Incorrect Questions Flashcards
(169 cards)
1
Q
Risk factor for cecal volvulus
A
Marathon running
2
Q
Is herpangina in the anterior or posterior pharynx
A
Posterior
3
Q
Is hand foot mouth in the anterior or posterior pharynx
A
Anterior
4
Q
Which is retroperitoneal: duodenum, jejunum, spleen, transverse colon?
A
duodenum
5
Q
Which is suspicious for NAT: clavicle fx, distal radius fx, posterior rib fx, spiral fx of tibia
A
posterior rib fx
6
Q
Why is ASA contraindicated in thryoid storm?
A
Displaces T4 from proteins
7
Q
Which heart rhythym can result in retrograde p wave?
A
Junctional rhythyms
8
Q
What is the classic triad of fat embolism syndrome?
A
hypoxemia, neurologic abnormalities, petechial rash
9
Q
What’s the difference between primary and secondary pneumothoraces?
A
Primary from trauma; Secondary from lung pathology
10
Q
What is the most common cause of secondary pneumothoraces?
A
COPD
11
Q
What opioid medication can cause depression and suicide in some patients secondary to its effect on seriotnin and norepinephrine?
A
Tramadol
12
Q
Which opioid can cause mydriasis in overdose?
A
Meperidine
13
Q
For unilateral pulmonary contusion, which side should go down, good or bad?
A
Good to ground
14
Q
When should good not go to ground?
A
Bleeding, abscess, unilateral emphysema
15
Q
Should epi for anaphylaxis be given SQ or IM?
A
IM
16
Q
What sort of spider is loxosceles?
A
Brown recluse
17
Q
What is the most common sign of bladder injury?
A
Gross hematuria
18
Q
Which SSRI is associated with delayed cardiotoxicity, up to 13 hours after overdose?
A
Citalopram
19
Q
What condition causes chondrocalcinosis, sweliing, pain, redness?
A
Psuedogout, + birefringent crystals
20
Q
Which requires patient authorization for disclosure: public health reporting, psych notes for insurance billing, worker’s comp claims, coordination of care with consultants
A
Psych notes for insurance billing
21
Q
What should you do with immature gastrostomy tube (less than 2-3 weeks) pulled out?
A
surg, abx, imaging
22
Q
What should be the treatment for mild exposure to hydrogen sulftide gas?
A
Basic decon, irrigation of eyes
23
Q
What toxic exposure should be suspected with headache, nasal irrtation, skin irritation, eye watering after exposure to substance smelling of rotten eggs?
A
Mild hydrogen sulfide exposure
24
Q
32yoM w/fever, N/V, HA, HIV, not on meds, unknown CD4, no menisgismus, nonfocal exam, LP with elevated opening pressure, lymphocytic predominant pleocytosis, glucose 60, protein 108, what most likely?
A
Crypotococcus
25
What are common side effects of efavirenz, NNRTI for HIV?
psych side effects, like depression, psychosis, nightmares
26
Does EMTALA make it illegal to transfer an unstable patient?
No, it only applies to unstable patient
27
What is the most common cause of pneumonia in young children with cystic fibrosis? What about late teen to early adulthood?
Young kids = staphylococcus auerus; young adults = pseudomonas aeruginosa
28
Which pathology will be 3mm and under in the toenail; onchomycosis or melanoma?
onchomycosis will be smaller
29
Where is the most common site of injury from intimate partner violene?
Face
30
What envenomation causes localized pain/paresthesia most commonly, but can cause systemic toxicity in small children such asjerking muscle movements, cranial nerve dysfunction, hypersalivation, ataxia, opsoclonus
Bark scorpion
31
What is VOO?
Ventricular pacing, no sensing, no response
32
What is the most likely cause of a single second heart sound with a harsh systolic ejection murmur in an infant?
ToF
33
Can you do an LP at the L3-L4 interspace on an infant?
No, it has to be L4-L5 or L5-S1.
34
What are the three scenarios that steroids should be started for PCP PNA?
SaO2 less than 70; SpO2 less than 92, A-a gradient of 35
35
In methanol toxicity, if there is ethanol onboard, should you give fomepizole?
No, because the ethanol is preventing metabolism, no need to give fomepizole
36
If a patient has a known methanol ingestion and is acidotic, but methanol level 0, does the patient need fomepizole?
No, because all the methanol already metabolized to formic acid
37
What is the role of hemodialysis in methanol poisoning?
Removal of the toxic metabolite, formic acid
38
When do ASO titers peak after streptococcal infection?
