

Front 88

avascular necrosis 2/2 fx in what common 2 loacal

Back 88

scaphoid and hip

Front 89

fx of humerus ephysis pt develops chest and axillary petechiae

Back 89

fat emboli ---- treat with steroids

Front 90

non-union after fracture common in which 3 types of fx

Back 90

jones, lisfranc and scaphoid

Front 91

Compartment synd ---- nml and diagnositc value, most common location, first 3 common symptoms in most common location

Back 91

<10 is nml, >50 is diagnostic---------anterior leg is MC -----common presentation big toe pain with passive movment and weakness with first web space numbness

Front 92

Posterior shoulder dislocation #1 cause

Back 92

seizure

Front 93

hill sachs

Back 93

superior tear/fx after dislocation

Front 94

bankart

Back 94

glenoid labrum tear seen on inferior aspect

Front 95

Elbow dislocation complication

Back 95

median nn dmg

Front 96

knee dislocation direction with complication

Back 96

anterior dislocation risk of popliteal art rupture

Front 97

ottowa ankle

Back 97

bony tenderness on malleoli, bony tenderness on navicular/5th metatarsal, cannot at least limp

Front 98

ottowa knee

Back 98

tenderness over patella, tenderness on fibular hed, cannot flex to 90, cannot weight bear

Front 99

LBP can't miss diagnosis

Back 99

"CRAFTI" cauda equina, renal, aaa, fx, tumor, infection

Front 100

b/l versus unilateral sciatica

Back 100

uni - slipped disc, b/l cord compression/dz get an MRI at minimum

Front 101

LBP w/ prolonged impotence diagnosis

Back 101

aortoiliac insufficiency

Front 102

Finklestein +test

Back 102

dequirvain's tenosynovitis, treatment - spica and RICE therapy

Front 103

Clavicular fx treatment

Back 103

sling w/ f/u

Front 104

SCFE versus Legg-Calve-perthes age of onset

Back 104

SCFE 8-15yo--------------LCP - 4-9YO

Front 105

Punching injury

Back 105

Bennet - simple fx, treat with sling-------------rolando = comminutied, treat with surgical "rolando = Ruptured"