Cardio/Medical

Question 1

Define Kehr’s Sign, caused by?

Answer 1

referred shoulder pain - possible splenic injury, gall bladder issue, or ectopic pregnancy

Question 2

Define Kernig’s Sign, caused by?

Answer 2

back, leg pain on knee extension - possible bacterial menengitis

Question 3

Define Brudzinski’s Sign, caused by?

Answer 3

back, leg pain on neck flexion - possible bacterial menengitis or subarachnoid bleed

Question 4

Define Hamman’s Sign, caused by?

Answer 4

crunching sound heard with auscultation over the anterior chest synchronized with heartbeat - tracheobronchial injury

Question 5

Define Steeple Sign (x-ray), caused by?

Answer 5

Trachea just below chords looks like church steeple on A/P neck view - croup

Question 6

Define Thumbprint Sign (x-ray), caused by?

Answer 6

Epiglottis looks rounded like distal thumb on lateral neck view; Epiglottitis

Question 7

Drugs for AAA

Answer 7

nipride and beta-blockers

Question 8

Abdominal assessment steps (in order)

Answer 8

inspect, auscultate, palpate, percuss

Question 9

Contraindications for thrombolytics

Answer 9

• Hx of hemhorrhagic stroke
• CVA in last 12 months
• SBP > 180
• Pregnant or 1 month post-partum

Question 10

First step to increase SpO2?

Answer 10

Increase (maximize) FiO2

Question 11

Electrical alternans may be seen when?

Answer 11

Cardiac tamponade (though only 10% of the time)

Question 12

Coumadin reversal agent

Answer 12

Vitamin K, FFP

Question 13

Define Beck’s Triad, caused by?

Answer 13

Hypotension, JVD, Muffled Heart Tones;

Cardiac Tamponade

Question 14

Treatments for cardiac tamponade include

Answer 14

Force fluids, pericardiocentesis

Question 15

MAP =

Answer 15

DBP + 1/3 PP

Question 16

Normal coronary perfusion pressure (CoPP)

Answer 16

50-70mmHg

Question 17

Define Trousseau’s Sign, caused by?

Answer 17

BP cuff inflated in arm >SBP and left for >3 min, causes contraction of muscles; hypocalcemia

Question 18

Signs of cardiac tamponade include

Answer 18

Pulsus parodoxus, Kussmaul Sign, Beck’s Triad, PEA

Question 19

B-type natriuetic peptide (BNP) evaluates

Answer 19

Fluid overload and heart failure

Question 20

Define Levine’s Sign, caused by?

Answer 20

Clenchedd fist held over chest; ACS

Question 21

Define Kussmaul’s Sign, caused by?

Answer 21

Rise in venous pressure with inspiration; Right heart failure or cardiac tamponade

Question 22

Drug of choice for esophageal varicies

Answer 22

Sandostatin (octreotide)

Question 23

Recommended urinary output for an adult

Answer 23

30-50 ml/hr

Question 24

Define Murphy’s Sign, caused by?

Answer 24

Palpation of RUQ, pain worse with inspiration than palpation alone; Gall Bladder

Question 25

Elevated ammonia levels are seen with

Answer 25

chronic hepatitis, hepatic encephalopathy

Question 26

Problem with HHNK, treatment

Answer 26

Severely elevated glucose, dehydration, high osmolality; | insulin, fluid, electrolyte correction

Question 27

Morphine is (historically) contraindicated for what abdominal problem

Answer 27

Pancreatitis

Question 28

Problem with diabetes insipidus, treatment

Answer 28

Underproduction of ADH, causing excessive and severely diluted urine output; Aggressive fluid replacement and vasopressin

Question 29

Problem with SIADH, treatment

Answer 29

Overproduction of ADH, causing fluid retention and hemodilution; Diuretics, hypertonic saline

Question 30

Problem with Graves Disease, treatment

Answer 30

Hyperthyroidism, causing weight loss, anxiety, buldging eyes, a-fib; glucocorticoids

Question 31

Problem with Addison's Disease, treatment

Answer 31

Acute renal insufficiency, causing hypotension, fatigue, weight loss; general supportive care

Question 32

Problem with Myxedema coma, treatment

Answer 32

Hypothyroidism, causing weight gain, fatigue, coarse hair, deep voice, chills; women >60 in winter; levothyroxine

Question 33

Problem with Cushing's Disease, treatment

Answer 33

Hyperaldosteronism, causing hypertension, moon-face, fatigue, core obesity /c thin extremities; Modify (start/change/stop) steroids

Question 34

Coronary perfusion pressure (CoPP) is calculated by

Answer 34

DBP - PCWP | diastolic - wedge

Question 35

Define Grey-Turner's Sign, caused by?

Answer 35

Bruising in flanks; intraabdominal bleeding

Question 36

Define Cullen's Sign, caused by?

Answer 36

Periumbilical bruising; intraabdominal bleeding

Question 37

Define Halstead's Sign, caused by?

Answer 37

Marbled abdomen; intraabdominal bleeding

Question 38

Define Stable Angina

Answer 38

- Occurs (usually) during physical exertion - Episodes of pain tend to be alike - Usually lasts a short time (5 minutes or less) - Is relieved by rest or nitro

Question 39

Define Unstable Angina

Answer 39

- Occurs while you may be resting, sleeping, or with little physical exertion - Lasts longer (>10 min) or feels different than usual angina - Not relieved by rest or nitro - May get worse over time

Question 40

Define Prinzmetal's Angina

Answer 40

- Coronary artery spasm caused by: cold weather, stress, smoking, drug (cocaine) use - Occurs (usually) at rest or during the night or early morning hours - Pain usually severe - Usually relieved by nitro