2-4 weeks after
39
Which AED would be ineffective in TCA overdose induced seizure?
Phenytoin, because they act on sodium channels in the excitatory neuron instead of exciting the inhibitory GABA neurons like benzos/barbs
40
Does activated charcoal work in lithium overdose?
No
41
Pediatric dose of adenosine?
0.1 mg/kg, 0.2 mg/kg
42
Pediatric dose of electricity for synchronized cardioversion?
0.5J/kg, 1.0 J/kg
43
What sort of alcohol is rubbing alcohol? What does it cause?
Isopropyl alcohol, ketosis without acidosis
44
The most common cause of acquired tracheoesophageal fistula in adults?
Esophageal malignancy
45
What level of lead regardless of symptoms would require chelation with dimercaprol?
>70 micrograms/dL
46
What has a higher mortality rate, high altitude cerebral edema or high altitude pulmonary edema?
HAPE
47
When is hyperbaric oxygen therapy indicated for carbon monoxide poisonings?
evidence of end organ damage - LOC, seizures, coma, FND, MI/dysrhythmia, persistent sxs despite tx, carboxyhemoglobin >25%
48
Hhow long does tick have to be attached for to meet criteria to provide lyme disease prophylaxis?
36 hours
49
When is bactrim contraindicated for breast feeding mothers?
Infants less than 2 years old
50
Should you give streroids for urticarial rash in a pregnant first trimester patient?
No, prednisone/steroids a/w birth defects in first trimester
51
Monocular vision loss from AML hyperviscosity retinal findings?
Venous engorgement with boxcar segments
52
Pt with MM, what most likely found; hyperreflexia, lytic lesions on xr, polycythemia, urinary retention
lytic lesions on plain film
53
When should a rust ring be removed in the ED?
When the patient can't get optho followup in 24 hours
54
What acts quicker for sedation, versed or haldol?
Versed
55
For corneal abrasion with no history of contact lens use, should gentamicin or polymyxin plus trimethropim drops be more appropriate?
Polymyxin plus trimethorprim
56
What's the most common cause of itchy butthole in a 60yoM?
skin irritation from feces
57
Are the criteria for empyema and exudative pleural effusion the same?
No
58
What additional EKG finding will a LCX STEMI have that a RCA STEMI would not?
STEMI V5 and V6
59
What nerve runs in the anterior compartment of the lower leg?
deep peroneal
60
What sensation/actions does it do?
decreased sensation between first and second toes, weakness of dorsiflexion
61
Most common location for embolus in acute mesenteric ischemia?
SMA
62
What's the treatment for gonococcal opthalmia neonatorum in neonates?
cefotaxime
63
What lab abnormality is associated with therapeutic hypothermia?
Hyperglycemia
64
What's consistent with optic neuritis: lack of pain, peripheral vision loss greater than central vision loss, reduced color perception, symptom improvement with exercise?
reduced color perception
65
Which condition is most specific for high altitude cerebral edema, ataxia or confusion?
Ataxia
66
How do body stuffers and body packers differ?
Body stuffers hurridly stuff small amounts in loose packets, body packers pack numerous large amounts premeditated
67
What coverage do you need for preseptal cellulitis?
Staph, need combo coverage
68
If sending hand cellulitis on o/p abx, when should they return for re-eval?
48 hours
69
What is an absolute indication for hospitilization in a patient with anorexia?
Temperature <35.56oC or 96oF
70
What condition mandates consultation for emergent hyperbaric oxygen therapy in setting of decompression sickness?
Vertigo
71
Which finding is more likely to be present in an elderly patient who has primary tuberculosis than in a young patient?
Pleural effusion
72
What is the greatest risk factor for malaria mortality?
young age
73
What can provide higher FiO2, venturi vs non-rebreather mask?
NRB
74
What's a more common complication from an untreated sinusitis, orbital cellulitis (postseptal) or cerebral abscess?
orbital cellulitis
75
What diagnostic test has the best diagnostic accuracy compared to other provocative tests for carpal tunnel syndrome?
hand elevation test or Median nerve compression test aka Durkan test
76
What does the tibial nerve innervate and muscle action?
posterior leg, plantar flexion
77
What is the effect of presence of family members during CPR?
Decrease family's PTSD
78
What electrolyte will be depressed in rhabdomyolysis?
hypocalcemia
79
What are the most common presenting signs and symptoms for poststreptococcal glomerulonephritis?
