Miscellaneous Notes/Research

Question 1

What is the usual duration between acute COVID infection and onset of MIS-C?

Answer 1

two to six weeks

Question 2

What CBC findings are seen in MIS-C?

Answer 2

lymphocytopenia
neutrophilia
mild anemia
thrombocytopenia

Question 3

Which inflammatory markers are commonly elevated with MIS-C?

Answer 3

CRP, ESR
D-Dimer, fibrinogen
Ferritin
Procal
Interleukin

Question 4

Do inflammatory markers correlate with severity of illness?

Answer 4

yes

Question 5

Which 3 organs are important to evaluate in MIS-C

Answer 5

heart
liver
kidneys

Question 6

Which inflammatory marker is NOT useful to trend in MIS-C?

Answer 6

ESR, because tx of MIS-C is commonly IVIG which elevated ESR

Question 7

What is the most common cause of aortic stenosis?

Answer 7

degenerative calcification; associated with aging, HTN, HLD, tobacco use, DM

Question 8

Which 3 electrolyte disturbances increase the risk for torsades de pointes?

Answer 8

Hypokalemia, hypomagnesemia, hypocalcemia

Question 9

What is first, second, and third line treatments for Torsades?

Answer 9

1. magnesium and defibrillation
2. magnesium and defibrillation
3. Isoproterenol with overdrive pacing by temporary transvenous pacemaker

Question 10

What CD4 counts are associated with toxoplasmosis?

Answer 10

CD4 <100

Question 11

What is the first line treatment for toxoplasmosis?

Answer 11

pyrimethamine
sulfadiazine

+leucovorin – co-administer to prevent pyrimethamine-induced hematologic toxicity

Question 12

What is the first/initial treatment for hyponatremia caused by SIADH?

Answer 12

fluid restriction

Question 13

What is the best next step when a CT scan is concerning for NPH?

Answer 13

Brain MRI

Question 14

What is the confirmatory test for NPH after MRI?

Answer 14

high volume lumbar puncture with monitoring for improvement of symptoms–specifically gait improvement; opening pressure and CSF studies should be normal

Question 15

What is the treatment for NPH?

Answer 15

ventricular shunting

Question 16

What is Spodick sign on ECG?

Answer 16

downward sloping TP segment seen in lead II and precordial leads; specific but not sensitive sign for acute pericarditis

Question 17

What is first line therapy for acute pericarditis?

Answer 17

NSAID – ie Ibuprofen

Question 18

Infarction of which coronary artery territory can lead to atrioventricular block?

Answer 18

Inferior myocardial infarction (the right coronary artery supplies the atrioventricular node and inferior heart).

Question 19

What is the treatment of sulfonylurea overdose?

Answer 19

Dextrose
Octreotide

Question 20

What is the dose of Octreotide for adults in sulfonylurea overdose?

Answer 20

Adults:
50-150 mcg q6h

Question 21

What is the dose of Octreotide for children in sulfonylurea overdose?

Answer 21

1-1.5 mcg/kg (up to 150 mcg) q6h

Question 22

What is the formula for estimating weight for pediatric dextrose administration?

Answer 22

(2 x age in years) + 8

Question 23

What is the dose and dextrose concentration for pediatric hypoglycemia in ages <1 year old?

Answer 23

5-10 mL/kg of D10

Question 24

What is the dose and dextrose concentration for pediatric hypoglycemia in ages 1-8 years old?

Answer 24

2-4 mL/kg of D25

Question 25

What is the dose and dextrose concentration for pediatric hypoglycemia in ages >8 years old?

Answer 25

1-2 mL/kg of D50

Question 26

Is serum insulin concentration high or low with sulfonylurea ingestion?

Answer 26

High

Question 27

What are the 3 treatments for HACE?

Answer 27

supplemental O2 descent steroids (dexamethasone)

Question 28

What is the rule of 9s for burn estimation?

Answer 28

9% Face 9% - chest 9% - abdomen 9% upper back 9% - lower back 9% RUE 9% LUE 9% LLE FRONT 9% RLE FRONT

Question 29

What blood pressure is required prior to Alteplase administration?

Answer 29

SBP <185 DBP <110

Question 30

What BP should be maintained for the first 24 hours after alteplase administration?

Answer 30

<180/105

Question 31

Within what amount of time should alteplase be administered from last known normal?

Answer 31

4.5 hours

Question 32

In addition to careful cleaning, tdap, and pain management, what is a treatment for stingray injury?

Answer 32

immersion in hot water (45C or 113F) for 30-90 minutes or until pain subsides -- believed to break down the poison

Question 33

What organism causes tinea versicolor?

Answer 33

Malassezia furfur

Question 34

What is the treatment for tinea versicolor/malassezia furfur infection?

Answer 34

topical selenium sulfide

Question 35

What is the role of desmopressin in the treatment of hyponatremia?

Answer 35

helps prevent a continued rapid rise in sodium

Question 36

What are the four Kanavel Criteria for Flexor Tenosynovitis?

Answer 36

1. Tenderness along the course of the flexor tendon 2. Fusiform or symmetrical swelling of the finger 3. Pain with passive extension 4. Flexed posture of the finger

Question 37

What factors are included in the Opioid Risk Assessment Tool?

Answer 37

1. Family History of substance use (EtOH, illegal drugs, prescription drugs) 2. Personal history of substance use (EtOH, illegal drugs, prescription drugs) 3. Age 16-45 4. History of preadolescent sexual abuse 5. History of psych disease -- ADHD, OCD, Bipolar, schizophrenia, depression