For sure on test

Question 1

How to position yourself in death disclosure?

Answer 1

1. Always be seated

2. Maximize Eye contact

Question 2

What to say in death disclosure?

Answer 2

1. Always say “died” or “dead”

Question 3

Classic signs thyroid storm?

Answer 3

1. Extreme Fever (often >104F)
2. Tachycardia (can be accompanied with AFib, widened pulse pressure)
3. AMS

Question 4

What is picture of leg maneuver showing?

Answer 4

Anterior drawer test for ACL injury

Question 5

How does NAC work?

Answer 5

Sulfhydryl group donor: Substitutes for natural sulfhydryl group donor, glutathione

Question 6

How is the anion gap calculated?

Answer 6

= ([Na] + [K]) − ([Cl] + [HCO−)

Question 7

Which bone is most likely fractured with pain in snuff box?

Answer 7

Scaphoid

Question 8

Want can not examining snuff box cause?

Answer 8

Avascular necrosis of scaphoid

Question 9

Proper rate of ventilations and compressions if no bag?

Answer 9

30:2

Question 10

Most common animal transmitting rabies in US?

Answer 10

1. Bats

Also: skunks, foxes, raccoons

Question 11

Most common presentation compartment syndrome?

Answer 11

Pain that is hard to control

Question 12

People at highest risk for suicide?

Answer 12

Depression, Rational thinking loss, serious attempt, and future attempt = highest risk
S = Sex (male)
A = Age (<19 or >45)
D = Depressive symptoms and hopelessness*
P = Previous suicide attempt or psychiatric illness
E= Excessive alcohol or drug use
R= Rational thinking loss*
S = Single, separated, divorced or widowed
O = Organized or serious suicide attempt*
N = No social support
S = Stated future intent*

Question 13

How to stop thyroid hormone production?

Answer 13

PTU: stops peripheral conversion from T4-T3 as well as release of these hormones

Question 14

Presentation HYPERkalemia?

Answer 14

1. 2nd or 3rd degree heart block, wide complex tachy, ventricular fib and asystole
2. Weakness
3. Cramps, paresthesias
4. N/V/D

Question 15

Definition Hyperkalemia?

Answer 15

K above 5.5

Question 16

EKG changes in Hyper K?

Answer 16

K 6.5-7.5 mEq/L Peaked T waves
K 7.5-8.0 mEq/L Widening of QRS, decreased amplitude of P waves
K 10-12mEq/L Sine wave, ventricular fibrillation, asystole

Question 17

First step in treating Hyper K?

Answer 17

1. Stabilize cardiac membrane:

Calcium gluconate 10ml (1 ampule) IV over 2-5 minutes. This dose may be repeated after 5 minutes if no improvement

Question 18

How to redistribute K in Hyper K?

Answer 18

Regular insulin 10-20 units IV

- Combined with Dextrose (D50 50 ml) if serum glucose is less than 250. Onset 15 minutes, duration 4-6 hours

Question 19

How to reduce total body K?

Answer 19

1. Kayexalate – binding resin that exchanges sodium for potassium in the colon, onset 1-2 hours, duration 4-12 hours.
2. Furosemide 20-40mg IV, onset 15 minutes to 1 hour, duration approximately 4 hours. May enhance renal excretion of potassium in patients with preserved renal function.

Question 20

Which drugs can be given via NT tube?

Answer 20

"Navel"
Naloxone
Atropine
Vasopressin
Epinephrine
Lidocaine

Question 21

What to do if a problem encountered during survey?

Answer 21

Any problem should be addressed before moving on

Question 22

How to intubate in trauma?

Answer 22

Maintain C spine and jaw thrust

Question 23

Nexus criteria for C spine imaging?

Answer 23

1. No tenderness posterior midlines
2. No neurologic deficit
3. Normal alertness
4. No intoxication
5. No distracting injury

Question 24

How to posterior mold foot / ankle?

Answer 24

1. Distal to MTP (MT heads)
2. Proximally to proximal calf
3. Positioning:
   - Prone
   - Knee flexed and ankle at 90 degrees

Question 25

How to posterior mold elbow?

Answer 25

``` 1. Distal along ulnar side of hand at the level of the palmar crease 2. Extending along ulnar forearm 3. Proximally to the proximal humerus 4. Positioning: • Elbow 90 degrees • Wrist and hand neutral • Wrist extends to 20 degrees • Abduct the thumb ```

Question 26

Indication sugar tong?

Answer 26

1. Distal ulnar fracture | 2. Distal radius fracture

Question 27

How to sugar tong?

Answer 27

1. MCP palmar around the elbow to MCP dorsally 2. Elbow flexed to 90 degrees 3. Wrist and hand neutral 4. Extend wrist to 20 degrees 5. Abduct thumb and flex MCP to 70 degrees

Question 28

Indication posterior mold elbow?

Answer 28

1. Fracture or soft tissue injuries of the elbow 2. Fracture or soft tissue injuries of the proximal radius or ulna

Question 29

Indication posterior mold ankle?

Answer 29

1. High-grade ligamentous sprain of ankle 2. Metatarsal or tarsal fracture 3. Distal tibia or fibula fracture

Question 30

How to thumb spica?

Answer 30

1. Distal to IP joint of thumb 2. Proximal along distal 2/3 of radial forearm 3. Positioning 4. Hand neutral 5. Extend wrist 20 degrees 6. Abduct thumb (as if holding a wine glass)

Question 31

When does TPA need to be given for stroke?

Answer 31

Door to drug administration: 60 minutes (and less than 3 hours from onset)

Question 32

IM or SQ epi better for asthma?

Answer 32

IM

Question 33

How to examine flexor digitorum superficialis?

Answer 33

1. Hold 2,4, and 5 digit straight do immobilize profundus | 2. Ask patient to flex 3 at PIP

Question 34

How to examine flexor digitorum Profundus?

Answer 34

1. Immobilize 2,4,5 2. Immobilize PIP of 3 3. See if they can flex DIP of 3

Question 35

Most common cause OM?

Answer 35

1. Strep Pneumo 2. H Flu 3. RSV

Question 36

Most common cause OE?

Answer 36

1. Pseudomonas | 2. Staph

Question 37

What is emtala?

Answer 37

Federal law that requiring ED to screen every seeking care and to stabilize or transfer those with medical emergencies, regardless of health insurance status or ability to pay

Question 38

Who needs tetanus?

Answer 38

1. Adults 5 years in prone wound 2. Adults 10 years non prone wound 3. IF never have gotten - Give Ig - Give Tdap