Gross hematuria, flank p ain, generalized edema, hypertension
80
What is another name for activated protein c resistance?
Factor V Leiden
81
What is passive vs active rewarming?
Passive = removing cold wet clothes and putting in warm dry environment
Active = applying heat
82
What's an indication for emergent hemodialysis following acute ethylene glycol ingestion?
Glycolic acid level greater than 8 mmol/L, ethylene glycol greater than 50, anion gap greater than 20, pH less than 7.3
83
What electrolyte abnormality will be seen with renal artery stenosis?
Metabolic alkalosis
84
Most common cause of acute interstitial nephritis?
Drugs
85
Do all croatilidae bites need antivenin?
No
86
Which croat bites need antivenin?
Those with moderate to severe envenomation = More sxs such as pain, edema, erythema, bullae, rhabod, weakness, paresthesias, taste changes, chest pain, dyspnea, coagulopathy, thrombocytopenia, bleeding
87
How long should dry croatilidae bites be observed?
8 hours
88
What is luxatio erecta and how present?
inferior glenohumeral dislocation, arm full abduction with hand behind head, from extreme abduction with downward force
89
What direction traction to fix luxatio erecta?
Upward axial traction
90
Which occurs later after birth, chlamydial or gonococcal conjunctivitis?
Chlamydial
91
Which occurs with more discharge bilaterally and no extensive eyelid inflammation, chlamydial or gonoccal conjuncitvitis?
Gonococcal
92
Can ciprofloxacin treat giardia?
No you need metronidazole
93
At what IOP does pilocarpine work for acute angle closure glaucoma?
40-50, if greater than ischemia will prevent from working
94
Can you get paralysis from decompression syndrome?
Yes, type II decompression syndrome is like transverse myelitis, ascending paralysis picture
95
Which type of anterior glenohumeral joint dislocation is the most common?
Subcoracoid
96
Whats the difference between type I, II, and III vWD?
Type I = decreased vWF, low F8
Type II = abnormal vWF
Type III = no vWF, low F8
97
What features support diagnosis of eczema?
Onset before 2 years old
Involves flexure surfaces
h/o asthma, allergies
pruritus
dry skin
lichenification
hyperpigmentation
98
Is eczema worse in dry or humid weather?
Worse in dry weather
99
What is an adverse effect to watch out for with rifampin?
Hepatotoxicity
100
What is associated with a higher risk of mortality after lightning strike?
cranial burns
101
In a positive straight leg raise, which leg does pain radiate down, the one raised or one flat?
One raised
102
What medication may be useful for nonfatal drowning victims?
Beta agonists for bronchospasm
103
How long does it take to recover from molluscum contagiosum?
Months
104
What's a minor criteria for rheumatic fever?
fever
105
Does the pain a/w ankylosing spondylitis worsen or improve with rest?
Worsens with rest, improves with exercise
106
What's the most common cause of ischemic stroke in children?
Sickle cell disease
107
Is nitrofurantoin okay in pregnancy?
No
108
Is amoxicillin appropriate for ecoli uti?
Yes, its first line
109
What is ST elevation in AVR > V1 with horizontal ST depression in I, II, V4-6?
Left main equivalent
110
Which way will a patient with CNIV palsy tilt head?
contralateral and down
111
What is the most common complaint of scuba divers?
Middle ear barotrauma
112
What level CO is indication for hyperbaric?
25%
113
What level CO is indication for hyperbaric in a pregnant woman?
>15%
114
Is syncope considered an indication for hyperbaric therapy?
Yes, along with end organ damage, coma, seizures, confusion, FND, visual symptoms
115
What post void residual is indicative of urinary retention?
100cc
116
Can cocaine cause sodium blockade and widened QRS?
Yes
117
What's the treatment for cocaine induced widened QRS
Sodium bicarbonate 1 meq/kg
118
What is the leading cause of non-solid organ cancer-related death?
Non-hodgkin lymphoma
119
What action taken for frostbite can leads to increased tissue losses?
friction massage
120
Is hypophosphatemia an indication for emergent dialysis?
No, hyperphosphatemia is
121
Do fungal infections give subcutaneous nodules?
No
122
What is erythema marginatum caused from?
Strep
123
Is erythema marginatum a/w subcutaneous nodules?
Can be yes
124
Are kerley B-lines seen in HAPE?
No
125
What clinical feature is typically seen in HAPE?
RML invovlement
126
Are autonomic symptoms common in Myasthenia gravis, such as dry mouth (+/- painful tongue, sore throat)?
No
127
Can botulism cause ptosis?
yes
128
Does multiple episodes of vomtiing in the initial phase of an iron overdose predict significant systemic toxicity?
Yes
129
Is a serum iron level of 250 mg/dL considered toxic?
No , a serum iron <300 is considered non-toxic
130
What can cause a noninfectious elevation in serum procalcitonin?
Malginancy
131
Is bleeding time useful in the acute setting for evaluating hemophilia for diagnosis, prognosis, or treatment of hemarthrosis?
No
132
What's the most common cause of status epilepticus in young children?
Febrile status epilepticus
133
What medication can be used to manage acute anxiety symptoms related to PTSD?
Propranolol
134
Is sertraline good for acute anxiety symptoms related to PTSD?
Not acutely, chronically yes
135
/What antibiotics have been associated with non-convulsive status epilepticus
Beta Lactams
136
Is it appropriate to needle aspirate a breast abscess in ED as initial management in conjunction with IV ABX?
YEs
137
Does OA get better or worse with activity?
OA gets worse, better with rest
138
What can be used for prophylaxis/management/prevention of cluster headaches?
Verapamil
139
What age group of people have the highest rate of completed suicide?
Older adults
140
What intervention is detrimental to a patient with demyelinating optic neuritis?
Oral prednisone, higher 2 and 10 year recurrence risk vs IV steroids
141
Is IV methylprednisolone detrimental in the treat to patients with demyelinating optic neuritis?
No
142
What is the most likely adverse effect of large volume red blood cell transfusion?
Thrombocytopenia, hence MTP
143
Is fever the most likely adverse effect of large volume red blood cell transfusion?
No, thrombocytopenia is more likely
144
What is a disorder that presents with acute respiratory distress, inspiratory stridor, that is often misdiagnosed as anaphylaxis or asthma, but exam only reveals inspiratory stridor, and laryngoscopy can confirm the diagnosis?
Paradoxical vocal fold motion where vocal cords are adducted on inspiration
145
How does amiodarone work?
electrolyte channel blockade to decrease AV node conduction velocity
146
Does amiodarone work by electrical stimulation of an absolute ventricular refractory period?
No, by electrolyte channel blockade to decrease AV node conduction velocity
147
What finding is seen on peripheral smear with a patient with G6PD?
Heniz bodies
148
Will patients with G6PD have a positive indirect coombs test?
Negative
149
What disease is seen with heinz bodies on peripheral smear?
G6PD
150
What are criteria for emergent hemodialysis in tumor lysis syndrome?
potassium >6
uric acid >10
creatinine >10
phosphorus >10 or rapid rise
volume overload
symptomatic hypocalcemia
151
In lithium toxicity, what are four criteria for hemodialysis?
elevated creatinine and lithium >4
lithium >5
Seizure, dysrhythmia, AMS
elevated lithium with symptoms in patient with fluid contraindication (HF, CKD/ESRD)
152
For how long should a hydrocarbon ingestion be observed for?
6 hours
153
Should a CXR be obtained on arrival in an asymptomatic hydrocarbon ingestion?
No, it should be obtained 6 hours post ingestion
154
Can you get pulsatile tinnitus in idiopathic intracranial hypertension?
Yes
155
What is a topical antiviral that can be used for herpes keratitis?
Topical trifluridine
156
What is the treatment for herpes zoster ophthalmicus?
Oral antivirals and topical steroid
157
What sign or symptom of basilar skull fractue is most frequently seen on initial evaluation?
Hemotympanum
158
Does a Jones fracture need a posterior splint?
Yes
159
What antidysrhythmic can cause a chemical epididymitis?
Amiodarone
160
Is HCTZ known to cause epididymitis?
No
161
Is lymphogranuloma venereum painful?
No
162
what is secondary blast injury?
Impact of fragments
163
Is body thrown by explosion secondary or tertiary blast category?
Tertiary
164
What symptoms does abruptly discontinuing an SSRI give you?
dizziness, lethargy, nausea, sensory disturbances like electric shocks, vivid dreams, irritability, depressed mood
165
The presence of what finding increases the severity and health risk of PTSD?
Borderline Personality Disorder
166
Is diltiazem the treatment for multifocal atrial tachycardia?
No, treat underlying disease
167
What beta blocker can cause delayed systemic toxicity?
Sotalol
168
What is the treatment for acute rheumatic fever without pharyngitis
Penicilllin
169
What's the most common complication of untreated hyphema?
Rebleeding
